Movement During Labor When and How It Matters

Chaunie Brusie, RN, BSN

When you see someone go into labor on TV shows or movies, two things usually happen: 1) their water breaks in a dramatic fashion and they immediately dissolve into painful contractions, and 2) they get rushed to the hospital where they plop down into a bed and stay there, until a baby arrives.

With real-life labor and delivery, however, typically neither of those things happens. In fact, many women choose to move around or get up and out of their beds during labor, whether they're looking to lessen the pain of contractions, take advantage of gravity to help the baby move down, or just want the freedom to move around. Whatever the reason, evidence-based research heavily supports the decision.

Movement during labor—walking around and changing positions—can, in fact, lead to better birthing outcomes. This article will explore why that is and how you can incorporate movement in your labor and delivery process.

What Research Says About Movement During Labor

The research on staying active and changing positions during labor is overwhelmingly positive. According to a 2014 evidence-based review in The Journal of Perinatal Education, women who are more mobile during labor have:

• Shorter labors (shaving off an average of 1 hour and 22 minutes)
• Fewer interventions, including C-sections
• Decreased pain
• Better fetal heart rate patterns
• Higher satisfaction with their overall birthing experience¹

The American College of Obstetricians and Gynecologists (ACOG) also supports women staying active during labor. The ACOG guidelines for labor state there's no single position that needs to be maintained for most women during labor. Instead, they recommend women be encouraged to practice "positions of comfort" that work best for them and help get their baby in the optimum position for birth.² One example is the Spinning Babies method, which encourages moms to incorporate the three principles of balance, gravity, and movement into their labor process.³

How to Practice Movement During Labor

There's no right or wrong way to practice movement during labor. You can move in any way that feels comfortable and helps you manage the pain. Every woman is different, every laboring experience is different, and every baby is different, so the best thing you can do is listen to your body.

Here are some possible options:

• Take walks in your room or the hallway. If you have a wireless fetal monitor, like the Novii(TM) Wireless Patch System or Mini Telemetry, walking around will be easy because you'll have fewer cords to worry about as both devices allow for ambulation. If this innovative option isn't yet available at your hospital, your nurse might have the ability to "unplug" you for a period of time (as long as it's medically safe) so you can take walks.
• Use a birthing ball. There are many ways to use a birthing ball during labor—whether sitting upright and bouncing, rolling on it to lessen perineal pressure, leaning against it while the ball is on the bed, or draping yourself over it while you're on hands and knees. All of these positions can help with the laboring process.
• Rock in a rocking chair. Using a rocking chair during labor allows moms to stay upright while providing a soothing movement and flow.
• Get your partner involved. Your partner can help physically support you, as you lean against them and sway back and forth. They can also provide counter-pressure to your back and hips while you're on your hands and knees.

How Plans May Change or Evolve

It's also important to stay in touch with your care team during your labor. They may have suggestions for you if a certain movement or position doesn't feel comfortable. They may also need to adjust your positioning based on how your labor is progressing or your baby's response.

Thanks to fetal monitoring and the valuable heart rate data it supplies, your care team knows when your baby is distressed, so you may have to try a few different movement strategies before finding one that works for both of you.

Additionally, medications or other interventions can affect how freely you can (or want to) move. Michelle Dowell, CHFP, Senior Usability Engineer at GE, initially wrote her birth plan with a focus on staying as active as possible during labor. She wanted to utilize strategies such as walking around and using a birthing ball. In fact, she requested to use a wireless Novii fetal monitor to allow her the most freedom of movement during labor.

However, Dowell's plans to stay active changed due to the need for an induction that required medication to help soften and open her cervix. Although she was initially able to move around—recalling that she found it helpful for a distraction—as the induction medication increased in her system, so did the pain. Moving was now out of the question.

Dowell's experience is the perfect example of how the value of movement can shift at different stages in labor. Walking around during early labor might feel good, but as your baby descends further down into the birth canal and you experience more pressure and pain, it might feel better for you to try other strategies that don't involve walking.

Why Movement Matters—But Is Not Everything

It's important to keep in mind that while remaining ambulatory is backed by research, that doesn't mean it's possible for everyone. There are so many variables to labor, and for some women, movement can be restricted for a variety of reasons. For example, you could have complications that keep you bedridden, your baby might be in a position where moving feels too uncomfortable for you, or you might give birth in a facility with heavy patient restrictions.

That is why you can learn about the latest research supporting movement during labor and seek out what technology is available at your local hospital—but ultimately, you should do what is safest for you and your little one.

References:

1. Ondeck M. Healthy birth practice #2: Walk, move around, and change positions throughout labor. The Journal of Perinatal Education. 2014;23(4):188-193. doi:10.1891/1058-1243.23.4.188
2. The American College of Obstetricians and Gynecologists. Approaches to limit intervention during labor and birth. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/02/approaches-to-limit-intervention-during-labor-and-birth. Accessed November 7, 2022.
3. Spinning Babies. The three principles in pregnancy. https://www.spinningbabies.com/pregnancy-birth/the-three-principles-in-pregnancy/. Accessed November 7, 2022.