Why Giving Birth in the Squatting Position May (or May Not) Be for You

Paige Schwaiger at Mountain Midwives notes that “when you want the ketchup to come out of the bottle, you don’t lay the bottle down.” She explains how “it’s the same when you want the baby to come out.”

Yet a supine (lying down) position for birth is typically the most common — and most likely the one you’ll experience.

Why? Well, this results from various cultural and historical factors, as well as the pervasiveness of this position in modern medical training. Beyond that, delivery rooms are set up in such a way that birthing while lying in bed often makes the most sense, due to things like lack of space.

There are various other alternative birth positions, including:

• standing
• squatting
• hands/knees
• sitting
• lying on your side

The idea is that moving your body during labor may help you feel more in control and may also help your baby make their way to their final destination.

Squatting, in particular, allows gravity to do some of the work of helping baby descend the birth canal — it may even increase the pelvic diameter!

Delivering in a squatting or other non-supine position has numerous potential benefits for both you and baby.

They include:

• fewer injuries to the perineum (tearing, etc.)
• less vulvar edema (fluid swelling)
• less blood loss
• shorter first and second stage of labor
• less use of pain relief (epidural) during labor
• wider pelvic outlet dimensions, which may ease delivery
• fewer heart rate issues for baby
• lower chance that baby will need to go to the neonatal intensive care unit (NICU)

One 2007 study compared women birthing in the squatting position with others who birthed while lying down. Those who squatted didn’t experience second- or third-degree tears compared with 9 percent of the non-squatting group.

Instrument delivery (forceps) also wasn’t needed as often for the squatting group — 11 percent versus 24 percent. And there weren’t any cases of a retained placenta or postpartum hemorrhage in the squatting group, compared with 4 percent and 1 percent in the non-squatting group, respectively.

In general, researchers conclude that you should be encouraged to birth in the position you find most comfortable whenever possible. Doing so may help your body relax and improve the overall birthing experience, which is important physically but also psychologically.

Some experts say the type of squat you practice and use during labor and delivery makes a difference in its effectiveness.

For example, there are parallel squats, which involve bending down so your buttocks don’t go lower than your knees, and then there are deep squats, which involve dropping your buttocks as low as your ankles.

Mindy Cockerman at Lamaze International explains that deep squats may increase your chances of developing hemorrhoids, a low lying placenta, and low umbilical cord vessels — or it may even put your baby in a breech position.

She also warns that too many squats in late pregnancy (weeks 34–38) may affect your baby’s engagement, possibly contributing to posterior presentation.

During labor, squatting may be tiresome, particularly if you haven’t prepared to be in this position for long periods of time. Squatting may also make fetal monitoring more difficult.

Some experts also say it may make the mother’s participation in delivery more difficult (for example, reaching down and holding your baby as they emerge from the birth canal).

Speak with a healthcare professional if you wish to birth in the squatting position.

Some hospitals may have policies about birthing in bed or other guidelines you’ll need to follow. Others may be fine with this position, but it’s a good idea to get on the same page before the big day arrives. You’ll definitely want to make sure your provider is comfortable with this type of delivery.

That said, if you’re hoping to use an epidural during your labor and delivery, squatting may not be for you.

An epidural may make it difficult or nearly impossible to stand or squat on your own. You may try squatting supported by your partner or a doula, but even with support, it may be difficult or unsafe.

You may also not be eligible for another reason, as determined by a healthcare professional. For example, squatting may not be a good idea if:

• You need extra monitoring.
• Your baby is showing signs of distress.
• You have certain conditions that would make a non-supine position dangerous to you or your baby in some way.

Birth is a marathon and not a sprint. Prepare your muscles so they have the endurance they need for the task ahead.

You can practice squats throughout your pregnancy to strengthen the quadriceps muscles in your thighs. Sitting or gently bouncing on a birth ball can also be helpful, as it strengthens your core muscles and helps with posture.

Stay in a squat for around the length of a contraction (60 to 70 seconds), but don’t actually push or bear down when in the position. And take note of any help you’ll need to get into a squat or any props that make it more comfortable.

Also focus on the form of your upper body. In non-supine positions, your upper body should be curved forward, with your chin tucked. This shape of the body helps baby descend the birth canal.

As you practice, note your upper body and inform your partner, if you have one, to help remind you of these positions during labor.

You’ll probably discover that many hospitals and doctors know about the benefits of squatting during labor and delivery. As a result, various tools may be available to you to help you assume this position as you progress.

These tools may include:

• Birth ball (yoga ball). A birth ball allows you to sit or drape your upper body over the ball to assume a squatting position.
• Squat bar. Ask your hospital or birthing center if they have birthing bars or squat bars attached to the hospital bed to help with squatting.
• Birthing stool. Also ask about a birthing stool. This seat-like device allows you to sit low, almost like when you’re having a bowel movement. It also has space so your baby has room to exit your body.
• CUB support. You may consider purchasing a CUB support device that inflates and acts as a birthing stool but can be used in your hospital bed. Not all hospitals or providers will be familiar with this tool, so you may want to ask about it before spending money.
• Partner assistance. You may also ask your partner or doula to support your upper body while you squat.

And if you want to squat during your labor, you don’t have to stay in this position the entire time.

Take breaks as necessary to allow your body to rest. Breaks will also likely be needed from time to time so a healthcare professional can monitor your progress and your baby’s health.

If you’re planning a home birth, you can most certainly add squatting into your birth plan. Speak with a midwife about this position, its benefits and drawbacks, and ways you may incorporate it into your own labor and delivery.

If you plan to have a doula attend your birth, also bring it up with them and ask what tools, like a birth ball or stool, you may want to gather to help make this possible.

It’s important to understand that while squatting does potentially help speed up labor and provide other possible benefits, it doesn’t guarantee a safe, fast, or otherwise easy birth.

Issues may still arise during a home birth that can necessitate a change in plans. So, be sure to stay flexible and have a plan B if things don’t progress as anticipated.

Siobahn Miller at The Positive Birth Company explains that all babies and all pelvises are different, so there’s really no single ideal labor or birthing position. Instead, try moving around and finding a position that feels best for you.

Squatting may feel great and get things going for your body and baby. Or you may prefer something different.

If you have any questions, speak with your provider about squatting and other non-supine positions, how they may help, and any other situations you’ll need to consider with your own birth.