I’m sure many of us have seen this scenario: a client has been contracting for many hours, is fully immersed in active labor, and decides to lie down for a break. What I see most often is an almost immediate increase in the mother’s perception of contraction intensity and experience of discomfort. Why? I look at it like slamming your finger in a door or hitting your head. You slam your finger, you shake it or squeeze it. You hit your head, you rub it (and if you’re like me, you also swear violently 😂).
In this same vein, the contraction and the process of labor itself provide an instinctual impetus to move. Our bodies are hard-wired to recognize the position and movements of the baby and respond accordingly, working through positioning and motion to assist with their birth.
Movement restrictions not only impede this literal dance between mother and baby, but they also reduce essential anatomical mobility of the dynamic pregnant pelvis, frequently making fetal descent and rotation prolonged and more difficult.
I typically try not to run my clients through the gauntlet of position changes unless they appear to be floundering and a suggestion would certainly be helpful. More commonly, I like to observe her intuitive movements and find a way to enhance them, possibly using props or myself and other support people to maximize their effectiveness. This can (and should) be done whether a woman is unmedicated or has an epidural - anesthesia should not be an excuse for foregoing movement.
Does this mean never letting them lie down? Lordt, no! If a mother needs a break and she is able to lie down comfortably to rest, then this is intuitively what her body and baby need. That’s the beauty of a woman laboring instinctively in a safe space - she can communicate more easily with her body and baby and take exactly what she needs at that moment.