Cytotec is a man made prostaglandin.It is approved by the FDA for ulcer prevention by people taking nsaid.

It is not approved for a labor induction. It can cause uterine ruptures, severe vaginal bleeding, retained placenta, shock and even fetal and maternal death. It softens the cervix and stimulates uterine contractions. It can cause hyperuterine reaction. If given in pill form and cant be reversed should there be a problem. All induction agents cause uterine contractions this can affect the blood supply to the fetus, especially if contractions become very frequent. Induction agents therefore need to be used with great care and with close fetal monitoring. One of the problems with induction using prostaglandins (such as dinoprostone or misoprostol) is that once given, the process is difficult to reverse. In contrast, oxytocin has a half-life of about 10 minutes and is administered via intravenous drip, which can be stopped immediately in the event of adverse reaction.[2] Be aware that death and serious adverse reactions, including increased heart rate, transient hyperglycemia, hypokalemia, cardiac arrhythmias, pulmonary edema, and myocardial ischemia have been reported after prolonged administration of oral or injectable terbutaline to pregnant women. Treatment with terbutaline administered by injection or by continuous infusion pump should not be used beyond 48 to 72 hours. In particular, injectable terbutaline should not be used in the outpatient or home setting. There are certain obstetrical conditions where the healthcare professional may decide that the benefit of terbutaline injection for an individual patient in a hospital setting clearly outweighs the risk. Oral terbutaline is contraindicated for the treatment or prevention of preterm labor. Report adverse events involving terbutaline to the FDA MedWatch program using the information in the "Contact Us" box at the bottom of this page.

Cervidal is a product inserted in and can be take out at any timeCervidil may increase the risk of uterine rupture, which leads to fetal death about 1 in 4 cases. It may cause uterine hyperstimulation, which can cause abnormal fetal heart rate. The use of Cervidil requires the constant monitoring of your baby's heart rate, which greatly decreases your mobility during labor. Cervidil Vaginal Insert (dinoprostone, 10 mg)

is indicated for the initiation and/or continuation of cervical ripening in patients at or near term in whom there is a medical or obstetrical indication for the induction of labor.
Pitocen is IV and can be stopped. Pitocin is indicated for the initiation or improvement of uterine

contractions, where this is desirable and considered suitable for reasons of fetal or maternal concern, in order to achieve vaginal delivery. It is indicated for (1) induction of labor in patients with a medical indication for the initiation of labor, such as Rh problems, maternal diabetes, preeclampsia at or near term, when delivery is in the best interests of mother and fetus or when membranes are prematurely ruptured and delivery is indicated; (2) stimulation or reinforcement of labor, as in selected cases of uterine inertia; (3) as adjunctive therapy in the management of incomplete or inevitable abortion. In the first trimester, curettage is generally considered primary therapy. In second trimester abortion, oxytocin infusion will often be successful in emptying the uterus. Other means of therapy, however, may be required in such cases. Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blood clotting problems; changes in heart rate; heavy or continued bleeding after childbirth; irregular heartbeat; pooling of blood in the pelvis; ruptured uterus.

Fetus: Bleeding in the eye; irregular heartbeat; seizures; slow heartbeat.

Anaphylactic reaction

Premature ventricular contractions

Postpartum hemorrhage

Pelvic hematoma

Cardiac arrhythmia

Subarachnoid hemorrhage

Fatal afibrinogenemia

Hypertensive episodes

Nausea

Rupture of the uterus

Vomiting

Excessive dosage or hypersensitivity to the drug may result in uterine hypertonicity, spasm, tetanic contraction, or rupture of the uterus. The possibility of increased blood loss and afibrinogenemia should be kept in mind when administering the drug. Severe water intoxication with convulsions and coma has occurred, associated with a slow oxytocin infusion over a 24-hour period. Maternal death due to oxytocin-induced water intoxication has been reported. The following adverse reactions have been reported in the fetus or neonate:

Due to induced uterine motility:

Due to use of oxytocin in the mother:

Bradycardia

Low Apgar scores at five minutes

Premature ventricular contractions and other arrhythmias

Neonatal jaundice

Permanent CNS or brain damage

Neonatal retinal hemorrhage

Fetal death

Neonatal seizures have been reported with the use of Pitocin.

The genesis of amniotic fluid embolism is described in Williams Obstetrics: "Vigorous uterine contractions combined with a long, firm cervix and a birth canal that resists stretch may lead to uterine rupture or extensive lacerations of the cervix, vagina, vulva or perineum. It is in these latter circumstances that the rare condition of amniotic fluid embolism most likely develops."(8) Misoprostol is known to cause unusually vigorous contractions of the uterus, and in the autopsy reports in the four cases of amniotic fluid embolism in this paper, microscopic examination showed hemorrhages and lacerations in the cervix and myometrium. (Wagner, 2009) Medical literature "indicated that either ether or chloroform could increase the danger of hemorrhage, could lead to protracted labor, could decrease uterine contractions, and could cause a newborn breathing th difficulty."[ the use of choloform or ether for relief of pain, during mid 19 century. Not all doctors used, many were concerned about the effects on women and fetus.

What doctors had not yet realized that twilight-sleep was the first step to complete control by the physician. Twilight-sleep had to be administered in a hospital and the birth had to be overseen by physician and staff. Women were completely unconscious and so did not experience birth. The widespread use of twilight-sleep also paved the way for other anesthesia. By encouraging women to go to sleep, women were further distanced from their bodies. They lost control over a process as natural as any other bodily function.
Twilight-sleep was a combination of scopolamine and morphine

1957: Thalidomide, a drug developed to help women overcome the symptoms of morning sickness during pregnancy, is first marketed in West Germany. Forty-six countries approve its use before thalidomide's terrible side effects become apparent. Thalidomide is a powerful synthetic tranquilizer, originally developed by Ciba, a Swiss pharmaceutical company. Unable to make it commercially profitable, Ciba gave up on the drug. A German company, Chemie Gruenenthal, took over and eventually began marketing thalidomide as a "completely safe" method for warding off morning sickness.

Inadequate testing procedures were to blame for what followed. Had the pharmaceutical labs done a better job of testing thalidomide, they would have discovered that the drug's molecules were able to penetrate the placental wall, especially during the first trimester of pregnancy when the fetus is largely unformed. This invasion of the womb resulted in a variety of profound birth defects, including deformed and missing limbs, deafness, blindness, cleft palate and a slew of internal problems.
The story of thalidomide in the USA is very different from the European experience. Fortunately, Dr. Francis Kelsey of the US Food and Drug Administration was more alert and would not accept that the drug had been adequately tested for manufacture and distribution there. As a result, only about 20 malformed babies were born in America and these were as a result of limited clinical trials that were carried out.

Hypnotic doses of barbiturates do not appear to impair uterine activity significantly during labor. Full anesthetic doses of barbiturates decrease the force and frequency of uterine contractions. Administration of sedative-hypnotic barbiturates to the mother during labor may result in respiratory depression in the newborn. Premature infants are particularly susceptible to the depressant effects of barbiturates. If barbiturates are used during labor and delivery, resuscitation equipment should be available. Data are not available to evaluate the effect of barbiturates when forceps delivery or other intervention is necessary or to determine the effect of barbiturates on the later growth, development, and functional maturity of the pediatric patient. Seconal, abien, benzos(valium(diazepam) versed(midazolam) reversal flumazenil The use of flumazenil to reverse the effects of benzodiazepines used during labor and delivery is not recommended because the effects of the drug in the newborn are unknown.

What are the potential side effects of opiates?

Opiates may have the following side effects on the mother:

Nausea Vomiting Itching Dizziness Sedation Decreased gastric motility Loss of protective airway reflexes

Hypoxia due to respiratory depression

How will the opiates affect my baby?

Throughout pregnancy, you were probably aware that medications you consumed could potentially affect your baby. Opiates also cross the placenta during labor and can cause the following side effects to your baby:

Central nervous system depression Respiratory depression Impaired early breastfeeding Altered neurological behavior Decreased ability to regulate body temperature

For these reasons, your baby may need medication to counteract the opiate effects. Naloxone is a medication that when given in small doses can reverse the respiratory depression that opiates may cause in the baby. This drug is usually given intravenously to your baby. The effects of naloxone can be seen within a few minutes and can last up to 2 hours.

What types of opiates are used during childbirth?

The most frequently used narcotic medications are:

Morphine Stadol Fentanyl Nubain Demerol

Demerol:
Demerol is a popular choice for pain relief during labor. Demerol alters how you recognize the pain you are experiencing by binding to the receptors found in your central nervous system. The advantages of Demerol include:

Can be given by injection into the muscle, the vein or by a Patient Controlled Analgesia (PCA) pump Demerol starts working in less than 5 minutes

How can Demerol affect me and my baby? Demerol can cause drowsiness, nausea, vomiting, respiratory depression, and maternal hypotension (low blood pressure). If injected within 2-4 hours of delivery, Demerol has been found to cause breathing difficulties in babies. Resp. depression in mom and baby, seizures, cardiovascular collapse, cardiac arrest

Morphine:

In recent years, morphine has not been routinely used as a method of pain relief during labor because it has been found to depress the babys ability to breathe. Overdose, respiratory arrest, cardiac arrest.

Stadol:
Stadol has been found to relieve pain when given in the first stage of labor. This narcotic is considered more potent then Demerol. It is usually given intravenously in small doses, usually 1 to 2 mg. The advantages of using Stadol include:

Starts working in less then five minutes Is a sedative Has minimal fetal effects Cause minimal nausea

How can Stadol affect me and my baby? Stadol can cause the mother to have respiratory depression, dizziness and dysphoria (a state of feeling unwell and unhappy). Stadol can cause respiratory depression in the baby.

Fentanyl:
Fentanyl is a synthetic opiate that provides mild to moderate sedation. The advantages of using Fentanyl include:

Begins working quickly (although, usually only lasts 45 minutes) Minimal sedation Minimal fetal effects

How can Fentanyl affect me and my baby? You and your baby may experience some sedation and/or nausea. According to Danforths Obstetrics and Gynecology, babys born to mothers who used Fentanyl to relieve pain during labor were less likely to need naloxone (medication to help with breathing) than babies born to mothers who used Demerol during childbirth.

Nubain:
Nubain is a opiate agonist-antagonist that is comparable to morphine. The advantages of using Nubain include:

Begins working within 5 minutes of administration Minimal nausea Minimal fetal effects

How can Nubain affect me and my baby? Nubain can cause the mother to have sedation and dysphoria (a state of feeling unwell and unhappy). Respiratory depression

How will my pain medication be given?

Medication can be given in any of the following ways:

A one time injection into the spinal column IV or Intravenous placement into a vein on the back of the hand or arm. A needle is inserted into a vein with a plastic tube connected to a bag holding fluid that slowly drips into your body. In a hospital setting, an IV is typically placed to help you stay hydrated throughout labor and assure access to administer medications if they are needed. Patient Controlled Analgesia (PCA) pump is a way a mother can control when she receives pain mediation during labor by pushing a button. The advantage of having a PCA is that it provides a sense of control and the mother does not have to wait for the nurse to bring pain medication. Fentanyl and Demerol are common narcotics that can be given through a PCA pump. The pump is pre-programmed based on the drug dosage into amounts small enough to relieve pain without releasing too much medication. Narcan for resp depression. Epidurals may cause your blood pressure to suddenly drop. For this reason your blood pressure will be routinely checked to make sure there is adequate blood flow to your baby. If this happens you may need to be treated with IV fluids, medications, and oxygen You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect from epidural use. If symptoms persist, a special procedure called a blood patch, an injection of your blood into the epidural space, can be done to relieve the headache After your epidural is placed, you will need to alternate from lying on one side to the other in bed and have continuous monitoring for changes in fetal heart rate. Lying in one position can sometimes cause labor to slow down or stop You may experience the following side effects: shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating You may find that your epidural makes pushing more difficult and additional interventions such as Pitocin, forceps, vacuum extraction or cesarean may become necessary For a few hours after birth the lower half of your body may feel numb which will require you to walk with assistance In rare instances, permanent nerve damage may result in the area where the catheter was inserted. Though research is somewhat ambiguous, most studies suggest some babies will have trouble "latching on" which can lead to breastfeeding difficulties. Other studies suggest that the baby may experience respiratory depression, fetal malpositioning; and an increase in fetal heart rate variability, which may increase the need for forceps, vacuum, cesarean deliveries and episiotomies.

How can my epidural affect labor? Your epidural can cause your labor to slow down and also make your contractions weaker. If this happens you may be given the medicine Pitocin to help speed up labor. How can an epidural affect my baby? As stated above, research on the effects of epidurals on newborn health is somewhat ambiguous and many factors may be contributing to newborn health at the time of birth. How much of an effect these medications will have is difficult to judge and could vary based on dosage, how long labor continues and individual babies. Dosages and medications vary, so concrete information from research is lacking. Studies reveal that some babies may initially have trouble "latching on" among other difficulties with breastfeeding. While in-utero, they may become lethargic and have trouble

getting into position for delivery. These medications have been known to cause respiratory depression, and decreased fetal heart rate in newborns. Though the medication may not harm the baby, the baby may experience subtle effects like those mentioned above.
However, as with any medication or procedure there are also risks. The major complication from epidural anesthesia is a drop in the mother's blood pressure. Most hospitals will try to prevent this by giving the mother IV fluids prior to the administration of the epidural. Sometimes an epidural can lead to fetal distress, fetal malposition, increased risk of forceps or vacuum extraction, episiotomy, and in some studies, and increased risk of cesarean section.

As if the risks these drugs pose on your unborn child are not enough, there are further side effects to the mother. Pitocin has a black box warning stating that it should not be used unless medically necessary. Medically necessary means that there is a serious risk to the mother or baby's health. Most women who are induced with Pitocin require an epidural as it makes uterine contractions unnaturally strong. These unnaturally strong and frequent contractions can also result in uterine tearing, vaginal lacerations and severe postpartum bleeding. Side effects of Pitocin also include seizures, coma and maternal death. What Happens When the Drugs Do Not Work More often than not, Pitocin induced labors do not work. Chances of an induced labor resulting in cesarean section for a first time mother triple. For some mothers, the increased stress of frequent and strong contractions puts much unneeded stress on herself and the unborn child. This will result in your doctor opting for a c-section whether you want one or not. For example, Pitocin induced labors have demonstrated a decrease in blood flow to the woman's uterus which in turn gives the baby a low heart rate. Pitocin has also been proven to cause permanent central nervous damage to the unborn child in some cases. Medically necessary means that there is a serious risk to the mother or baby's health. Most women who are induced with Pitocin require an epidural as it makes uterine contractions unnaturally strong. These unnaturally strong and frequent contractions can also result in uterine tearing, vaginal lacerations and severe postpartum bleeding. Side effects of Pitocin also include seizures, coma and maternal death. What Happens When the Drugs Do Not Work More often than not, Pitocin induced labors do not work. Chances of an induced labor resulting in cesarean section for a first time mother triple. For some mothers, the increased stress of frequent and strong contractions puts much unneeded stress on herself and the unborn child. This will result in your doctor opting for a c-section whether you want one or not. Wait for Your Baby to Be Ready Yes, in today's fast paced world it may seem illogical to wait around for your child to be born. The fact is, your baby will come when he or she is ready to be born. Labor is a natural event that will occur when the time is right. It is also worth noting, that women should extensively question their doctor if they suggest inducing labor. If you feel that your doctor has recommended Pitocin to help fit his schedule, then you need to voice your concerns and let him know how you want your labor to unfold.

A variety of health care professionals may work in the birth center setting such as registered

Benefits for baby

Baby may be less groggy and more alert after birth. Baby may have an easier time latching on and breastfeeding. Baby will not have narcotics or other medications in his system. Baby will have a lower risk of fetal distress during delivery. Babys APGAR scores may be higher.

Benefits for mom

Mom can walk around, soak in the tub, go to the bathroom, and change positions during labor. Pain can be beneficial to mom as it helps her to know what stage of labor she is in, when she may need to shift positions, and when it is time to push. Mom does not lose sensation in her lower body should not need a catheter. Mom will not have to worry about having a post-epidural headache. Mom can get up and walk around shortly after birth. There may be less chance of having nausea, vomiting, dizziness or other side effects associated with pain medications. Mother will be less groggy after birth. Although there is some debate on this, having a natural childbirth may reduce the chance of needing a csection. Mom may have a more positive birth experience or feel empowered by having natural childbirth. Some women compare natural childbirth with running a marathon. The sense of accomplishment can be a rewarding ev

nurses, certified nurse midwives, and doulas (professionally trained providers of labor support and/or postpartum care) who act as labor assistants.

Studies indicate that getting continuous support during labor from a trained and experienced woman, such as a midwife or doula, can mean shorter labor, less (or no) medications, less chance of needing a C-section, and a more positive feeling about the labor when it's over.

6. Research has shown that in mothers who have natural childbirth, babies are more alert and show more interest in such as sucking and massaging the mother's breasts, as well as the actual length of time they spend nursing within the first 90 minutes.

Benefits of Medicated Birth

pushing 1. Mothers who are having a very long labor can benefit from using pain medication to get some rest before the stage. 2. If the mother is tensing up during contractions, pain medication can help her relax so that her body is not fighting against the labor. 3. If the mother has a lot of fear about birth or issues from her past, it may affect the progress of her labor. At times, medication may help to ease her anxiety.

Additional Thoughts
On a personal note, I can share my own experiences of natural childbirth twice. The pain was intense, but it was not impossible to manage. My obstetrician was very supportive of natural childbirth and his encouragement had a great impact on me. I have also attended over 300 births as a birth doula supporting women during labor in the last 11 years. About 70% of those women had natural childbirth. In no specific order, I want to share some of my additional thoughts with you based on what I have seen and experienced. pain relief techniques Mothers have the ability to give birth naturally. Very often the things done or said to her inhibit her ability to do this very important job (i.e., restricting her movement, restricting , lack of support or encouragement as well as a lack of non-medical .) Pain medication is a wonderful resource in very difficult and long labors when the mother simply has no energy left to birth her baby. I have seen several births like this and would have used an epidural myself had I had active labor last for days. pushing Pain medication, such as , carry with them hefty sacrifices and intervention such as restricting movement to bed, IV fluids and increasing her need for pitocin. Epidurals also increase the mother's need for instruments to be used such as vacuum extractors or forceps, since is more difficult. I very seldom have clients in my doula practice who have natural childbirth with a first baby, choose to use pain medication with the next birth. Once they have realized the benefits of natural childbirth, they do not tend to go back. From what I have seen, pain medication solves one big problem - pain. However I wonder when we take the pain away, if we are also removing helpful feedback for the mother. (see #2 above - Benefits of Natural Birth) Is it not like a person who takes medication for headaches (ie.. treating the symptom) instead of finding out why they are getting headaches?

Though I firmly believe that women have the ability to have natural childbirth, it should never be used as a scale to judge the woman either as a person or as a mother. How she lives her life, treats others and raises her family tells us much more about who she is than whether or not she used pain medication in labor. So, this author and mother wishes to simply encourage every mother to take this decision seriously and evaluate for yourselves the benefits and downsides to both natural birth and medicated birth before you jump to any hasty conclusions. I firmly believe that there are two valid sides to consider and that you should discuss this issue at length with your spouse or birthing partner, family, doula and primary provider as well as factor in the circumstances of your own labor before you decide. In one study, mothers who changed
positions frequently during labor and birth demonstrated a 50% reduction in time progressing from 3cm to 10cm dilatation.(1)

Research also demonstrates that birthing in a non-supine position can lead to lower levels of reported back pain, reduced pain during pushing, fewer perineal tears which also serves to reduce the need for suturing or surgical repair of the pelvic floor and overall easier pushing.(2) When unrestricted birth positions are available, mothers are better able to adapt to changes throughout the first and second stages of labor.

THE CURSE OF CONVENIENCE

While US hospital practices are beginning to come in line with research evidence regarding the importance of mobility during both portions of first stage early labour and active labor, with 24% of mothers reporting walking around or moving once they were admitted to the hospital and regular contractions had begun,(3), such is not the case for second stage labor.(3, 4)

For the majority of US women giving birth in hospitals, the most-used birth positions for second stage labor, the birth of the baby, remain lithotomy (flat-on-back with legs pulled back to either side) and semisitting, also known as the C-position (resting on tailbone with body curled in the shape of a C) which are used in 65.9% of vaginal births.(4, 5, 6) "More than half (57%) of women who gave birth vaginally reported that they lay on their backs while pushing their baby out and giving birth. Slightly more than one-third (35%) indicated they gave birth in a

propped up (semi-sitting) position, while the remainder gave birth either on their side (4%), upright (e.g. squatting or sitting) (3%) or in a hands-and-knees position (1%). "
Listening to Mothers II: Report of the Second National U.S. Survey of Women's Childbearing Experiences. (3)

Unfortunately, the use of these birth positions is rooted in convenience for doctors, not research evidence.(7) While they allow doctors easiest access to the birthing woman, they are detrimental for many reasons. Foremost is that the pelvic outlet is up to 30% smaller; it forces the woman to put direct pressure on her sacrum (tailbone) which flexes it upward, forcing it into a curved position which restricts the diameter of the pelvic outlet and can inhibit the baby's descent through the maternal pelvis. The birth canal is effectively placed in an "uphill" orientation, forcing the mother to push upward against gravity to expel the baby.

When a woman's legs are held back, a woman is also at risk of developing or worsening symphysis pubic dysfunction if excessive, unequal force is applied to either leg. The pubic symphysis is the location where the two sides of the pelvis meet at the groin.

While in lithotomy, if too much pressure is exerted on the woman's legs, excessive hip abduction and external rotation occur which can further distract the joint, forcing the sides of the pelvis apart, resulting in excruciating postpartum pain as well as prolonged supra-pubic pain for the mother and lasting complications after birth such as difficulty walking severe enough to require the use of crutches or a wheelchair, or more rarely, bladder dysfunction.(8) Dorsal lithotomy also restricts a woman from freely moving and puts greater pressure on the perineum, all of which can lead to other unnecessary interventions or complications like tearing, episiotomy, forceps delivery, or vacuum extraction.(9, 10, 11)

Mothers who elect epidurals are at higher risk for developing symphysis pubic dysfunction. If the dosage of drugs is too high, she can lose all sensation below the waist, which may leave her unable to sense when too much force is being applied or whether she is pushing with excessive effort. Her mobility is also greatly restricted which in turn further restricts her choice of birth positions, especially during second stage labor, the pushing stage.

In addition, risk to the baby also increases. Ineffective birth positions like lithotomy can compress major blood vessels which interferes with circulation and lowers maternal blood pressure, which can then lower fetal transcutaneous oxygen saturation as much as 91%(12) decrease fetal heart rate or contribute to other forms of fetal distress, including cord compression, which may lead to continuous or internal fetal monitoring, increased risk of shoulder dystocia/problems with fetal presentation, or a prolonged pushing phase.(13, 14, 15)

"An ideal birth position allows the mother's sacrum and coccyx the freedom to rotate backward, the rest of the pelvis room to open to optimal dimensions to allow for birth, and contractions to remain strong and close together. She (the mother) should choose the position that best enhances the quality of her contractions and her ability to push."
Anne Frye inHolistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice, Vol. 2: Care of the Mother and Baby from the Onset of Labor Through the First Hours After Birth

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OPTIMAL LABOR AND BIRTH POSITIONS

There are five main types of labor and birth positions. It's important to note that most of these positions can be used for both early labour and second stage active labor. While some are definitely not glamorous, they offer unique benefits to labor and birth. These include:

HANDS-AND-KNEES POSITIONS
Quadruped childbirth positions, which include the "crawl" and the "full moon", are beneficial for back labor, turning a posterior baby, and are often the best birth positions for birthing a large baby.

SITTING POSITIONS
Sitting positions combine the helpful force of gravity with relaxation. A birth ball, rocking, or toilet sitting can be utilized to rest while gravity helps labor progress.

SQUATTING POSITIONS
Squatting positions are helpful in opening the pelvis to allow a baby to find the optimal position for birth. Squatting can be performed through use of a birth companion or a tool such as a squatting bar.

SIDE-LYING POSITIONS
Lateral or Side-lying positions are beneficial for resting during a long labour, promoting body-wide relaxation, and minimizing extra muscular effort. They are best used in the latter stages of labor since gravity isn't able to speed the process.

UPRIGHT OR STANDING POSITIONS

Upright positions for childbirth use gravity to the mother's advantage. They help the baby drop into the pelvis and prevent pressure from being concentrated in a particular spot. They also allow the birth companions to apply other comfort measures easily. They represent the most under-used birth positions.
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Changing positions, and moving around during labor and birth, offers several benefits. Some are obvious to the mother in labor: increased comfort / reduced pain, distraction, and an enhanced sense of control: merely having something active to do can relieve the sense of being overwhelmed and out of control. Beyond these advantages, there are equally important effects on the baby and on the progress of labor. Changing positions during labor can change the shape and size of the pelvis, which can help the babys head move to the optimal position during first stage labor, and helps the baby with rotation and descent during the second stage. Swaying motions such as walking, climbing stairs, lunging, and swaying back and forth are especially helpful with this. Movement and upright positions can help with the frequency, length, and efficiency of contractions. The effects of gravity can help the baby move down more quickly.

Changing positions helps to ensure a continuous oxygen supply to the fetus, rather than causing supine hypotension (low maternal blood pressure) by lying on your back or even semi-sitting. Changing position can reduce the length of labor. Mendez-Bauer and Newton (1986) state: duration of labor from 3 to 10 cm cervical dilation was about 50% shorter in patients who alternated supine and standing, standing and sitting positions.
Rocking, Rhythmic Motion: In labor, it just feels better when mom rocks and sways in
rhythm to her breathing.

Activity: Walking, climbing stairs, lunging. Activity helps baby to descend, helps
baby to rotate into position for birth. In early labor, be active occasionally, but dont exhaust yourself by walking all through early labor. Walking is more effective in active labor and transition when baby has descended far enough to put pressure on moms cervix and encourage the cervix to open.

Positions for Back Labor (when mom has back pain, irregular contractions, or is progressing slowly)

Leaning Forward: Many women, especially those with back labor, find it most
relaxing to lean forward during contractions. Hands and knees / kneeling. Can relieve back pain, help a posterior baby rotate, allows easy access for backrubs / counterpressure massage; makes it possible to sway side to side, rock back and forth, or do pelvic tilts to aid rotation and increase comfort. Having knee pads or kneeling on something soft will help knees. Can rest upper body on pillows, chair, or birth ball.