Dr. Lauren Keller, Chiropractor

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Squats and Pregnancy (Part 3): Why Should I Squat during Pregnancy and Labor?

Lauren Keller

Now that we know how to squat during pregnancy and the health considerations we should look at prior to squatting, why would I even want to squat during pregnancy? How will squatting even possibly help labor? What are the possible benefits (and risks) of squatting while in labor?

Squat during Labor for Optimal Fetal Position

Supported squatting allows for greater mobility of pelvic joints than any other position and eliminates external pressure allowing for optimal fetal position (4)

  • May enable you to rotate and descend in a difficult birth
  • Squatting lengthens the trunk and allows more room for baby to maneuver into position

Squatting for Pain Management during Labor

Squatting may decrease pain severity during the second stage of labor compared to lying on one’s back:

  • During the latent phase, pain severity in lying down and squatting positions was significantly less than the mean pain severity in sitting. (7)
  • During the active phase, pain severity was significantly less in squatting position compared to lying down or sitting. (7)

Squatting for Decreased Labor Time

Squatting may decrease time of labor:

  • The first stage of labour was approximately one hour and 22 minutes shorter for women upright as opposed to lying down (9)
  • The upright position was associated with a reduction in duration of second stage for women without epidural anesthesia (8)

Benefits of Squatting during First Stage of Labor

  • Reduces the need for epidural (9)

  • Babies of mothers who were upright were less likely to be admitted to the neonatal intensive care unit (9)
  • Women who were upright were less likely to have caesarean section. (9)

Benefits of Squatting during Second Stage of Labor

  • Reduction in assisted deliveries (8)

  • Reduction in episiotomies (8)
  • Fewer abnormal fetal heart rate patterns (8)
  • Reduction in shoulder dystocia rate (5,10)

Risks of Squatting during Labor

  • Possible increase in second degree perineal tears (8)

  • Increased estimated blood loss greater than 500 mL (5, 8) Note: This may be due to the ease of measuring blood loss when upright. (5)

Squatting vs Lying Down on Back Position, other Considerations during Labor

  • Research shows that there is no clear difference in the number of third or fourth degree perineal tears (8)

  • No clear difference in the rates of caesarean section when squatting during second stage of labor (8)
  • There was mo clear difference in the number of babies admitted to neonatal intensive care when squatting during the second stage of labor (8)

Squatting in Labor: the Decision is UP TO YOU

I whole-heartedly believe that women should give birth in the position they feel most comfortable. This can include squatting, lying on their backs, sitting, on all fours, lunging, etc. There are risks and benefits in everything we do so it’s important to listen to your body and do what you feel is right. There is not one way or a right way to give birth. It’s important to take the research and do what is best for you given your circumstances and preferences!

References:

  1. Russell, J.G.B., “The rationale of primitive delivery positions”, British Journal of Obstetrics and Gynaecology, Sept. 1982, Vol. 89, pp. 712-715.
  2. Di Paolo, Julia, Montpetit-Huynh, Samantha, Vopni, Kimberly, “Pregnancy Fitness”
  3. Russell, J.G.B., “Moulding of the Pelvic Outlet”, J. Obstet. Gynaec. Brit. Cwlth, Sept. 1969, Vol. 76, pp. 817-820.
  4. Penny Simkin, Janet Whalley, Ann Keppler, Janelle Durham, April Bolding, Preconception: Improve Your Health and Enhance Fertility
  5. Vicky Chapman, Cathy Charles, The Midwife's Labour and Birth Handbook
  6. Reid, Harris., Alternative Birth Positions. CAN. FAM. PHYSICIAN Vol. 34: SEPTEMBER 1988
  7. Valiani M1, Rezaie M1, Shahshahan Z2. Comparative study on the influence of three delivery positions on pain intensity during the second stage of labor. Iran J Nurs Midwifery Res. 2016 Jul-Aug;21(4):372-8. doi: 10.4103/1735-9066.185578.
  8. Gupta JK1, Sood A2, Hofmeyr GJ3, Vogel JP4., Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database Syst Rev. 2017 May 25;5:CD002006. doi: 10.1002/14651858.CD002006.pub4.
  9. Lawrence A1, Lewis L, Hofmeyr GJ, Styles C., Maternal positions and mobility during first stage labour. Cochrane Database Syst Rev. 2013 Aug 20;(8):CD003934. doi: 10.1002/14651858.CD003934.pub3.
  10. Nasir A1, Korejo R, Noorani KJ. Child birth in squatting position. J Pak Med Assoc. 2007 Jan;57(1):19-22.