Having a baby is an extremely precious moment, but it’s not always easy. Shoulder dystocia is one such condition where your baby's shoulder gets lodged behind your pelvic bone while the head already comes out.
It might be scary, but understanding how your birthing position impacts the risk can be a game-changer. Selecting the right one can help widen your pelvis, utilise gravity to assist you, and provide your baby with sufficient room to move safely through the birth canal.
Let's explore how it works and which positions are best to avoid to minimise the risk of shoulder dystocia.
What Does Shoulder Dystocia Mean & How Does It Occur?Shoulder dystocia happens in about 0.2% to 3% of normal deliveries. It’s because one of the baby's shoulders gets lodged behind the pelvic bone of the mother while the head emerges. This can momentarily stall your labour.
Things which might cause it:
- A large baby, usually over 4 kgs
- If you’ve diabetes during pregnancy or have had it before
- A long or difficult labour
- Past delivery with shoulder dystocia
- Use of instruments like a vacuum or forceps
- Lying flat during childbirth narrows the pelvic passage
How Do Birth Positions Affect Shoulder Movement?Your pelvis isn't a fixed bone structure; it can expand and tilt slightly during childbirth. The position you maintain during labour determines how much room your baby gets to move through the birth canal.
For instance, lying flat on your back limits your pelvis's ability to open. In contrast, upright or forward-lining positions are beneficial because they:
- Make room in your pelvis
- Let gravity help move your baby downwards
- Make contractions more effective
- Get the baby into a good position for birth
Which Birth Positions Can Help Avoid Shoulder Dystocia?
1. All-Fours (Hands & Knees) PositionThis position can be particularly beneficial if shoulder dystocia occurs unexpectedly. It shifts your weight forward, creating space around your pelvis.
What does it do?
- Moves your pelvis forward, creating space for the birth canal
- Helps get the baby's shoulders out with the help of gravity
- Eases lower back pain
2. Squatting PositionSquatting is one of the most natural positions for birthing. It helps the baby descend by using gravity. It also expands your pelvic area by up to 20% to 30%.
How it helps:
- Makes enough room in the pelvis
- Strengthens pushing power on its own
- Promotes better alignment of the baby's head and shoulders
3. Position of Side-LyingAlso referred to as the lateral position, lying on your side helps you feel relaxed and lets your assistant easily access support labour.
What does it do?
- Maintains a stable blood circulation and oxygen level
- Eases pain in your back and pelvic joints
- Eases pressure and allows gentle pelvic movement
4. Kneel or Forward LeaningYour pelvis can tilt freely when you kneel or lean forward, taking support from a bed, a birthing ball, or your birth companion.
What does it do?
- Uses gravity to give birth
- Widens the tailbone or sacrum area
- Reduces strain on your lower spine
5. McRoberts' PositionWhen shoulder dystocia occurs unexpectedly, doctors often use the McRoberts manoeuvre position. You lie on your back in this posture, with your knees drawn towards your chest.
How it helps:
- Helps to tilt your pelvis by straightening your lower back
- It gets the baby’s shoulders in the right spot for a smooth delivery
When Should You Call Your Doctor?It's good to be aware of the risks beforehand, particularly if:
- You have diabetes during pregnancy or have had a large baby in the past
- You’re pregnant with a baby weighing more than 4 kg
- Had shoulder dystocia in the past delivery
- Have back issues or limited pelvic movement
Your doctor might recommend specific birthing positions or a birthing plan that prioritises pelvic movement and flexibility.
What Steps to Follow Further?
- During your prenatal visits, talk about what birth positions you’d prefer
- If your doctor says it’s okay, try squatting or some easy pelvic tilts
- Attend antenatal or Lamaze classes to pick up some movement tips
- Maintain your body's hydration and activity levels to ensure a smooth childbirth
- Ask your assistant or partner to help change postures
Emotional & Social Things to ConsiderYour life can be filled with excitement and nervousness to welcome a new life into the world. Recognising what your body is capable of doing can help you stay calm and prepared.
Cheer your partner to join you; their support and presence can help boost your confidence. When you’re in labour, try visualising peaceful scenes, practice breathing exercises, and have your loved ones around for support, as these will help you stay calm and focused.
Finding the best position for birth can lessen the likelihood of shoulder issues and make the process of giving birth safe. If you listen to your doctor, stay active, and talk about what you want with your healthcare team, you’re basically giving yourself and your baby the best ways to have a safe childbirth. Every bit of effort during labour helps your body function naturally and welcomes the baby.
Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.
FAQs on What Birth Positions Can Help Reduce the Risk of Shoulder Dystocia
Can I pick my preferred birth position in the hospital?
Yes, usually. So that you know, some positions might not work if you’re under serious observation or have an epidural. Be sure to discuss the positions you’re comfortable with with your medical team.
Can shoulder dystocia happen by lying flat?
Lying flat increases the likelihood of shoulder dystocia since it doesn’t provide your pelvis with as much space. Squatting, upright, or side-lying positions usually help create more space for your baby to descend through the birth canal.
Can working out when you’re pregnant lower the risk?
Yes. Pelvic tilts, squats, and walking-like activities during pregnancy also help increase your flexibility and improve your ability to move your pelvis more effectively.
