Movement & Position in Labor — Evidence Library

What it is

Being free to walk, sway, kneel, or use tools like a birth ball during labor — versus staying in bed.

Evidence review links

Each link opens the full review on the publisher's site in a new tab.

Possible benefits

May help labor progressReview sources ↓
Many people report better coping with contractionsReview sources ↓
Upright positions may shorten the first stage in some studiesReview sources ↓

Possible risks

Limited if continuous monitoring or epidural restricts movementReview sources ↓
Some positions may be uncomfortable depending on circumstancesReview sources ↓

Alternatives

Bed-based positions with frequent changesReview sources ↓
Intermittent monitoring to allow movementReview sources ↓
Birthing ball, peanut ball, squat barReview sources ↓

Current evidence

Cochrane reviews and ACOG's physiologic-birth guidance support freedom of movement and frequent position changes when there is no medical reason to restrict mobility. Evidence Based Birth's birthing-position review separates first-stage movement, pushing positions, epidural-adapted positions, and upright options so users can match the evidence to their situation.

Where the evidence is clear · where people may choose differently

For most topics, guidelines from ACOG, WHO, and other major bodies broadly agree on the core safety points (when to act in an emergency, informed-consent standards, monitoring baselines). Where reasonable people — and even guidelines — differ tends to be around thresholds (when to start or stop something), preferences (comfort, environment, support), and values (how you weigh small risks against benefits). Use the questions below to explore those pieces with your care team.

Educational only. Your care team can help you weigh what applies to your specific situation.