You do not need to be on your back.

From my own experience and talking with many birthing people, the position you choose during pushing can make a significant difference in comfort and outcomes. Lying flat on your back might seem natural because it’s common in hospital settings, but it actually compresses major blood vessels and narrows the pelvic opening. This can slow labor progress and even reduce oxygen supply to your baby. Many birthing parents find that using upright positions—such as squatting, kneeling, or standing—or side-lying positions during pushing helps them feel more empowered and supported. These positions take advantage of gravity, expand the pelvic outlet, and promote better fetal rotation, which can lead to a shorter pushing stage and less need for instrumental assistance like forceps or vacuum. Even if you have an epidural, you’re not limited to pushing on your back. With the right support and guidance, alternative positions can be used safely and comfortably. Personally, I’ve seen how encouraged movement during labor and varying pushing positions can improve both maternal satisfaction and birth outcomes. It’s important to communicate your preferences with your care team beforehand and have a birth plan that includes your desired positions. Advocating for yourself can help ensure that your labor aligns with your body’s natural design rather than just the convenience of the medical staff. Remember, your body deserves a birth position that works for you—and your baby.