It is well known among my followers and clients that I educate my clients about the importance of positioning in labor. Proper positioning facilitates easier delivery, avoids injury to hips/low back, reduces exacerbation of pains experienced in pregnancy, and protects the pelvic floor, but how do you the pregnant person or laboring person discuss positioning with your provider?

With good reason, communicating with your pregnancy provider can be challenging for many people during labor. During labor, you should be focusing on your body, not discussing your opinions and preferences with someone who may or may not agree with you. In fact, if possible you should not be discussing these preferences during your third trimester. Ideally, you should not be having this conversation during second trimester either. Ideally, this should be one of many questions asked in interview of your potential provider.

That’s right, if you want to be free to select a variety of positions during labor and delivery, then you should select a birth provider who believes in allowing freedom of movement during labor and delivery. Providers have their own thoughts and philosophies about how to manage and observe your labor. The more closely your views align with your providers, the easier these conversations will be.

What if it is too late?

Well, it is never too late. Your provider has been hired by you. While it may not seem extreme to some, it is important to note that you can fire your provider at any time in pregnancy, including during labor. The harder step is making sure you have another provider.

I know, you want to know how to work with your previously selected provider

So, what do you do if you have selected a provider, and then find out that person wants to limit your positions in labor and delivery. How do you communicate in late pregnancy or even in labor to get your provider on board.

It is hard!

That is why I recommend avoiding these conversations by choosing a provider you agree with. It makes the whole process smoother, but it is not always possible. Your best tool in communicating with a provider you do not wholeheartedly agree with is to hire a doula.

“If a doula were a drug, it would be unethical not to use it.” -Dr. Kennell

A doula will likely cost some money (although some locations have volunteer doula organizations available if cost is prohibitive for you). A good doula is worth every penny to ensure that you feel supported, empowered, and safe during your entire labor from beginning to end. A good doula helps you speak up for yourself about positions you want to utilize, interventions you want or do not want, and helps you find coping techniques that work in the moment. Without a doula, having an untrained support person who understands your preferences is helpful, but less effective. Your support person will never be equivalent to a professional doula with coursework in labor support, years of experience at many births, and a passion for supporting people in labor, but you may still decide this is the best choice for you.

In order for your support person to be as effective as possible, you should attend a childbirth education class together. Attending a good childbirth education class will help your support person learn to be as effective as possible. The class can really help to inform you of your options in labor so that you can form your preferences and communicate those to your support person. Childbirth education classes also help to improve your communication in labor, teach them techniques to help you cope, and generally makes sure that you are on the same page. A good childbirth education class willnot cover how your provider “likes to do things”, hospital preferences about providing or not providing interventions, or the check in process. A good childbirth education class will go over stages of labor, positions to cope with pain, risks and benefits of possible interventions, and questions to ask your provider about any suggested intervention for augmentation or induction.

To review, if you want to have freedom to move through your labor (or to be free to labor your way):

1. Choose a provider who supports your preference to move (or labor your way)

2. Hire a doula to help you speak up and communicate effectively

3. Make sure your support person receives training from a good childbirth education class

I hope this helps you ensure you have a labor and birth you want. Good luck!