Optimizing Labor Progress: evidence-based tips for a smoother birth

1. Move, Rock, and Change Positions

• I’ll be real — with my first son, labor was challenging. I wasn’t offered position changes other than lying on my back. Pushing felt awkward and exhausting, especially with my epidural. Research shows that upright and mobile positions can help labor progress: squatting, hands-and-knees, or walking encourages the baby to descend and makes contractions more effective.

• What You Can Do: Don’t be afraid to ask for movement options. Use a birth ball, lean over the bed, sway, kneel, or try gentle squats. Every shift helps your pelvis open and lets gravity do its job. With my second labor, I moved frequently and it made a huge difference.

(Source: Cochrane Review, 2017 — Upright vs supine positions for labor.)

2. Use Gravity to Your Advantage

• Gravity is a laboring mother’s BFF. Standing, sitting, or leaning forward can help the baby move down, shorten labor, and reduce intervention risk. Staying flat on your back may feel safe, but it can actually narrow the pelvis and slow labor.

• What You Can Do: Try hands-and-knees, leaning over the side of the bed or a partner, or supported squats. These positions can also relieve back labor — trust me, it’s a real thing.

3. Stay Hydrated and Energized

• Labor is marathon-level work. Light snacks (if your provider allows) and hydration help maintain energy, keep contractions strong, and prevent exhaustion. With my first, I barely had anything to eat or drink and it made pushing even harder.

• What You Can Do: Sip water, coconut water, or electrolyte drinks. Small snacks like dates or crackers can keep energy up. Think of it as giving your uterus a pep talk: “You got this, girl!”

(Source: ACOG Practice Bulletin, 2020 — Oral intake in low-risk labor.)

4. Consider Non-Pharmacologic Pain Relief

• Even with an epidural, small adjustments can help. Counter-pressure for back labor, warm compresses, showers, and breathing techniques make contractions more effective and help your body work naturally.

• What You Can Do: Ask your team for these options, even if you have an epidural. With my second labor, combining pain relief with counter-pressure and visualization made the experience much more manageable.

(Source: AWHONN, 2020 — Non-pharmacologic interventions for labor pain.)

5. Continuous Support Matters

• Having someone cheering you on, reminding you to move, hydrate, and breathe makes a big difference. Continuous support is linked to shorter labor, fewer interventions, and higher satisfaction.

• What You Can Do: Ask a partner, doula, or supportive nurse to be your labor coach. Even a gentle hand on your back or a quiet “you’re doing amazing” can boost oxytocin and keep contractions effective.

(Source: Cochrane Review, 2017 — Continuous support for women during childbirth.)

Final Thoughts

Optimizing labor progress isn’t about following a strict rulebook — it’s about giving your body the space, support, and tools it needs to do its job. Moving, upright positions, staying fueled, pain relief techniques, and continuous support make labor more effective and empowering.

Mom-to-mom humor: If I could go back, I’d tell my first-labor self: “Move around, try the weird leaning-on-the-bed position, and don’t worry — pushing might feel awkward, but you’ve got this!”

Every birth is unique, but with knowledge, preparation, and support, you can help your labor progress more smoothly — and feel empowered along the way.

With love and support,

Candace Stewart, RN, CLC, and Doula
Compass Doula & Lactation PLLC