natural birth

Positions for Birth, Part 3

"Hands & Knees" 


Hands and knees is a great position for labor that allows for open hips and pelvis, and can also be a highly effective position for pushing. If you experience significant back pain in labor it’s likely you will find a lot of relief on your hands and knees. It’s thought that significant back pain in labor can be the result of a mal-positioned or posterior baby. Hands and knees may be suggested if labor is stalling. You might not find it comfortable at first (or at all); try to give it a few contractions for your body to adjust – it might be what your labor needs to take the next turn.  


The most important thing is that you get comfortable. You might be on your knees for a while if you find your groove in this position, so make sure to set yourself up with cushioning under your knees and a comfortable place to rest between contractions. If you have an exercise ball you can try draping yourself with your arms over top and room for your belly. Lay a blanket over top if you find the ball uncomfortable and keep a glass of water with a straw nearby to stay hydrated. The ball allows you to rock through contractions comfortably and makes a nice resting place in between. A couch or hospital bed moved to a comfortable level also make a good place to anchor yourself and rest in between.


Keep your hips wide for hands and knees. The rocking motion of the birthing ball can be beneficial to encourage baby to descend into your pelvis. Through contractions try to drop your arms and shoulders into the ball or bed and relax your bottom to bring baby down and open your cervix (as much as you can – this can be easier said than done! Your doula will encourage and remind you of this.) Having your partner or doula use counter-pressure or the double hip squeeze can help relieve the pressure you may feel in your back through contractions.

Listen to your body. If you are feeling uncomfortable, find a new position. You are the most in tune with what your body needs to go through labor and birth your baby – don’t ignore it! 

Is A Doula Like A Midwife? ...and other FAQ's

I'll never forget my introduction to the word doula...

I went to visit a friend in the hospital after her long a difficult labour, and she introduced me to her doula. 

Her what???

She raved about this woman standing next to her, telling me all about the massages she gave in labour and the way she'd supported her through a very challenging birth. 

I left that day thinking a doula was a woman trained to give great massages in birth, and while that's certainly something that we do, there are so many other unanswered questions that have left many people a bit confused as to what it is we do. Allow us to clear up some of those wonderings by answering some of the most frequently asked questions:


Is a doula like a midwife?

Midwives are medically trained professionals who provide prenatal, birth, and postpartum care to women. Midwives often have hospital privileges, and like doulas offer care for both home and hospital birth. I don't know a midwife who hasn't gone into the profession with a passion and empathy for caring for women through pregnant and labour, but their primary role in birth is to ensure the safety of mother and baby, and this often requires a lot of their attention. 

A doula differs from a midwife in that she is not medically trained, but rather trained and experienced to provide physical and emotional support, with a knowledge of comfort techniques and the sole focus of attuning to your needs in labor.  Her priority is to hold the space for an environment that supports you in a way that the medical professionals caring for you often can't. While nurses, midwives and GP's care about their patients, the job they are doing is important and your safety is their number one priority. While a doula understands and can help you navigate the unfolding of your birth, she doesn't carry the responsibility of the medical components of birth; her eyes are on you as she intuitively responds to your needs, making you as comfortable and cared for as possible.


Are doulas trained to offer prenatal or childbirth advice?

A doula can and certainly does share information regarding pregnancy and birth. It’s important that any information she gives you or suggestions that may be made throughout your pregnancy, are reviewed and considered by your primary caregiver – your doctor, OBGYN or midwife. Doulas are not medically trained and do not (should not) claim to have the expertise to offer any sort of medical advice or perform any medical procedures including using a doppler for fetal monitoring, vaginal exams, or external palpitation to suggest babies positioning.  


What kind of training or certification is required for doulas?

The doula industry is not currently a government regulated industry, but there are definitely standards of professionalism that most doulas adhere to. Our doulas have taken a minimum of a  20 hour, in person workshop, and while pursuing certification, are required to complete a comprehensive exam, hands-on labour support, numerous client evaluations, and continual professional development to maintain certification. 


Can I access a doula for free? 

We believe that your doula holds immense value. While this work is extremely rewarding and it is an incredible honor to be welcomed as a support into a birth space, it is a line of work that requires huge commitment to being on call for weeks or months on end, meeting and conversing prenatally and postpartum, and providing continuous labour support, and our rates reflect that value. Maintaining certification usually requires annual fees and attending workshops and seminars. It is essential in this profession to continually keep up to date on new information and we want to give our clients our best through a personal commitment to learning and expanding our knowledge every day. We make payment plans available for our clients, and have a limited bursary fund for those who qualify for a reduced-fee for support. 


Won't a doula replace the role of my partner?

Not at all! Doula’s love birth partners and our priority is to help you both have the birth you imagine. We are there to support both the mother and her partner, because let’s face it, birth can leave you both exhausted, perplexed and out of sorts. We are experts in supporting women in labour and your partner is the expert on you; together we join forces and make a team that brings out the best in everyone. For the hands on partner, we can offer up suggestions for him to give you comfort and support while we meet your needs from another angle. Some partners will find birth emotionally overwhelming, physically exhausting, and others may lean on the side of squeamish. Having another trained support person there means the partner can be as involved as they can or want to be, while resting assured that your needs will be met to the fullest. We get to make sure you’re both fed and hydrated, that you find your voice to express your needs and desires in birth, and that you both feel confident and cared for going from start to finish.


Are doulas just for homebirth and unmedicated birth?

Doulas believe that birth is deeply personal. We have no preference for your birth place, nor do we hold any opinion on way you choose to bring life into this world. It is our greatest goal to offer support for all families, compassionately, without judgement or bias. We attend homebirths, hospital births and water births. We support women with epidurals and women who choose to manage their pain without intervention. While we believe information is essential to any decision through pregnancy and birth, we support you in every choice along the way because we believe that you know yourself better than anyone else!


Still wondering about what we do? Email us your questions or book a free consultation; we love to get to know new families to share about the work we do and how we could make your birth experience brighter.