The most effective positions in labor are those that allow you to lean forward, use gravity, and open the pelvis. It can be helpful to change positions frequently - every 20 to 30 minutes during labor. This may decrease your pain and help your labor to progress faster.

Often when a mom changes positions, her contractions will feel stronger, as the new position can help the body labour more efficiently. She may need extra support and reassurance as she adjusts to the more intense contractions.

To help the baby move down during the second (pushing) stage of labor, try positions which use gravity, lengthen the torso, relax the pelvic floor and keep the tail bone mobile.

Walking and standing are helpful in the first stage of labor as gravity helps your baby to move down. Backache may also be relieved and your contractions are often more regular. Since standing is tiring, you may find it more restful to lean forward over something or someone.

Sitting upright in the first and second stage uses gravity to improve your contractions and is a good resting position. However, it can worsen backache and hemorrhoids if you sit up too long. Leaning forward into your partner is a good position - you can have your back rubbed at the same time. Sitting on the toilet or a birthing stool helps widen the pelvic outlet during bearing down in the second stage.

Kneeling on all fours in the first and second stages is useful for short periods of time. It can take the pressure off hemorrhoids and can relieve backache, especially if you do the pelvic tilt in this position (see Part 1, Exercise).

Lying on your side in the first and second stages is a good resting position to alternate with walking. You can combine this position with a pelvic tilt to ease contractions, relieve backache and help you relax between contractions. Try pulling your knees up and placing a pillow between them.

Squatting in the first and second stage takes advantage of gravity and widens your pelvic  opening to help your baby move down. Squatting is not easy so if you plan to use this position during labor, start practicing early in your pregnancy to build up stamina.

Take this self assessment to help prepare yourself for coping with labor.