The first stage of labor requires a significant physical transformation of the cervix, the lower, narrow part of the uterus. This process involves two distinct but related changes: dilation and effacement. Dilation is the opening of the cervix, measured from zero to ten centimeters, with ten centimeters marking full dilation for the baby to pass through. Effacement is the thinning and softening of the cervix, measured in percentages, and must reach 100% for a vaginal birth. These changes prepare the birth canal for the baby’s descent and accelerate once active contractions begin.
The Direct Answer: How Movement Affects Labor
Staying upright and engaging in movement like walking during labor encourages the progression of dilation. The primary benefit is mechanical, utilizing gravity to aid the birthing process. When vertical, gravity helps the baby move down into the pelvis. This downward movement allows the baby’s head to press directly against the cervix, creating the “wedge effect.” This pressure encourages the cervix to open and thin out more effectively with each contraction, and movement also helps the baby find the optimal position for navigating the pelvis.
Movement also plays a significant role in the hormonal environment of labor. Walking helps stimulate the natural production of oxytocin, the hormone that causes uterine contractions necessary for dilation. Consistent movement maintains a steady level of this hormone, leading to stronger, more efficient contractions. Physical activity also helps manage the body’s stress response by lowering adrenaline, which can slow labor by inhibiting oxytocin. Furthermore, movement stimulates the release of endorphins, contributing to a greater ability to cope with the intensity of contractions and potentially reducing the overall duration of the first stage of labor.
Practical Guidance for Walking During Labor
Walking is generally most beneficial during the early phase of labor, when contractions are manageable and spaced further apart. This allows the use of gravity without overtaxing reserves before active labor begins. The pace should be slow and steady, focusing on gentle, rhythmic movement rather than strenuous exercise.
It is beneficial to have a support person, such as a partner or doula, to walk with during contractions. This support provides comfort and stability, allowing the person in labor to relax into the movement. Taking short, focused walks, often around the room or a hallway, and resting in between is a better strategy than walking continuously until exhaustion.
Walking is not advisable if you are experiencing exhaustion, have been advised to remain in bed, or have medical complications like high blood pressure. If your water has broken and the baby is not yet engaged in the pelvis, walking may be restricted to prevent complications. If an epidural has been administered, walking may be impossible due to limited leg function and hospital policy, though some facilities may permit limited movement with a “walking epidural.”
Alternative Active Positions for Labor Progression
When walking becomes too tiring or is no longer an option, many other active positions can continue to promote labor progression by using gravity and pelvic movement. Regularly changing these active positions, ideally every 30 minutes, helps to keep the labor momentum going and encourages the baby’s continuous journey through the birth canal.
Effective Active Positions
- Swaying or slow dancing with a partner encourages a gentle, rhythmic motion that eases contraction discomfort and helps the baby descend by opening the pelvic outlet.
- Using a birthing ball allows the person in labor to remain upright while resting their legs; gentle hip circles or pelvic tilts encourage the baby to rotate and move lower.
- For asymmetrical opening of the pelvis, methods like lunging or walking sideways up a set of stairs can be attempted.
- The hands-and-knees position is useful if back pain is prominent, as it relieves pressure on the spine and can help a baby in a less optimal position rotate.
- For those who must remain in bed, lying on the side with a peanut-shaped ball between the knees can significantly widen the pelvic outlet.