Staying upright, moving your body, and keeping yourself calm during contractions are the most effective things you can do to help labor progress. A Cochrane review of multiple trials found that upright positions during the first stage of labor shortened it by an average of about 1 hour and 20 minutes compared to lying in bed. No single trick will dramatically accelerate labor, but combining movement, positioning, and relaxation works with your body’s natural mechanics to keep things moving.
Why Upright Positions Make a Difference
When you stand, sway, sit on a birth ball, or lean forward during contractions, gravity helps your baby descend into the pelvis. But gravity is only part of the story. Upright and forward-leaning positions widen the pelvic outlet, which reduces the chance of labor stalling. Your baby’s head presses more evenly against the cervix, and that steady pressure signals your body to release more oxytocin, the hormone that drives contractions.
Contractions themselves tend to be stronger and more efficient at dilating the cervix when you’re upright. Being vertical also improves blood flow to your uterus and your baby. In the second stage (pushing), upright positions shaved about 6 minutes off pushing time in trials, a modest but real effect, and were associated with higher rates of spontaneous vaginal birth.
Positions to try during contractions include standing and leaning over a counter or your partner’s shoulders, sitting upright on a birth ball and circling your hips, kneeling with your arms draped over a raised bed, or slow dancing with a support person. The common thread is keeping your torso upright or slightly forward and letting your pelvis stay mobile.
Movement Between and During Contractions
Walking during labor is one of the most commonly recommended activities, but the evidence is more nuanced than you might expect. A large randomized trial of over 1,000 women found that walking during the first stage of labor neither sped it up nor slowed it down compared to laboring in bed. The first stage lasted about 6 hours on average in both groups.
That doesn’t mean movement is useless. Walking is just one form of movement, and the real benefit comes from asymmetrical, hip-opening motions rather than simply putting one foot in front of the other. Lunging to one side during a contraction, walking up stairs sideways, stepping one foot up on a curb or stool, and swaying your hips in a figure-eight pattern all create uneven pressure in the pelvis that can help a baby rotate into a better position. These movements are especially useful if labor has slowed because the baby’s head isn’t lined up well with the cervix.
The Miles Circuit
If labor stalls or contractions space out, the Miles Circuit is a three-position sequence designed to encourage the baby to shift into a more favorable position. First, you get into an open-knee child’s pose with your chest low and your hips high, which creates space in the upper pelvis. Next, you lie on your side with your top leg propped as high as possible on pillows and your bottom leg straight, holding this for about 30 minutes. Finally, you get up and do asymmetrical movement: lunges, sideways stair climbing, or curb walking. Many labor nurses and doulas use this sequence when progress slows, though formal studies on its success rate are limited.
Low Sounds and Open-Mouth Breathing
The sounds you make during contractions can affect how your body responds. Intentional vocalization, producing low, open-throated sounds like “ahhhh” or “ohhh” or deep humming, relaxes the muscles of your mouth, jaw, and throat. Those muscles are neurologically connected to your pelvic floor. Relaxing the top end helps relax the bottom end.
This open-glottis technique (breathing out through an open throat rather than holding your breath and bearing down) is recommended by the World Health Organization for the pushing stage specifically. Studies have linked it to a shorter second stage, less pelvic floor injury, and reduced fetal distress compared to the traditional “hold your breath and push” approach. During earlier labor, low vocalizing gives you something to do with each contraction that doubles as pain management and muscular relaxation.
The practical version: when a contraction peaks, drop your jaw, keep your shoulders low, and let out a deep, steady sound. High-pitched or tight sounds tend to signal tension. If your voice creeps up, consciously bring it back down.
Keeping Stress Low to Keep Oxytocin High
Your body runs labor on oxytocin. Stress hormones directly oppose it. When cortisol and adrenaline spike, they suppress oxytocin release, and contractions can space out or weaken. This isn’t a vague mind-body idea; it’s a well-documented hormonal feedback loop. The higher the activity in your stress system, the lower the oxytocin-driven effects that keep labor progressing.
This means the environment around you during contractions matters as much as what you physically do. Dim lighting, quiet voices, warmth, familiar smells, and feeling safe all support oxytocin release. Having a continuous support person (a partner, doula, or trusted friend) has one of the strongest associations with shorter labor of any non-medical intervention.
Touch and massage are particularly effective. Research shows that gentle, repetitive touch on the abdomen, back, or legs increases both circulating and brain levels of oxytocin. Warm compresses on the lower back or belly during contractions serve double duty: pain relief and hormonal support. Signs that your oxytocin-stress balance is working well include regular contractions paired with deep sighs, rhythmic swaying, and a sense of being “in the zone” between peaks.
Warm Water Immersion
Getting into a warm tub or shower during the first stage of labor is associated with shorter labor and less need for epidural pain relief. The American College of Obstetricians and Gynecologists recognizes water immersion as a reasonable option for healthy pregnancies between 37 and 42 weeks. The warmth relaxes tense muscles, lowers stress hormones, and makes it easier to find comfortable positions.
Most birth centers and many hospitals have tubs available. If a tub isn’t an option, a shower aimed at your lower back during contractions provides similar pain relief, though the effect on labor length is less studied. The ideal time to get in the water is during active labor (typically after 6 centimeters of dilation). Getting in too early, before contractions are well established, can sometimes slow things down.
Eating and Drinking
Labor is a physical endurance event, and your uterus needs fuel. Randomized trials show no difference in labor outcomes between women who ate during labor and those restricted to water only, which means eating doesn’t speed labor up. But it also doesn’t cause problems, and running out of energy can make contractions feel harder to cope with, which feeds the stress-tension cycle that slows progress. Light, easily digested foods like toast, fruit, broth, or honey sticks keep your energy up. Staying well hydrated is equally important, since dehydration can contribute to inefficient contractions.
Peanut Balls With an Epidural
If you have an epidural and can’t move freely, a peanut-shaped exercise ball placed between your legs while lying on your side can help. A randomized controlled trial found that first-time mothers who used a peanut ball during induced labor with an epidural had a significantly shorter first stage compared to those who didn’t. The effect was less pronounced for women who had given birth before. The ball keeps your pelvis open and asymmetrical even when you can’t stand or walk, mimicking some of the benefits of upright positioning.
Changing sides every 30 minutes or so with the peanut ball, and alternating between a side-lying position and a throne-like seated position when the bed allows it, keeps things shifting. Even small position changes with an epidural prevent the baby from settling into one spot without making progress.
What Actually Stalls Labor
Understanding what slows labor down is just as useful as knowing what speeds it up. The most common culprits are lying flat on your back for long periods, tension and fear that spike stress hormones, dehydration, and a baby whose head is tilted or facing forward (toward your belly) instead of toward your spine. Many of the techniques above address more than one of these factors at the same time. Upright positions use gravity and open the pelvis. Relaxation techniques lower cortisol. Asymmetrical movements encourage the baby to rotate.
Labor also has a natural rhythm that isn’t always linear. It’s common for contractions to slow down during the transition between early and active labor, or to space out briefly before the urge to push begins. A temporary plateau doesn’t always mean something is wrong. Consistent, patient use of movement and positioning through these slower phases is more effective than anxiously trying to force progress.