3 Tips to Using Movement During Labor WITH an Epidural

I am a huge fan of movement during birth. In fact, it’s one of my 3 proven secrets. However, you may feel, with an epidural, that you can’t use movement to your benefit — but that’s not true at all. Today I’m going to share 3 easy tips to using movement during labor even with an epidural that you can use in YOUR birth.

Before we get going, I want to remind you that there are a LOT of tips that help make your labor better. This one holds the tips you need from bump to bassinet.

A Note on Movement With an Epidural

Every now and then I run across someone on social media talking about how you can still squat with an epidural… or even get out of bed. I want to be clear that at probably 95% of facilities they do NOT want you to get out of the bed with the epidural.

In fact, they will likely turn off the epidural and they find you out of bed…. It’s too much liability for them to keep running medication that’s meant to make you numb. If you want to know more about varying the amount of epidural you have going in — check out my post on the walking epidural.

I am a huge fan of having a bit less epidural medication to make sure you can incorporate movement more. I juts don’t want you to think that it’s going to look the same as someone who doesn’t have an epidural.

The Good News? Movement doesn’t really have to be squats or standing — even small movements, and changes in your pelvis can make big changes in how baby descends.

Want to know more about movement in labor– check out these posts:

• 3 Proven Labor Secrets You Don’t Want to Labor Without!
• YOUR Birth Priorities: How to make them clear
• Advocating For Yourself in Labor

Ok, let’s jump into my three tips:

Use the Bed

That labor bed has a lot of good options that can help you move your body into a variety of ways.

• The head can go up and down
• Side Rails can be used to prop pillows/balls on them
• Foot Pedals / stirrups can be used to place legs on
• Handles can be used to hold onto or prop supplies on (see more below)
• The bottom of the bed can move down
• Most hospitals have a “squat” bar that fits into the bottom of the bed

For instance, sometimes I’ll have the patient (with an epidural) sitting on the edge of the bed with the bottom of the bed down with her feet on it. I also have the squat bar set up that she can hold onto with her arms and make sure she’s steady on her bed.

It’s really close to a squat position. It’s definitely opening your hips in a similar way. But, it’s safe with an epidural!

Don’t forget to use the bed like origami — let it help you achieve the positions you want. That can be really helpful when you….

Add Supplies

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There’s lots of other “supplies” in the room which I have used to get patients into great labor positions.

My first couple of hospitals did NOT have peanut balls, so we often used other things in the room to achieve this. Judge away, it’s fine. I cleaned all the items before we used them….

Things I have used:

• Step Stools
• Doctor’s stool (usually at the bedside to put a foot on wtih something behind it to make sure it doesn’t move)
• The garbage (no jokes here)
• Pillows. Tons, and tons of pillows. and blankets — think princess and the pea. 🙂

Most hospitals now have a couple of things that are awesome to use as well (you can also bring your own if you’d like).

• Birthing ball (or yoga ball as the rest of the world calls it)
• Peanut ball (looks just like a peanut) – usually in varying sizes

Here is the big secret, are you ready for it:

Nurses are QUEENS at McGuyvering it. If you feel like you want to be in a specific position, talk to them about it.

Let’s say you want to do hands and knees…. but those legs are still pretty numb.

Nurses can use supplies to get you safely into that position.

I’ve used the peanut ball between their legs, with the indent allowing their belly to rest in that with their upper body resting on an inclined back of the bed.

Now, I want to be really clear that position is NOT comfortable for long. Your hips really start to feel painfully unstable after about 5 contractions, but the good news is that moving into that position for 20 minutes can really make a big difference!

SO, when your nurse is using other stuff in the room to help position you, don’t freak out. We’re doing that for your safety and comfort, it just may not always feel that way.

Understanding more about how the hospitals and nurses work can be a HUGE advantage as you go in for labor. I recommend this for learning more about it!

Partner Help

This is a HUGE tip for partners, and movement in general. If your partner is a willing participant in helping you to move it can make a BIG difference.

Reality: when you have an epidural, you’re heavy. As an RN when we’re hoisting human bodies and moving you for you it can really place a toll on our bodies (especially our backs). We usually try to get another nurses in there to help us to prevent us (and you) from getting hurt, but sometimes that’s not possible.

SO, when a partner is willing it helps a lot. And honestly — they feel a lot more engaged in the whole process when they ARE able to help out. Many really do want to do something — so this is something they can help with! If your partner wants more tips — I recommend this!

You don’t need previous experience. Moving people is very similar to moving other items, and shoving pillows in the right place is something every adult can do.

Also, if you do the big work, the nurse can fix the details after the big work is done.

So, having a willing partner who asks “how can I help” is one of the BIGGEST things you can do to move more during your labor.

I see some people online frustrated that their partner or family needed to help. In this instance, it’s not “necessary” — you’re safe without it. BUT when they are willing and able it can help a lot!

So, those are my three biggest tips for using movement when you have an epidural, but I do have one more…

Bonus Tips: Small Movements

Don’t feel like you have to do GIANT movements like hands and knees. Often we can get similar effects by using the birth ball or a large peanut ball and rotating you from side to side without the issues with your hips.

Even just being fully on your side, and then turning to more of a “tilt” can make a difference.

SO, don’t feel like it has to be big – small changes (even with the angle of your knees/hips) can help!

What About Sleep?

Great question. One of the BIGGEST benefits of an epidural is that it allows you to sleep as your baby descends into the birth canal.

I 100% recommend sleep. If you truly CAN sleep I think it’s one of the most productive things you can do. It helps your body relax and that includes your pelvis.

BUT in those spots where you wake-up (because hello — blood pressure cuff, and the nurse will still be in frequently) ask to turn. And again — you don’t need giant movements.

One of my favorite circuits to put patients through is left sims (that means all the way to your side almost onto your belly with your top leg up at a 90 degree angle), right sims, and Buddha (same pose as the guy). I can still let you sleep in Buddha but putting pillows next to the side rail to rest your head on.

So, if you CAN sleep do it. but if you’re not asleep I really want you moving at least every 30 minutes, if not more frequently (but I do think you want at least 5 contractions in every position).

What if you hate a position?

I will say that sometimes I put people in position and they are not fans initially. I always encourage them to try to make it at least 3 contractions in it.

Pro Tip: Sometimes a vaginal exam can really help us know what position might help baby descend better (not always, but sometimes). Be sure to get your nurse’s thoughts on what position they think would be best. They’re a wealth of info, but often don’t want to shove their opinion on you.

Of course, if they are suddenly feeling a lot of pressure I’ll check their cervix to see they’re ready to have a baby. I will say that is the goal of these positions — to get that baby into the birth canal, and make labor faster.

The other thing to consider is if your epidural is still working. If you are suddenly feeling contraction pain I would recommend my post on what to do if your epidural isn’t working (but the cliff notes is to have anesthesia come check you).

I will say that so many people think they’ll get an epidural and then labor will be sunshine and roses an that just isn’t the case. You may need to troubleshoot the epidural, you need to keep moving and there may be increased interventions you’ll need to understand with an epidural (like an IV bolus, increased turning etc).

We’ve talked a lot about how your family and nurse will help you in this process, but understanding the basics of birth is your job in this one. The best way to do that is to take a high quality birth class.

I recommend The Online Prenatal Class for Couples it:

• Takes just a few hours — so you don’t have to devote your life to it.
• Is taught by an expert — so you’re not missing anything important
• Is meant to help your partner — so you get a teammate, not just a cheerleader (including how they can help more during labor instead of just turning you).

Want to do a vibe check before diving into the whole thing with me? — check out my free labor pro tips. It’s your first step toward getting in the driver’s seat of your birth.