Active Birth – why is it better?

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In my last Active Birth Workshop, I was asked this question.
Actually, it was a father to be, wanting the best for the birth of their baby, who asked this question so thank you Thomas.

Why should I have an Active Birth?

For several decades I have been teaching couples the benefits of an Active Birth along with all the practical guidance they need, to understand how it works and to compare different upright positions such as walking standing, sitting, squatting and kneeling during labour and birth. In the UK these days, you are likely to find custom designed birth centres and midwives who will support mothers in this, provided labour is normal and progressing well. This is wonderful because you can then follow your instinctual feelings, move freely and enjoy the environment and encouragement you need for an Active Birth.

You have a right to choose the positions most comfortable for you during labour and when giving birth and should be supported to do so. This is because there is now a body of research evidence highlighting and confirming the benefits.

Upright positions, especially when leaning slightly forward. are beneficial to labouring women because:

  • They engage the help of gravity – which assists the baby’s descent into and through the pelvis and the efficiency of uterine contractions.
  • They allow mobility of the sacrum, and this helps to make more internal space in the pelvis and to open the pelvic outlet from back to front (its widest diameter).
  • They do not compress the blood flow to the uterus from the aorta – the body’s main blood vessel. This means more oxygen to the baby AND more oxytocin carried to the uterus in the blood stream, so better contractibility.
  • They lower pain levels due to the above and to the uterus being able to tilt forward during contraction without resistance.
  • There is less need for interventions and fewer emergency Caesarean Sections
  • Being upright usually leads to a more positive and empowering birth

What is the Evidence?

This subject has been well researched and evidence has been available for several decades – please refer to the Active Birth Manifesto, which I wrote in 1981 and the list of research evidence at the end as well as my book New Active Birth (Amazon)

Research over the decades including more recently, re-confirms this to be true. The website ‘Evidence Based Birth’ https://evidencebasedbirth.com in the section on upright birthing positions lists many reliable studies and trials confirming the benefits.

For example, take a look at a 2020 review and meta-analysis* which combined the results of 12 randomised controlled trials. In the second stage more than 4300 women who had not had epidurals participated. Those who were selected randomly to be in the upright group were:
Less likely to have an assisted birth with ventouse or forceps
To have a shorter birthing phase (second stage)
Less likely to have a severe tear
No increased risk of postpartum haemorrhage

*Zang. Y.,Lu,H.Zhao, Y.,et al.2020. Effects of flexible sacrum positions during the second stage of labour on maternal and neonatal outcomes: A systematic review and meta-analysis” J Clin Nurs 29(17-18):3154-3169

You can also check out my film:

Active Birth – “Your Guide to Mother Nature’s Plan” available at www.activebirthfilm.com

And even better come to one of my Active Birth Workshops. Learn more at www.activebirthcentre.com

I wish you all the very best for your birth,

“My wife and I attended Janet’s two day course a few months before delivering our baby. It was fantastic in every way. As a partner I’m really interested in ways that I can actually be useful and helpful during this wild process. It felt empowering to know when to stay out of the way, and when you can assist your partner. Plus it was really fun to geek out on physiology and anatomy. I won’t spoil any of what you learn but it’s fascinating and instructional at the same time.!!!! every bit of 5 stars.”
A recent Google review!”


Active Birth is designed for mothers who wish to give birth naturally and have had a healthy pregnancy and no medical complications during labour and birth. Aspects of an Active Birth can also sometimes be used in combination with medical interventions. The website and newsletters offer general information only. They are not a substitute for the professional advice, diagnosis or treatment offered by your midwives or doctors. The Active Birth Centre/ Janet Balaskas in general, accept no liability for the guidance herein, and advise that you do not disregard professional medical advice and inform yourself with other trusted evidence-based sources of information when making your decisions.

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