Written and reviewed by Amelia Hill, BNutrSc 

Pregnancy, birth and the early postpartum period ask a lot of a women’s body. The way you move, rest and position yourself can play an important role in how you feel along the way. From managing pelvic discomfort and preparing your body for labour to finding comfortable positions during birth and feeding a newborn, small changes to the way you move can make everyday tasks feel more manageable. But with so much advice online about pregnancy mobility, baby positioning and the “best” positions for labour, it can be difficult to know what actually matters, or where you should begin.

We asked Susanna, a doula, prenatal movement educator, personal trainer and certified Body Ready Method (BRM) and Optimal Maternal Positioning (OMP) practitioner, to answer some common questions about movement and positioning during pregnancy, labour and the early postpartum period. Drawing on her professional experience as well as her personal experience as a mother of two, Susanna shares practical ways to work with your body, prepare for labour and stay comfortable feeding through the early days. 

About Susanna

My name is Susanna Alvarado, I’m a doula, prenatal movement educator and founder of The Birth Suite. I spent over 20 years as a personal trainer, competed as a national-level athlete, and am certified in, Body Ready Method and Optimal Maternal Positioning, I’ve also attended a Spinning Babies Workshop. Bottle feeding has been a big part of my own journey. I’m a mum of two and my son has been on LittleOak pretty much his whole life, while my daughter was on it for a lot of hers too. When you're feeding around the clock, having a formula that sits well with your little one makes such a difference to how those feeds feel, for both of you. It's one less thing to worry about, and in those early weeks, that's everything.

What is Optimal Maternal Positioning, and can posture help with pelvic pain during pregnancy?

BY definition 

Optimal Maternal Positioning (OMP) 

“Optimal Maternal Positioning (OMP) is an evidence-informed approach to maternal positioning during pregnancy, labour, and postpartum. It focuses on comfort, safety, and supporting the body’s natural mechanics to promote smoother births and faster recovery. OMP is designed for parents, birth professionals, and anyone preparing for birth, managing pregnancy discomfort, or looking to recover faster postpartum. The guidance is step-by-step, practical, and easy to follow, whether you’re new to positioning techniques or a seasoned practitioner. OMP is safe and adaptable for home practice during pregnancy and postpartum, and it is also suitable for clinical settings or client guidance”.

OMP is getting a lot of attention at the moment, and , for the most part, I think for good reason. But birth isn’t about finding one perfect position. From my own experience and my work in the birth space, it often matters less about one single position and more about your individual movement patterns and posture throughout pregnancy and labour. 

I believe learning how you use your body day to day, and how that gives your baby space is crucial for a Mum to be. Your pelvis isn't a fixed bowl. It's a set of joints that move, and the muscles, ligaments and soft tissue around it all influence how much room there is or that we can create. 
We don’t move the way we used to when we spent our days hunting and gathering. For many of us, we might spend hours slumped back on the couch, sitting in the car, or standing with all our weight hanging into one hip. Over time, some of those muscles can get shortened while others get weaker. That can contribute to pelvic pain, lower back/SIJ pain or pubic bone pain, and sometimes it might mean that your baby has a little bit less room to wriggle into a good spot and make the most efficient decent through the pelvis.

Posture can play a big role in both your comfort during pregnancy and how your baby positions themselves for birth.

Simple posture tips for a more comfortable birth:

• Sit with your hips a little higher than your knees: Try sitting on a fitball or adding a cushion to your chair.
• Lean forward rather than reclining: Lean forward over the kitchen bench or the back of the couch to encourage a more upright position.
• Be mindful of how you stand: For example, noticing which hip you always stand on, and trying to distribute the load where you can.

The research on how maternal positioning affects labour outcomes is still emerging. And while that doesn’t make it useless,  I just mean it’s not necessarily a magic trick. What I see time and time again is that women who move more tend to feel better, know their bodies better, and walk into labour with a lot more confidence. That confidence and trust in your body is worth its weight in gold. 

When should I start mobility and birth preparation exercises during pregnancy? Is it ever too early? 

No, absolutely not. I see birth preparation as something that can be woven into our everyday lives.  
 

Coming from a sports background, I know that preparation takes time. We wouldn’t expect an athlete to start training three weeks out from the biggest event of their life. Labour is a physical event, and it deserves preparation, time, and respect. 

As long as your care provider is happy and you're feeling okay, gentle mobility can start as early as possible. In the first trimester that might be walking, doing some hip circles on the fitball, and simply breathing down into your belly and pelvic floor on the days you feel rubbish. The second trimester is usually when women feel their best, and it's a beautiful time to build strength and control throughout your range of motion. In the third trimester we lean more into giving baby room and practising the positions you'll use in labour. 

Many resources suggest moving from the 36-week mark. I understand where this comes from, particularly when it comes to getting baby into a great position, which matters later in pregnancy. But our bodies aren’t switches we simply flick on at 36 weeks. Women who start building mobility and strength earlier in pregnancy often find that they move more comfortably, which can help a great deal when preparing for birth.  

Can sleeping positions affect my baby’s position during pregnancy? 

You spend around a third of your life in bed, so I think it's worth setting yourself up well. Generally, I’d suggest placing a pillow between your knees and ankles to stop your leg from dropping down and twisting your pelvis. Tuck another pillow under your belly for support, comfort and alignment. This can be a great way to give your body some support, particularly when we might not get that alignment in a standing posture. Many of my clients also love a slight forward lean with their top knee resting on a big pillow in front of them. 

Are there any positions I should avoid? 

 I'm not one for banning things outright. I don't want anyone scared to sit on their own couch. It’s more about thinking about the positions we spend the most time in, rather than worrying about any one position being wrong. For example, if you love to slump back in a deep couch or recliner at the end of the day, that’s absolutely fine. It’s more about finding a little balance and variety throughout the day, where you can, and giving yourself opportunities to move and change positions.  

What are the best positions for labour and birth? Which are your favourites, which do you tend to avoid, and why do so many women give birth lying on their backs?  

My short answer? Upright, forward and free to move.  

Labour isn't a stand-still event. Your baby is rotating and moving down through your pelvis, and your pelvis wants to change shape to make room. Upright and forward-leaning positions can work with gravity and let your sacrum and tailbone move back and out of the way. This could look like leaning over the bed or the bench, kneeling over a fitball, being on your hands and knees, swaying in your partner's arms, lunging with one foot up on a chair, or even sitting on the toilet (seriously underrated in my opinion). When you need a rest, side-lying with a peanut ball between your knees can be great. It’s important to note that there’s no one position that suits everyone. It depends on the mum, her history, her posture, her lifestyle and movement patters and where she is in labour.  

My favourite is what I call the Bench Lean Jiggle. I leaned over a bench, in my case, the bathroom basin, and swayed, jiggled and rocked through most of my three-hour labour. I find that it takes pressure off your back and opens up the middle of the pelvis. Many women tend to find their way into a similar position when they have the freedom to follow what feels good in their body.  

My least favourite is lying flat on your back as the automatic default--not because it’s wrong but because it may not allow as much movement for some people. On your back you're sitting right on your sacrum, so the back of your pelvis can't move, and you're working against gravity. Of course, there are absolutely times it's needed, like some assisted births or medical situations, and that's completely fine. The important thing is that your position should be guided by your needs and preferences--not assumed in advance.  

So how did birthing lying flat on your back become so common? As birth moved out of homes and into hospitals, having women on a bed made it easier for doctors to examine and monitor. Heavier pain relief also made it harder to be up and moving. Many of us have seen birth depicted on screens far more often than in real life, and that image can start to feel like the only way birth happens.  The good news is that there are many ways to give birth, and many hospitals support movement and position changes where possible--including upright, active birth. The most important thing is finding what feels right for you, with your care team supporting you to make choices that are safe for your situation.  

What role can a birth partner, support person or doula play during labour? 

A huge one, and not just on the day. 

In pregnancy, your support person can learn the positions with you, get good at the comfort measure (a proper hip squeeze is a skill!) and really understand what matters to you, so they can feel ready to support you. I love it when partners come to sessions. They often leave with really practical ways to support Mum and a clearer idea of what to expect.  

During labour, a support person can create a calm and supportive space so you can focus on labour in the way that works for you. This might be helping you change positions or get comfortable, bringing the water and the snacks, or even reminding you to pee (super important). They hold the space so you can switch off your thinking brain and just labour as you do best. 

A doula brings experience from supporting many births. They can offer practical support, suggest any comfort measures or position changes, and support your partner as well. A doula doesn’t replace your midwife, your doctor or your partner but work alongside your care team and help fill in the gaps. 

How can I improve my posture when feeding and holding my newborn? 

The fourth trimester can mean hours upon hours of time spent feeding a tiny human. Coming from a movement background, I noticed how quickly I was hunching over and how much my back started to ache.  A few small adjustments can make these moments feel more comfortable:

• Bring baby to you, not you to baby. Whether you're breastfeeding or bottle feeding, use pillows or a feeding pillow to lift baby up towards your chest so you're not rounding down over them for hours. 
• Support your back and your feet. Sit all the way back in the chair with a cushion behind your lower back and rest your feet on a stool or a stack of books.  
• Swap sides. We all have a "good side". Hold, burp and bottle feed on both so one shoulder and hip isn't doing all the work. 
• Drop your shoulders. Every time you sit down to feed, breathe in and out and let your shoulders fall away from your ears and check your jaw while you're at it.
• Move between feeds. A few cat-cows on hands and knees, a chest stretch in a doorway, a walk with the pram can help. Small and often beats the big session you never get around to or are unable to maintain consistency with.