So what do you do if you’re having an epidural?
Well, you can still do a lot actually. The main factor in reducing the amount of assisted vaginal births with an epidural sited seems to be waiting until you feel a spontaneous urge to push, as opposed to being told to push because you’re fully dilated (Decker, 2018) but there is some evidence to suggest that being helped into a side-lying position with the lower leg remaining extended on the bed and the upper leg rested, flexed on a stirrup, also made a difference.
Using a peanut ball – basically a monkey nut shaped ball has been associated with decreasing the length of labour and a “significantly lower incidence of caesarean surgery” in those using an epidural (Tussey et al, 2015). Technically you’re not necessarily upright whilst using one of these things but depending on the positions you use, you’re creating more space in the pelvic capacity to allow your baby to make use of maximum room in the pelvis.