Skip the Pain: How Birthing Positions Can Prevent Severe Tears

Changing your pushing position can affect tear risk more than you might expect. Lying flat on your back places the greatest pressure on the perineum. By contrast, upright positions—like hands-and-knees, side-lying, or supported squats—use gravity to ease the baby’s descent and can lower the odds of severe tears. Water births offer similar benefits. Warm water helps soften tissues and supports your weight. A warm compress applied by your midwife or doctor during crowning can also cut third- and fourth-degree tears by about half, according to clinical trials. Before labour, discuss with your provider which positions they can safely support.

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