No need to give birth on your back. In fact DON’T!
Alexia cleared her own tokophobia and developed a method that has helped women clear theirs for more than 10 years.
Childbirth is often compared to running a marathon, and for good reason. The physical and emotional demands are not dissimilar, and researchers have compared the strain labour puts on the body with endurance events like marathons.
So I thought I’d take this comparison a step further and explore the kind of messages that women are frequently subjected to when pregnant and see how those same messages might look if she was putting herself forward for a marathon instead.
This is to highlight the ridiculousness of what pregnant women have to put up with and to show how our culture encourages fear among women when it comes to birth.
Doesn’t this woman look ridiculous?
If you were running in a race, you definitely WOULD NOT be dressed like that. Those heels are bound to cause you some hardcore foot injuries, not to mention adding a bucket load of hours to your marathon time. And who starts a marathon crouching on the floor, anyhow? All of it is nonsense, and we know it. In fact, we all know it so well, that you would NEVER see this. Not even in a comedy that featured a woman running a race. Imagine watching a reality TV show about marathon runners and seeing the coaches advising the women to do this. IT WOULD NEVER HAPPEN!
And yet when it comes to birth, this is what we’re seeing … EVERYWHERE! And don’t even get me started on a certain birthing reality show! In fact we see it so much that women just think that when you give birth you lie on your back. That’s just how it happens. WRONG!
The problem with making women think that you give birth on your back
This is a problem. A HUGE problem. This alone feeds a ton of fears in women when it comes to labour and birth.
Things like:
Loss of control
When you’re heavily pregnant, lying down on your back is a nightmare for lots of reasons. But I’d say the main one is this; feeling a total loss of control. If you’ve never been pregnant, you wouldn’t understand but let me try to help you. Imagine you’re in bed and a large St Bernard dog has fallen asleep right across your body. Now try to move; get out of bed, turn over, sit up… NOPE! Not happening! You’re stuck.
In my last month of pregnancy, to get out of bed, I needed to swing my legs sideways to get some momentum going in the hope that my back would get up in response. It’s crazy thinking that’s based on having some kind of core strength to draw against (core strength that has disappeared now that you’re pregnant!), so, as expected, this typically failed and instead I’d have to call my partner to pull me up. When I was having ultrasound scans, it was the nurse that needed to pull me up.
Now imagine going through that but you’re in labour. WHOLE DIFFERENT STORY and a few thousand notches UP the I feel outta control scale.
Fear of losing control is very common among pregnant women and this myth feeds it beautifully.
Vulnerability
Lying on your back, with your legs in the air and having a bunch of strangers looking at your wootsy is GUARANTEED to make you feel vulnerable. Just the thought of it when you’re not pregnant is bad enough, but when there’s a St Bernard dog lying on top of you weighing you down too, it doesn’t bear thinking about. Childbirth is already a vulnerable time for a woman, and what she needs more than anything is to feel safe, secure and loved. THIS is what helps labour keep moving at a pace that’s right for mum and baby. When she feels vulnerable and not in control, feelings of safety and security are out the window, and fears come rushing in… this is very bad news for labour!
Loss of respect
I don’t need to labour (!) this point too much as it’s easy to understand how lying on your back with your legs akimbo and strangers, (including men) are looking at your ladybits, is going to make you feel. And respected isn’t it.
So, having already established how damaging it is mentally and emotionally for pregnant mamas to think that you give birth on your back, let’s take a closer look at how bad it is for labour itself.
Why giving birth on your back is bad
Lying on your back is unhelpful for a host of reasons.
- Giving birth on your back can make labour more painful.
That reason alone should make us think twice, but let’s carry on.
- When you’re lying on your back, you’re quite literally pushing uphill. The birth canal curves upwards when you lie down, so you’re going against gravity.
- Birthing on your back can make labour last longer because the body has to work much harder to eject the baby.
- Upright positions such as kneeling or squatting can give your baby more room. One MRI study found a kneeling squat widened key measurements of the pelvis by around 7–15% compared with lying on your back (Reitter et al., 2014).
- Birthing in this position is linked to a higher chance of an assisted birth.
- Laying on the back constricts blood vessels, meaning baby and mother won’t receive the optimum levels of blood & oxygen.
- If baby is in a non-optimal position (such as posterior), then the baby is less likely to shift into a better position while mama is on her back.
The irony is that lying on your back can increase the need for the very interventions that doctors want you in this position to check for. Now don’t get me wrong, sometimes it works for women, and that’s fine, but let her decide if it feels right for her. DON’T PRESSURE HER.
As I write this it strikes me how absurd the myth of birthing on your back is. The emotional impact of lying on your back is bad enough, given how important your state of mind is when you give birth. But it can also make labour longer, more painful and more difficult, which adds up to VERY GOOD REASONS to avoid it unless you choose it or there’s a medical reason.
Why are we seeing it everywhere?
Who is advising the people who make these films, dramas and documentaries? If they were portraying any other experience, you’d expect them to do some research and talk to the people who live it. Birth deserves the same care.
So, why do we continue to see women being shown birthing on their backs?
In 2015 I started a petition asking UK broadcasters to portray childbirth in a more balanced way, to make it less frightening. A key part of it was to show good birthing practice and not just the drama and horrors of birth.
If you think this is a crazy state of affairs, here’s what you can do;
When you see a bad case of birthing on the back, tell the TV show or film producers. Most of them are on social media, so it only takes a minute.
Another thing you can do is BLOG OR VLOG about it and join me in making some noise about the absurdity of all this. If you do, keep me posted so that I give you an internet high 5!
FREE: 9 Steps To A Fearless Birth – grab the guide
What do you think about how often we see women birthing on their backs? Do you agree we need to stop it? Tell me in the comments below.
Giving birth on your back: FAQs
Do you have to give birth on your back?
No. Unless there’s a specific medical reason – continuous monitoring, an epidural limiting movement, an assisted delivery – you’re free to labour and birth in whatever position works for your body. It’s your birth; positioning is your call.
Is giving birth on your back bad?
It’s generally the least helpful position: it narrows the pelvic outlet, asks you to push uphill against gravity, and can compress major blood vessels. It can slow labour and make contractions harder work than they need to be.
Why do women give birth on their backs, then?
Convention, not biology. It suits hospital monitoring, it suits the people attending the birth, and it’s what film and TV have shown us for decades – which is why most of us picture birth that way without ever questioning it.
What positions are better for giving birth?
Upright and forward-leaning positions – kneeling, all-fours, squatting, standing supported, or side-lying if you need rest – let gravity help and give the pelvis room to open. Moving between positions as labour progresses is the real win. Position is one piece; going in without fear is the other – that’s where fear-first birth preparation comes in.
Keep reading
- Childbirth without fear: why FEAR equals PAIN
- The problem with One Born Every Minute
- 3 lies about childbirth we’ve all been told
Fear Free Childbirth is a publication and is not a substitute for medical or mental-health care. If you’re struggling to cope or in crisis, please contact your GP, midwife or a qualified professional.
- A Healthy Baby Doesn’t Mean the Birth Wasn’t Traumatic: What New Research Shows - 23rd October 2026
- What Happened to Having Babies? Fertility, Fear and the Rabbit Hole - 23rd October 2026
- Thousands of Mothers May Be Living With Undiagnosed PTSD After Childbirth - 16th October 2026
From the research I did I understand that giving birth on your back started with Louis XIV who wished to watch as his mistress gave birth. It was for him to have a better view. That’s all. What a pity she didn’t say: You’ve got to be joking!
One of the reasons that I don’t think you mention that it’s so unhealthy is that the pressure on the aorta (major blood vessel near the mother’s back behind the womb) leads to pooling of blood in the mother’s legs, which can then lead to heavy bleeding, and also reduces the amount of blood in active circulation in the mother and therefore oxygen available for the baby.
Great series Alexia, I look forward to the next episode!
Glad you’re enjoying them Catherine!
And thank you so much for adding yet another VERY GOOD REASON women shouldn’t give birth on their backs.
Much appreciated!
My mother gave birth to all her 3 children in the early nineties at home, stood up, with no painkillers at all, just a midwife and my father. No problems whatsoever. My sister (second child) was late by 3 weeks too and very large! My mother is only 5’3. She said she was doing lots of pregnancy yoga, that hospitals would make her panicky and stood up is a better position, and that women lie down because it was easier for the (male) doctors. She had to find a doctor where we were from who would approve it and apparently that was a bit of a task because it was so unconventional, and eventually she found an old female doctor in a village over who gave her the green light. I used to think this was especially kooky and impressive of her but now I’m a bit older I feel quite strongly that stood up makes SO much more sense for an easier birth.
The lying down status quo is actually quite a travesty when you think about it! The stress and anxiety of the mother, and a traumatic or difficult birth, could have serious long term implications for a child, psychologically.
I am really impressed by her conviction in what she believed would be the best, most natural way for her to give birth. The idea was that if there was an issue they would drive her to hospital if necessary, but nothing went wrong. Just a midwife and my dad, and her other kids taken out for the day by a family friend! It’s really quite wild. Let me know if you’d ever like to chat to her about it, she’s happy
to talk about it.
Your mum sounds like a total badass!