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UFO: Upright, Forward and Open – Positions for Labour and Birth

Written by Amina Hatia RM
amina haita
Medically reviewed by Amina Hatia RM

When you think of giving birth, you might imagine a bed being involved – with you lying on your back or perhaps sitting upright. Films and TV programmes often portray birth this way, so unless you’ve given birth yourself or supported someone through labour, this can feel like the “normal” way birth happens.

In reality, labour and birth requires a lot of movement – swaying, rocking, kneeling, squatting and changing positions – and to support this you ideally will spend little time lying on a bed. NHS guidance and midwifery evidence consistently support being upright and mobile during labour, as this can help labour progress and support comfort, particularly in uncomplicated labours.

So what positions are best?

Rather than one fixed position, midwives use the helpful acronym UFO – not an alien invasion, but an easy way to remember the key elements that support labour and birth:

Upright, Forward and Open

These principles can be adapted throughout labour to suit what feels right for you and your baby.

Upright

Being upright means working with gravity rather than against it. Positions such as standing, walking, sitting upright, kneeling or squatting can help your baby move down through your pelvis.

NHS guidance encourages staying upright and changing position during labour where possible, as this may:

  • help your labour progress 
  • reduce the need for certain interventions
  • help you feel more in control 
  • Help with pain management

Forward

Leaning forwards can help open your pelvis and support your baby to rotate into a position that is easier for birth. Forward-leaning positions can also be particularly helpful if you experience back pain in labour.

Examples include:

  • leaning onto your partner
  • leaning against a wall or bed
  • using a birth ball
  • being on all fours

As labour progresses, you may naturally move into positions that feel more supportive. Listening to your body is key – there is no “right” position, only what feels right for you at that moment.

Open

Upright and forward positions often naturally lead to more open postures. Positions such as standing, squatting, kneeling, being on all fours or leaning forwards can help maximise the space in your pelvis and may make it easier for your baby to move through the birth canal.

Changing position regularly can also:

  • Help manage discomfort
  • Support steady labour progress
  • Help you find a comfortable position for giving birth itself

Benefits of Staying Upright and Mobile

According to NHS and NICE guidance, being upright and changing position during labour may help to:

  • ease pain and discomfort
  • increase your sense of control
  • shorten labour for some women
  • help you find the most comfortable position for birth.

But Rest Matters too

Every labour is different. You may need to rest or adopt more supported positions at times, particularly if you have an epidural or require continuous monitoring. Your midwife will support you to move safely and comfortably wherever possible. Midwives are used to supporting women in all kinds of positions – what matters most is that you feel safe, supported and comfortable.

Positions to Try During Labour

There are lots of positions you can try. Do what feels right for you, and remember that your midwife and birth partner are there to help and encourage you.

You might like to try:

  • sitting upright and leaning on a table
  • straddling a chair or sitting on the toilet facing backwards
  • standing and leaning on a bed, table or your birth partner
  • standing and leaning on a birth ball placed on a bed
  • kneeling on the floor while leaning over a birth ball
  • kneeling on all fours (often helpful if you have back pain)
  • kneeling over the back of the bed or leaning into your birth partner
  • rocking, sitting on or gently bouncing on a birth ball.

Walking around can also be helpful. If contractions become stronger or you feel tired, you can continue to move by gently rocking your pelvis or shifting your weight from one foot to the other.

Comfort and Support

Many upright and forward-leaning positions make it easier for your birth partner to offer massage or counter-pressure. Touch and reassurance can help release endorphins – your body’s natural pain-relieving hormones.

There are also a range of pain relief options available during labour, from breathing techniques and water to medical pain relief. Your midwife will discuss these with you so you can make informed choices that suit your needs and circumstances.

When Lying Down May Be Needed

While staying upright and mobile is often helpful, there may be times in labour when lying down or resting on the bed is the safest or most comfortable option for you. This can include:

  • if you feel very tired and need to rest
  • if your blood pressure needs close monitoring
  • if you have an epidural or continuous fetal monitoring
  • if your midwife recommends a specific position for you or your baby at that moment.

Lying down does not mean labour has “stopped” or that you are doing anything wrong. Side-lying positions, especially lying on your left side with pillows for support, can still be gentle, effective and protective for you and your baby. Your midwife will support you to change position when possible and help you find the safest and most comfortable option throughout your labour.

Want to Explore This Further?

Understanding how to use movement and position in labour can make a real difference to how confident and prepared you feel.

Join our interactive, complete antenatal course to explore labour positions in more depth, practise what feels right for you, and speak directly with our experienced midwives. Our sessions cover labour, birth and early parenthood, with plenty of time for questions, discussion and personalised support with our midwives.

References

  • Lawrence, A. et al. (2013). Maternal positions and mobility during first stage labour. Cochrane Database of Systematic Reviews.
    https://www.cochranelibrary.com
  • Gupta, J.K., et al. (2017). Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database of Systematic Reviews.
    https://www.cochranelibrary.com

Written by: Amina Hatia RM
Reviewed: 28/01/2026
Next review: 28/01/2028