Overcoming the challenges: maternal movement and positioning to facilitate labor progress.

The benefits of maternal movement and position changes to facilitate labor progress have been discussed in the literature for decades. Recent routine interventions such as amniotomy, induction, fetal monitoring, and epidural anesthesia, as well as an increase in maternal obesity, have made position changes during labor challenging. The lack of maternal changes in position throughout labor can contribute to dystocia and increase the risk of cesarean births for failure to progress or descend. This article provides a historical review of the research findings related to the effects of maternal positioning on the labor process and uses six physiological principles as a framework to offer suggestions for maternal positioning both before and after epidural anesthesia.