Staying upright, moving frequently, and keeping your stress hormones low are the most effective things you can do to help labor progress. A large body of evidence supports several practical strategies, from positioning and hydration to emotional environment, that can shorten labor and support stronger, more regular contractions. Most of these techniques work by helping your body release oxytocin naturally and by using gravity to encourage your baby to move deeper into the pelvis.
What “Progress” Actually Means
Labor progress is measured by how quickly your cervix opens (dilates) and how far down your baby descends. Current guidelines from the American College of Obstetricians and Gynecologists define active labor as beginning at 6 cm of dilation, which is later than many people expect. Before that point, you’re in early labor, and dilation can be slow and irregular for hours or even days without anything being wrong.
Once active labor begins, older estimates suggested the cervix should open at roughly 1.2 cm per hour for a first birth and 1.5 cm per hour for subsequent births. But more recent data shows wide variation in what’s normal, and slower progress doesn’t automatically signal a problem. Understanding this helps you avoid unnecessary anxiety during early labor, which itself can slow things down.
Stay Upright and Keep Moving
Gravity is one of your strongest allies. A Cochrane review of 21 studies involving over 3,700 women found that those who stayed upright during the first stage of labor (sitting, standing, walking, or kneeling) had a first stage that was approximately one hour shorter than those who stayed lying down. That’s a meaningful difference achieved with no medication or intervention at all.
Upright positions work in two ways: gravity pulls the baby’s head onto the cervix, which triggers stronger contractions, and the pelvis can open more freely when you’re not lying flat. Some effective options include:
- Slow walking between contractions
- Leaning forward over a birth ball, counter, or bed
- Swaying or rocking your hips in a standing or kneeling position
- Squatting with support, which opens the pelvic outlet by up to 30%
You don’t need to stay in one position. In fact, changing positions every 20 to 30 minutes encourages the baby to rotate and descend. If you feel the urge to move a certain way, trust that instinct. Your body often knows what position will help the baby navigate through the pelvis.
Positioning With an Epidural
If you have an epidural, staying upright or walking isn’t realistic, but you still have options. A peanut-shaped exercise ball placed between your legs while you lie on your side can help keep the pelvis open. A meta-analysis of four trials found that peanut ball use showed trends toward more spontaneous vaginal deliveries and fewer cesarean deliveries compared to lying flat. Total labor time trended about 79 minutes shorter in the peanut ball group, though results varied between studies.
Even without a peanut ball, changing sides every 30 minutes and using pillows to create asymmetry in your hip positioning can help the baby rotate. Ask your nurse to help you shift between exaggerated side-lying positions, where your top leg is elevated higher than your hip.
The Miles Circuit for a Stalled Labor
If labor has stalled or your baby seems to be in an unfavorable position, the Miles Circuit is a specific three-position sequence designed to encourage rotation and descent. The full circuit takes 90 minutes:
- Open knee-chest position for 30 minutes: Kneel on a bed or floor with your chest low and your knees wide apart. This gives the baby room to tuck their chin and reposition.
- Exaggerated side-lying for 30 minutes: Lie on your side with your top leg draped far forward over a stack of pillows, creating an extreme lunge-like shape.
- Upright and asymmetric movement for 30 minutes: Walk, lunge, or climb stairs sideways to create uneven motion in the pelvis.
This circuit is most useful when contractions are irregular or seem to have plateaued. It’s not a guarantee, but the combination of gravity, asymmetry, and time gives the baby the best mechanical opportunity to shift into a better position.
Reduce Stress to Protect Oxytocin
Your emotional state directly affects your hormones during labor. Oxytocin drives contractions, but stress hormones (adrenaline and noradrenaline) can interfere with oxytocin’s effects and slow or stall labor. This creates a cycle: fear produces tension, tension increases pain, and pain produces more fear, each step pumping out more stress hormones that work against your contractions.
Breaking this cycle is one of the most underrated ways to help labor progress. Practical steps include dimming the lights, minimizing the number of people in the room, playing familiar music, and having a trusted support person present. Feeling safe, warm, and unobserved allows your brain to release oxytocin more freely. This is the same hormone involved in intimacy and breastfeeding, and it responds to the same environmental cues: privacy, comfort, and calm.
Skin-to-skin contact with a partner, slow breathing techniques, and even laughing between contractions can all help lower stress hormones. Some people find that labor progresses noticeably faster after they move from a bright, busy triage area into a quieter, more private room.
Nipple Stimulation
Nipple stimulation triggers your body to release oxytocin, the same hormone used in synthetic form to augment labor medically. You can use hand massage or a breast pump, alternating breasts, for periods of several minutes at a time. Some protocols suggest stimulating for at least two hours total during a stall. The stimulation mimics breastfeeding signals and can help establish or strengthen a regular contraction pattern.
This technique is most commonly used in early labor or when contractions have spaced out. It’s simple, free, and something you can control yourself, though it works best when combined with upright positioning and a calm environment.
Try Warm Water Immersion
Getting into a warm bath or shower during labor can make a significant difference. ACOG notes that water immersion during the first stage of labor may be associated with shorter labor and decreased need for epidural pain relief. Beyond the physical effects, women consistently report that warm water increases feelings of relaxation, warmth, and a sense of control during labor.
The mechanism is partly about pain relief (less pain means less adrenaline, which means more oxytocin) and partly about the buoyancy reducing pressure on your body so you can change positions more easily. Water immersion is generally considered appropriate for uncomplicated pregnancies between 37 and 42 weeks. Even if a tub isn’t available, a warm shower directed at your lower back during contractions can offer similar relaxation benefits.
Eat and Drink for Energy
Labor is physically demanding work. Your body burns an estimated 50 to 100 calories per hour during active labor, roughly equivalent to moderate exercise. Running out of fuel can leave your uterus unable to contract as effectively, and it leaves you exhausted.
A systematic review of over 3,300 patients found that women who were allowed to eat during labor experienced no increase in complications like vomiting or aspiration compared to those restricted to ice chips and water. One study in the review found that eating correlated with significantly shorter labor duration. Overall, women who consumed light foods (low-fat, low-fiber options, carbohydrate drinks, or honey) had labor durations averaging about 16 minutes shorter than those on restricted intake. The safety data was reassuring, with no cases of aspiration reported across all studies.
In early labor especially, eating easy-to-digest foods like toast, fruit, broth, or energy bars can help maintain your stamina. Staying well-hydrated with water or electrolyte drinks is equally important, since dehydration alone can cause contractions to weaken and space out.
What About Breaking the Water?
Amniotomy, where a provider manually breaks the amniotic sac, is one of the most commonly discussed medical interventions for stalled labor. However, the evidence is less compelling than many people assume. A Cochrane review found no clear statistical difference in the length of the first stage of labor between women who had amniotomy and those who didn’t. The review also noted a possible increase in cesarean delivery rates in the amniotomy group, along with rare but important risks to the umbilical cord and baby’s heart rate.
This doesn’t mean amniotomy is never useful in specific clinical situations, but it shouldn’t be considered a reliable way to speed things up on its own. If your provider suggests it, it’s reasonable to ask what other signs they’re seeing that make it the right choice for your situation.
Putting It All Together
The strategies that help labor progress share a common thread: they support your body’s own mechanisms rather than forcing a timeline. Staying upright uses gravity. Reducing stress protects oxytocin. Eating maintains energy. Warm water lowers pain and tension. Changing positions helps the baby find the best path through the pelvis. None of these are dramatic interventions, and that’s the point. Labor is a physiological process that tends to work best when the conditions are right, not when more force is applied.
If labor does stall despite these efforts, it may simply mean the baby needs more time to rotate, or that your body is resting before the next phase of intensity. A plateau in early labor, before 6 cm, is extremely common and rarely a cause for concern on its own. The combination of movement, calm, nourishment, and patience covers the vast majority of what’s within your control.