What Is a Birthing Chair—and Should You Use One During Labor?

If your due date is around the corner, you’re likely thinking about ways to make labor and delivery go as smoothly as possible. So you might have read that an upright birthing position can be helpful in getting baby out faster—and keeping you more comfortable. That’s why some people recommend a birthing chair—or birthing stool—to make use of gravity during labor.

You probably won’t find one at your local hospital’s labor and delivery unit: For the most part, they’ve been replaced by modernized birthing beds that can largely provide the same benefits. But birthing chairs are still a popular choice for people planning to deliver at home or at a birthing center.

Here’s what to know about birthing chairs and stools—including potential benefits, disadvantages and how to use them.

What Is a Birthing Chair or Birthing Stool?

Birthing chairs and birthing stools are four-legged, raised seats that letyou sit or squat during labor. They both have an opening or semi-circular cutout in the center, says Rebecca Keith, MD, ob-gyn at Pediatrix Medical Group, but birthing chairs have more support (a back and possibly armrests) while a stool is simply a seat with no added support.

What’s the History of the Birthing Chair?

The use of birthing chairs dates as far back as 2000 BC, according to The MIT Press Reader. They’ve been used in a wide variety of cultures to assist women during childbirth, says Keith. “Midwives or other ‘lay’ persons typically attended births for centuries and would use the chair or stool,” she says. “It fell out of favor over the last several centuries as physicians began replacing midwives.”

In the late 1500s, a French physician named Jacques Guillemeau introduced giving birth while lying down, claiming it was most comfortable for women and would help induce labor. And as physicians began replacing midwives, Keith says birthing chairs and stools—and the upright birthing position in general—fell out of favor.

Are Birthing Chairs Still Used Today?

Birthing chairs are still used in some birthing centers today, though they’re not all that common, says Rikki Baldwin, DO, an ob-gyn with Memorial Hermann Medical Group in Texas. “I’m not aware of any hospitals that have them,” she says. “Modern labor and delivery units have beds and methods to help mimic what birthing chairs or stools are made to do.”

Hospital beds have come a long way, offering adjustable positioning and increased functionality that allows them to basically transform into a birthing chair, says Keith: “The back of the bed can be elevated so the woman can lean on it, and the bottom of the bed can be dropped to allow for the patient to be placed in essentially a throne position [to] emulate a birthing chair.”

But there’s also an increased lack of provider training in upright birthing, says Lucy Chapin, CNM, a pregnancy and holistic health expert at Mad River Birth and Wellness. “The issue is that many birth attendants likely don’t have the opportunity to attend many hands-and-knees, squatting, standing or tub births in their training unless their clinical sites [offer] this,” she says.

That said, you can request a birthing chair or stool if you wish. Chapin—who credits a birthing chair for helping her through the last stage of her own labor with her first child—says labor and delivery staff can sometimes purchase special items for their unit if enough patients request them. And if you choose to deliver with a midwife outside of the traditional hospital setting, like in a birthing center or at home, you may be able to use a birthing chair or purchase one of your own, says Keith.

How to Use a Birthing Chair or Birthing Stool

A birthing chair or stool can support you in a variety of birthing positions, says Baldwin, including sitting, squatting and getting down on all fours.

Keith recommends a chair over a stool, if possible, because of the added back support it provides. For leverage during contractions, you can sit forward in the chair and press yourself against the backrest or sit backward in the chair with your legs wrapped around the backrest. In between contractions, she adds, you have a stable place to rest in the forward-facing position and the ability to get a backrub or massage from a support person when in the rear-facing position.

Benefits of Using a Birthing Chair or Stool

Upright birthing is a practice that’s been well-studied and shown to be potentially effective at shortening the second stage of labor, between full dilation and delivery of the baby (i.e., the pushing stage). According to 2019 and 2023 reviews of studies on birthing positions, upright birthing:

• Helps the uterus have more effective contractions
• Guides baby through the birth canal more quickly
• Opens the pelvis wider to allow for easier passage of baby during birth
• Makes it easier for you to change positions frequently during labor

In addition to taking advantage of gravity to keep labor moving along, Keith says birthing chairs can take pressure off the lower back, relieving some of the pain of back labor. Chapin says they promote better circulation and may help you deliver the placenta more efficiently.

Finally, birthing chairs might reduce the chance of interventions: On top of potentially shortening labor by more than one hour, a 2019 study suggests that giving birth in an upright position lowers your risk for C-section too.

Potential Disadvantages and Risks of Using a Birthing Chair or Stool

Generally speaking, there aren’t any major risks associated with using a birthing chair, although one birth-related complication in particular may be more likely: a perineal or vaginal tear.

“There’s the chance of more severe tearing with using a birthing stool or chair,” says Baldwin, “since gravity is applying more pressure to the pelvis during delivery.”

If you’re already at risk of a perineal or vaginal tear because it’s your first pregnancy, baby is large or baby’s spine is facing your back instead of your belly, giving birth in a chair or stool may not be right for you. Likewise, Chapin says anyone with a history of extensive perineal tearing (such as a fourth-degree tear) might want to skip the chair and consider birthing on all fours or lying on their side instead. Not only do more extensive tears need to be repaired with stitches, which raises your risk for complications like infection, incontinence and painful sex after birth, tearing also increases your risk for blood loss. Chapin says this can be difficult to monitor in a birthing chair, so if you’re at risk for hemorrhage, your birth attendant may not want you to labor this way.

Finally, if you’re planning to receive pain medication or an epidural during labor, you likely won’t be able to use a birthing chair because you need to be able to walk around and change positions, which is often off-limits after you’ve received pain management during labor, according to the American College of Obstetricians and Gynecologists (ACOG).

If you’re interested in using a birthing chair or birthing stool, it can be incorporated into your birth plan. But always make sure to discuss the options with your provider.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.