The Epidural Rollover: Maximizing Movement for a Smoother Labor

If you’re planning on getting an epidural, you might assume that once it’s placed, you’ll be stuck in bed for the rest of your labor. But that doesn’t mean you can’t—and shouldn’t—keep moving. In fact, staying mobile is one of the best ways to help your labor progress, even with an epidural.

This is where the Epidural Rollover comes in. Created by renowned birth expert Penny Simkin, PT, this technique allows laboring individuals to shift positions regularly, encouraging the baby’s descent and optimizing pelvic space. With the help of your nurse, doula, or birth partner, you can rotate through a series of positions to support your body’s natural birthing process.

Why Movement Matters With an Epidural

An epidural blocks sensation, making it harder to move on your own. However, movement remains crucial in labor because:

• It helps your baby move through the birth canal.

• It reduces the risk of labor stalling.

• It allows gravity to assist in the process.

• It can alleviate discomfort and prevent prolonged pushing phases.

Since you may not be able to reposition yourself easily, your nurse, partner, and doula can help facilitate movement. Setting a timer for every 30-60 minutes ensures you’re rotating through the Epidural Rollover sequence regularly.

The Epidural Rollover Technique

The Epidural Rollover consists of six strategic positions, designed to open different parts of the pelvis and keep labor progressing. Props like an adjustable hospital bed, pillows, and a peanut ball can help achieve these positions comfortably.

Position 1: Semi-Sitting Lunge

• Sit upright in the hospital bed with a peanut ball under one leg.

• Switch sides with each rotation.

• Why? This position mimics a lunge, opening the pelvic inlet and creating asymmetry to help the baby navigate the mid pelvis.

Position 2: Side-Lying (Right Side)

• Lay on your right side with a peanut ball between your legs.

• Variations:

  • Place the ball between your knees/thighs with one ankle over the bed edge to open the inlet.

  • Keep the top leg parallel to the ball to open the mid-pelvis.

  • Place the ball between your ankles to open the outlet.

• Why? This is a great position for resting while still supporting pelvic opening.

Position 3: Runner’s Pose (Right Side)

• Lay on your right side and bring your top leg over the ball, bending it at about 90 degrees.

• Why? Ideal for relaxation while keeping the pelvis open.

Position 4: Hands and Knees

• Use a pillow under your knees for comfort.

• Variations:

  • Lean over a birth ball if kneeling is uncomfortable.

  • Stand and lean over the bed for a modified version.

• Why? This position relieves back pain, reduces pelvic pressure, boosts baby’s oxygen supply, and is especially helpful if baby is posterior.

Position 5: Runner’s Pose (Left Side)

• Same as Position 3, but on the left side.

Position 6: Side-Lying (Left Side)

• Same as Position 2, but on the left side.

Making the Epidural Rollover Work for You

• Set a Timer: Since sensation is reduced with an epidural, you may not feel the need to move. A timer ensures consistent repositioning every 30-60 minutes.

• Involve Your Support Team: Your nurse, partner, and doula can assist in moving you safely and comfortably.

• Advocate for Movement: Let your birth team know that you want to use this technique to optimize labor progression.

The Role of a Doula in Epidural-Assisted Births

If you’re wondering why hire a doula when getting an epidural, the answer is simple: a doula supports all births, including medicated ones. A doula can:

• Encourage position changes and comfort measures.

• Communicate with your nurse about movement.

• Help you stay engaged and confident throughout labor.

• Assist with relaxation techniques between position changes.

Final Thoughts

Getting an epidural doesn’t mean labor has to slow down. The Epidural Rollover technique keeps things moving, helping your body and baby work together. With the right support system—including your nurse, birth partner, and doula—you can still have an active, empowered birth experience.

So, if an epidural is part of your birth plan, plan for movement too. Your body and baby will thank you for it.