Date of Defense


Date of Graduation




First Advisor

Mary Ann Stark

Second Advisor

Kimberly Searing

Third Advisor

Wendey Kershner


The birthing process for many women is a complex period of time that involves many changes in the mother’s body as well as the baby’s preparation to enter the world. Medical advances and technology have improved care for at-risk women but the increased number of unnecessary interventions during labor currently may actually hinder a healthy mother from having the best possible birth experience and outcomes for her and her child. Mothers can use many different, non-medical, non-pharmacological strategies to cope with the stress of labor. These strategies may include ambulating or position changes during the first stage of labor, massage or reflexology, many forms of hydrotherapy (i.e. showering, bathing), hot and cold therapy, and birthing environment mediation. The purpose of this thesis is to examine the relationship between ambulation, or movement, and position changes during labor and the hormonal physiology of childbearing. “Hormonal physiology of childbearing” here refers to the innate, endogenous hormones and hormone systems that regulate the biologic processes of childbirth (Buckley, 2015).

“Ambulation during labor” here will refer to moving from place to place during early and active labor that reduces the amount of time a woman spends laying down during these phases. Ambulation during labor may include but is not limited to walking, dancing, swaying or rocking while standing, squatting or in an all fours posture, or any combination and movement to different positions. Ambulation and movement in labor may help to reposition a fetus from a position that is not ideal for birthing to a more favorable position (Simkin & O’Hara, 2002; Stremler, Hodnett, Petryshen, Stevens, Weston, & Willan, 2005), to promote gravity to move the fetus to a lower station (Prabhakar, George & Karkada, 2015), and may also reduce pain perception associated with contractions and discomforts of the labor process (Gau, Chang, Tian & Lin, 2011; Ondeck, 2014; Romano & Lothian, 2008; Simkin & Bolding, 2004; Spiby, Slade, Escott, Henderson & Fraser, 2003; Stremler et al., 2005).

This thesis will include a literature review that explores different aspects of ambulation related to the progression of labor and current practice recommendations of the use of ambulation in labor. It will also compare the benefits of and potential barriers to ambulation in labor to the mother and baby. A brief exploration will be made of the similarities and differences between ambulating in labor and showering in labor. Finally, it will investigate the relationship between ambulation in labor and its influence on hormone levels associated with physiologic labor and birth.

Access Setting

Honors Thesis-Open Access