When I was pregnant with my first baby, I had a secret fear: that my pelvis might be too small for my baby. I was petite, just like my mom. And I had been born by cesarean section. 8 babies later, however, I know that I can have a normal delivery - in fact, my last baby was 10lbs 10oz and born naturally!

You can increase your pelvic size during delivery - in fact, there are simple techniques to use starting in pregnancy. These easy steps get your pelvis ready for birthing. In the delivery room you can switch labor positions, keep your energy high, help baby rotate, and use techniques that bring baby down, increase pelvic size, and lead to vaginal delivery.

Each of these techniques is simple, but you’ve got to know how to use them. You also need to get the insider scoop on what really matters during labor and birth - surprisingly it’s not just your baby’s size or your pelvic size.

Pelvic Size, Baby Size, and Position - How and When They Matter

Many women are scared their babies “won’t fit” through their pelvis - and with good reason. You often hear stories about how “the baby was too big.”

But the truth is that cephalopelvic disproportion (CPD) - the clinical term for a “too big” baby - is rare. The medical term literally means that a baby’s head is too big to go through a mother’s pelvis (so it’s not referring to the size of the baby, just the baby’s head).

If it’s so rare, why do we hear “my baby was too big” so often? What’s really going on?

We’re really dealing with a few issues:

Historical Childbirth Problems

Historically, women did experience problems during childbirth due to pelvic size. That problem isn’t an issue for most women in modernized countries.

Women in the past had issues because lack of quality food caused an epidemic of rickets. Rickets is a bone problem caused by lack of nutrients (primarily Vitamin D) and results in soft, weak bones. Rickets can lead to a permanently contracted pelvis.

Such nutrient deficiencies are rare in modernized countries and even many developing countries because awareness of the disease has led to better nutrition and humanitarian aid to prevent it.

If you grew up with your basic food needs met, rickets is unlikely to have been an issue. If you feel you were malnourished in childhood, talk to your care provider.

Unrealistic Expectations of Mothers During Labor

“Failure to progress” is a dreaded term for many mamas hoping for a normal delivery. It’s often blamed on CPD or “too big” babies.

That’s not often the case, however. Many care providers have been trained using outdated models of labor and delivery - “curves” that showed labor moving along a perfect, predictable pace (a first-time mom should dilate a centimeter every hour, for example).

Fortunately more current research is being recognized and outdated textbooks are being revised - but a lot of damage has been done by the expectation that every woman should follow a textbook “curve.”

Sometimes women just take longer to birth their babies - or babies need to do some moving of their own, which I’ll talk more about shortly.

Women are also expected to get through labor without eating - and without moving. A mom stuck in one position who has no energy to give birth cannot have a vaginal birth, even with a normal pelvic size!

As I’ll share further in this article, mobility is a key to increasing your pelvic size for a normal delivery. And having the energy to move and push your baby out is essential.

(NOTE: Want a Perfect Birth Plan Template? Use this template and step-by-step videos to write a birth plan that gets your birth team on your side for a beautiful birth experience! Get the kit here.)

Misunderstanding of Baby Position

Every obstetric and midwifery textbook covers baby position, but many care providers completely ignore baby’s position during birth. They pay attention to heartbeat, contractions, and dilation.

But a baby’s position can make a big difference. For example, a posterior baby’s head tucks in a different way in relation to your pelvis…

...so it's larger in diameter than that of an anterior baby.

Click here for my full article including illustrations and videos on baby position - it makes it much easier to understand baby position!

You can do a LOT to get baby in a good position during pregnancy, and simple techniques can rotate baby and create more room in your pelvis during birth. You just need to use them 🙂

Lack of Childbirth Skills

The simple techniques I just mentioned are skills that midwives and families have known for ages.

Obstetricians are surgeons - their skill is in surgery (cesarean section). That’s not necessarily a bad thing...

...but if you need to get a baby to rotate into a good position for birth - or if you want to increase your pelvic size - you need skills to do that.

A good care provider will know techniques to help do that without resorting to surgical birth.

Additionally - perhaps even more importantly, there are skills you can learn that help increase your pelvic size for a smooth birth.

Here’s the truth - many VBAC mamas out there go on to vaginally birth a baby BIGGER than their previous c-section baby!

Knowing how to increase your pelvic size and how to work with your baby during your labor can make a HUGE difference in how your birthing time goes <3

What You Need to Know About Bones

You likely think of something hard and rigid when you think about pelvic bones…

…and when you think about your baby’s skull!

I’ll share a secret: a birthing woman’s pelvis and a newborn baby’s skull are not rigid. Understanding this can really increase your confidence in birth.

Your Pelvis on Relaxin

Relaxin is a hormone normally released by the ovaries, but during pregnancy it’s also released by the placenta and even the lining of the uterus.

As you’ve likely guessed by the name, relaxin actually helps soften and relax joints and ligaments during pregnancy.

This is the reason why I tell my online birthing class students to avoid high-impact exercises, and to listen to their bodies as they get further along in pregnancy. Sometimes you can hurt yourself without realizing it because your joints and ligaments have softened so much.

Your pelvis is strongly affected by relaxin - everything softens up and gets more mobile, making it much easier for your baby to come through your bones.

This is what helps petite women, like I was, birth a good-sized baby. Your bones shift and spread for your baby.

Additionally, the pelvis is originally made of different segments of bone that do not completely calcify until your 20’s - so if you’re birthing at that point, your pelvis is likely to permanently change a bit from relaxin changing the cartilage.

Even women past that age, however, experience softening due to relaxin’s very powerful effects.

Your Baby’s Head

Your baby’s skull is made up of a number of different bones held together by strong cartilage (these lines of connection are called sutures).

During childbirth, the bones can move quite a bit, even compressing and sliding somewhat to help your baby fit through the pelvis.

This movement is called “molding” and if you’ve ever seen a newborn with a cone-shaped head, that’s what’s going on! I think that may be why hats get put on newborns…

…but most molding is gone within 24 hours or so 😉

This is really an incredible design for birth - between your mobile, flexible pelvis and baby’s ability to move, rotate, and skull flexibility, most babies can get through mama’s bones!

Choose a Good Birth Team

As I noted above, care providers can make a difference when it comes to birthing your baby.

A good care provider will understand how labor works - and what baby position and rotation mean.

A skilled care provider knows techniques to help shift your baby’s position if necessary. This can be invaluable if you want help to increase your pelvic size and have a vaginal delivery.

In addition to your doctor or midwife, a skilled doula can help. Doulas are women who come specifically to support you during your birthing time. Because a doula’s role is only to help you (she lets your doctor or midwife oversee safety, delivery, etc.), she often knows many tips and techniques to lower pain and keep labor moving along…

…including how to help a baby rotate, how to keep your energy levels up, and how to help you increase room in your pelvis.

Go Into Labor Well-Nourished and Well-Rested

I’ve mentioned energy a couple of times already - and you need a lot of it during labor. Essentially, labor is an athletic event.

You wouldn’t run your first marathon without eating a clean, healthy diet beforehand. You also wouldn’t run on no sleep!

Pay careful attention to a full, nourishing pregnancy diet - what you eat literally builds your baby, and it helps get your body ready for birthing.

A well-nourished uterus is a good thing - it holds your baby in a better position, getting him or her lined up for birth. And it opens your cervix and pushes your baby out more smoothly.

Don’t skip meals to try and keep your baby smaller. It’s much better to lower your level of sugars and carbohydrates while getting in ample calories, protein, and healthy fat - this builds a strong, healthy baby without too much extra “fluff.” If you’d like help designing a great pregnancy diet, I do that for every student in my online MamaBaby Birthing classes.

Studies actually show that very small babies may be harder to push out - possibly because the baby doesn’t have as much energy to help, or because they’re so small that their heads don’t trigger the cervix to dilate well.

You also want to be well-rested when you go into labor. Spend the last few weeks of your pregnancy taking things easy - eat well, walk daily, nap daily, enjoy quiet evenings…

…in short, pamper yourself a bit.

Prioritize sleep so you feel well-rested going into labor. And don’t rush around too much when your labor begins - you can usually go about your normal day, nap, and sleep through all of early labor, conserving energy for when things pick up.

Go Into Labor Well-Adjusted

While rickets and other chronic deficiencies aren’t usually a problem for women today, lack of mobility is.

Most people in modern cultures spend a lot of time sitting - in chairs.

This can impact your bones and the flexibility your pelvis.

Walking is the easiest and best pregnancy exercise - and I recommend you take a walk every day. Start with a short walk and work up to a good walk or hike every day.

This helps align your pelvis and build flexibility.

Your pelvis is made of a number of different bones - the bony plate in the back is called your sacrum. Reach back and feel your tailbone. The broad plate above your tailbone is your sacrum.

Your sacrum is flexible - and relaxin makes it even more flexible.

Walking every day, squatting regularly to pick things up, dancing, and doing prenatal exercise help create movement in your pelvis. This regular movement and shifting helps you increase your pelvic size across pregnancy (as relaxin works) and keeps you flexible during labor, too.

If you’ve had pelvic injuries, or if you feel rigid, nervous, or just want to feel better throughout your entire pregnancy, chiropractic care is a good option.

Your chiropractor can work with your sacrum and spine gently to bring you into alignment and help you prepare for birth.

Physical therapy is another option, especially if you’ve had a past injury, to prepare for giving birth.

Your chiropractor or physical therapist will work with you to gently bring increased size and mobility to your pelvis.

Go Into Labor Well-Informed

As I noted above, there’s a lot of misinformation about the process of labor and birth. Most care providers have a textbook knowledge of how birth works - but that doesn’t always apply to real life very well!

Early Labor vs Active Labor

The “first stage” of birth is measured by dilation of the cervix - it goes from 1cm to 10cm in dilation (the second stage is pushing your baby out, and the third stage is birthing the placenta).

This first stage is additionally broken into two different phases: the early, or latent, phase and active labor.

Textbooks used to teach doctors that “active labor” began at 4cm, but that’s revised now to reflect 6cm as a better marker for most women.

This is important, because progress can feel “slow” through that early, latent part of labor. Sometimes care providers are impatient and want to say that labor is “not progressing” - even blaming a “too big” baby or a “too small” pelvis…

…when truthfully, labor is just not really going yet!

It’s ideal for you to be at home during this early part of labor, which is why I spend a lot of time in my childbirth classes talking to women about when to head to the hospital or when to call the midwife!

It’s Not Just About the Cervix (Your Baby Needs to Move)

I talked to you about baby positions earlier in the article - your baby doesn’t just stay in the same position throughout labor.

Most of the time we think about childbirth as just getting to 10cm and then pushing a baby out.

But that’s really simplistic and it dismisses the many hidden things going on during labor.

Your baby’s rotation is just one of those things - your baby is an active participant in birth!

In fact, it’s your job to help your baby move - which is where good birth skills come in really handy. You can move to help create room for your baby to move…

…and suddenly a “stuck” baby can come flying out (I literally had that happen during my first baby’s birth - it was so dramatic that my midwife had to do a football-style catch and ended up with a baby imprint on her shirt!)

(NOTE: Want a Perfect Birth Plan Template? Use this template and step-by-step videos to write a birth plan that gets your birth team on your side for a beautiful birth experience! Get the kit here.)

Creating Pelvic Mobility

Let’s dive into the nitty-gritty of giving birth…

…Skills!

There are a number of different skills and techniques you can use to help increase your pelvic size.

Only a small amount of change is needed to create big movement for your baby, so don’t be discouraged if you need to help your baby rotate.

A skills-based course like The Birthing Better course goes into great detail on how to “map” your pelvis, then choose positions specifically for your pelvic type. Birthing Better also teaches you how to prepare your pelvis during pregnancy by softening your tissues and ligaments.  I personally used it during my pregnancies.

I discuss some of these techniques in my article on How to Handle the Ring of Fire During Your Natural Birth, as well.

Spinning Babies also has a good resource covering techniques to help your baby move (and encouraging good alignment during pregnancy)

Movement is Essential

Moving during your birthing time is the most important thing you can do to increase your pelvic size and have a normal delivery!

Changing positions gives your baby room to rotate and move. Talk to your care provider about intermittent fetal monitoring and skipping the IV so you can get up and move around.

An old OB shared story that led to an epiphany for him:

Movement is powerful!

Hear me share this story and see me demonstrate a powerful technique in my free childbirth mini-class series:

You can create a lot of movement even in a small room - 

Don’t forget to give yourself energy during birth - even if you don’t feel like eating a lot, or at all, you should keep your energy up. Bring an energy drink with quick sugars in it (even a soda or soft drink can give you a quick boost if that’s all that’s available).

Midwives like honey, but you can use whatever sounds good for you - yogurt or toast with jam, honey, soda, whatever!

One Final Note - How an Epidural Can Cause CPD

This is a natural birth site, so I realize I have a bias! But I want you to know that there’s a real issue with “failure to progress” or “stuck babies” and epidurals…

There are a number of different reasons that an epidural can contribute to a slow or stalled labor.

That stall can be mistakenly labeled as cephalopelvic disproportion when that’s not the case at all - the real problem is a sluggish uterus and a mama who can’t move to help her baby rotate.

Doctors use Pitocin to help counteract the slow contractions, but that doesn’t fix everything that leads to poor positioning.

It’s good to be aware of that - especially if you want to increase pelvic size or if you’re worried that your pelvis is (or was, in a previous birth), “too small.”

I highly recommend you take a good childbirth class so you know natural pain relief techniques for labor - and so you have the skills you need to keep your labor moving quickly and easily. Natural birth is a great gift to your baby, and to yourself!

Related Questions

Can you give birth naturally if you have a small pelvis? Yes - especially because most women who believe they have a “small pelvis” don’t actually have one! As I discussed above, a true small pelvis is rare, and even petite women can have a vaginal birth. Staying active and healthy before your baby’s birth, taking childbirth classes so you know how to position your baby - and how to have a smooth birth - will all help you birth naturally even if you’re small.

Does the pelvic bone expand during childbirth? Yes - the hormone relaxin is a powerful hormone that dramatically increases circulation during pregnancy and remains high throughout childbirth. This hormone softens connective tissue and ligaments so the pelvis can actually flex during labor. Changing positions can also create a lot of room in the pelvis.

Is it harder to give birth if you’re skinny? Many women worry about giving birth when skinny because they assume it means you have a smaller pelvis. But “skinny” or petite really has nothing to do with your frame (women of all sizes have pelvises of all sizes). Unless you were malnourished, your pelvis is likely plenty big to birth your baby. You should eat well during pregnancy so you have a healthy baby and energy for labor.

(NOTE: Want a Perfect Birth Plan Template? Use this template and step-by-step videos to write a birth plan that gets your birth team on your side for a beautiful birth experience! Get the kit here.)