Seems like a ridiculous title, right? "How to Use a Bed..." The truth is, a hospital bed, in labor and birth, can be used in so many helpful ways -- the least of which is lying in it!
You may have already heard that gravity can be very helpful in birth. If you think about how you get ketchup out of a squeeze bottle, it makes perfect sense. Baby needs to come down and out; contractions squeeze down and out; so you should.... lay down flat?? Of course not! (Though laying down in labor certainly has its place; keep reading.)
Staying in more upright/vertical positions throughout labor and birth allows you to take advantage of the natural laws of gravity as well as how your body is designed. There are a handful of tools you can purchase and bring with you to assist in different positions, but one of the most useful and versatile tool is none other than your hospital bed -- and a great support team, of course!
Changing positions in labor helps keep labor progressing, can reduce pain, and can help avoid interventions. Getting into different labor positions is helpful and possible whether you have birth with or without an epidural. Let's take a look at how you can use a hospital bed to your biggest advantage in labor.
Labor Positions to Use with a Hospital Bed
Sitting/Monitoring
Most simply, a hospital bed can be used to sit on. Lower the bed to it's lowest setting where you can easily rest your feet on the floor. You can sit on the bed to take a break from standing, or for intermittent fetal monitoring ("IFM"). Sitting on a bed is considerably more comfortable than laying flat on your back while having contractions. Sitting on the bed can also be used with an epidural. You can also sit up "in" the bed, with your legs and feet out flat or sitting cross-legged.
Semi-sitting/Monitoring
Semi-sitting allows you to rest in an upright position that uses gravity to encourage baby to descend. Semi-sitting, which is also sometimes called "throne sitting" is done with the help of a nurse who can modify the bed to position it more like a chair (see picture, right). This position also allows for easy monitoring. Opening your legs butterfly style (as pictured) will help keep your pelvis opening wide, giving baby more room to wiggle down. This position can also be used with an epidural. This position may not be ideal for those experiencing low back pain or "back labor."
Supported Standing/Leaning
For this position, raise the bed to its highest height and depending on your own height, you may need to add a pillow or two to comfortably rest your arms and head. Standing allows for optimal use of gravity to help baby descend. Leaning allows for more rest in between contractions, while still in a standing position. This position also allows a support person access to massage your back, perform a hip squeeze, or apply heat or ice to your lower back/sacrum. This is typically a good position for those experiencing back pain/"back labor." This position cannot be used with an epidural, as an epidural does not allow full use of leg muscles.
Standing/Leaning with Ball
Follow the directions above, but add a yoga/exercise ball (see picture, right) to lean over and drape yourself over for support. The ball provides allows you to take a more upright stance, which can relieve pressure on your back, and 
gives you the ability to sway/move back and forth if desired. It's also an ideal position to encourage hands-on support from all members of your team!
Squatting
Squatting during labor helps widen the opening of your pelvis which can encourage baby to move down and get into a more optimal position for birth. Lower or raise the bed to a height that will allow you to use it to support your squat by bracing onto the side. Your support persons can help make sure you're stable in your position by staying near by or offering hands-on support.
Hands and Knees / All Fours / Kneeling
Getting on your hands and knees can help relieve back pressure and allow baby to get into a more optimal position for birth. The hospital bed provides the perfect surface for a hands-and-knees or "all fours" position. You can use a flattened bed for a traditional hands-and-knees position, or you can enlist the help of your nurse to adjust the bed by lowering the bottom, creating a shelf (see picture, above), or raising the back of the bed to lean over while you kneel on the flat part of the bed. These positions can be used with an epidural.
Squatting for Pushing
Hospital beds come equipped with a particularly useful removable piece called a "squat bar." This metal bar attaches to the mid-section of the bed and provides helpful leverage to get into a deep squat, which can be very effective to help with pushing. Be sure to let the staff and your provider know you would like to try using the squat bar for pushing so they can make sure it's available (it may be in another room or tucked away). This position can most likely be used with an epidural.
Side Lying
If you're going to lay down in a hospital bed, it's ideal to lay on your side, as this is often more comfortable during contractions and allows you to keep your pelvic opening wide with the use of pillows or a peanut ball (see right). This position works well with an epidural and can be used with monitors in place. This position also allows you to rest and gives access to your back for massage or counter pressure from a support person or doula.
Recovery
If you're going to use a hospital bed for laying down on your back, it's best done after birth, during recovery. There, you can snuggle with your newborn skin-to-skin, feed baby, and of course, sleep.
How did you use your hospital bed in birth?
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Birth Hospital Birth Comfort measures Labor Positions Labor Progress Hospital bed Labor comfort Squat bar