Can the Miles Circuit Bring on Labor?

Key Points

• Midwives developed the Miles circuit to help encourage the progression of slow labor.
• The Miles circuit takes 90 minutes to complete.
• This series of movements may not work for every laboring woman.

If your labor is stalling, can you do anything to help get things going?

The Miles circuit is a way to potentially induce or kick-start labor that's progressing slower than may be preferable. Learn how it works.

What is the Miles circuit?

The Miles circuit is a set of movements designed by midwives to help a baby get into a better position or to progress labor.

Childbirth doula Sharon Muza and her doula friend Megan Miles swapped their favorite positions for a mother having difficulty advancing labor. The positions appeared to work to get the baby into the left occiput anterior (LOA), so Muza dubbed the positions the "Miles circuit."

It takes 90 minutes to complete the full circuit, said Liesel Teen, B.S.N., R.N., a delivery nurse and the founder of Mommy Labor Nurse in Raleigh, North Carolina.

"It works by relaxing and opening up your pelvis, which makes room for the baby to rotate and shift their position optimally for birth," she said.

What are the Miles circuit positions?

The combination of positions in the Miles circuit is meant to encourage a mispositioned baby to move into the correct position by creating more room.

Each position should take 30 minutes to complete. You may want to spend a minimum of 30 minutes in the last position, though, to encourage your baby to move down with gravity.

The following three steps comprise the Miles circuit:

1. Move into an open knee-chest position or a forward-leaning inversion.
2. Use an exaggerated side-lying position on lots of pillows.
3. Get up and move by lunging, walking up stairs or walking with a foot on the curb.

Once there is space, the theory is that the baby can move toward the cervix, which may signal your body to begin contracting, Teen said.

These stages are based on the doulas' experience. The mother should be more than 37 weeks pregnant before trying them, though. Speak with your healthcare provider to learn more about the types of things they will recommend if you stall a little during labor and delivery.

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Can you use the Miles circuit to induce labor?

Women who have passed their due date may look for something, anything, to help induce labor. We know hot sauce won't induce labor, but some people do put stock in the Miles circuit, despite a lack of published scientific data on the circuit yet. Even so, it may be worth a try.

"The method appears to be safe, and any comfortable pelvic movement is advisable during labor," said Asnat Walfisch, M.D., the head of obstetrics and gynecology at Rabin Medical Center in Tel Aviv, Israel.

"Psychologically, it can help the birthing parent to relax and let go. They feel that they've done something to help themselves and their babies," said Lorna Phillip, a certified doula and the founder of Black Mamas Birth Village in Birmingham, United Kingdom.

Having seen it in action, Phillip believes the Miles circuit can help make the minor adjustments needed to help shift the baby into a more favorable position and be ready for birth. Phillip has started to see hospital midwifery teams being trained in the 'biomechanics of birth' upon which the concept of the Miles circuit is based.

"It's definitely gaining in popularity," she said.

Is the Miles circuit safe?

"The Miles circuit can be done from the comfort of your own home, should be painless, doesn't require the assistance of a medical professional and might even help your body go into labor," Teen said.

Having tried it herself, she is now a believer.

"In general, pelvic movements during labor help the fetus in correct head engagement and descent within the mother's pelvis," Walfisch said.

The only concern Walfisch has about safety is potentially falling. Perform the circuit in a safe environment to avoid that. Stay within your physical abilities by avoiding over-flexing.

Are there Miles circuit success stories?

"I started the Miles circuit on Sunday afternoon and, finally, things got going. I gave birth during the night," said Vittoria Valeriana Veltri, a London-based event planner who dealt with stalled labor.

Phillip advised two mothers to use the circuit with stalled labor. They contacted her later to say the exercises had helped move them to the delivery stage without intervention.

While some people swear by it, the movements don't work for everyone.

"I used it with my son last year. I felt like it didn't work because he was born back-to-back, and I ended up transferring into the hospital from a homebirth because I had been pushing for too long," said Rachel Evans, Ph.D., a psychologist based in Derbyshire, U.K.

Is there anything you can do to encourage birth positioning?

In order to prepare for optimum birth positioning, Phillip recommends the following:

• Maintain good posture
• Use a birthing ball for sitting
• Stay moving

Walfisch recommends some steps to prepare for birth, too:

• Acquire knowledge so you have a general idea of what to expect.
• Keep in shape during pregnancy.
• Choose the right companions who will help you feel calm and confident.

Keep a few more practical things in mind, too, according to Teen:

• Think through the logistics. How will you get to the hospital?
• Pack your hospital bag.
• Take a childbirth class.
• Create a birth plan but stay flexible.
• Do some nesting activities.
• Set things up that will help with the postpartum transition.

The bottom line

Labor and delivery look different for every woman. What works for someone else may not work for you. Maintain realistic goals. It's impossible to do every single thing in order to prepare for labor.

The process doesn't always go smoothly. Things can get frustrating. If labor isn't progressing the way you hope, ask your doctor for help or for advice before beginning a program such as the Miles circuit.