How the Miles Circuit Supports Birth Positioning
When it comes to preparing the body for labor and supporting optimal fetal positioning, there are few tools as simple yet effective as the Miles Circuit. This three-step series of maternal positions is often recommended during the third trimester and early labor—not just to get baby into position, but to work with the body’s natural biomechanics to create the most space possible for a smooth descent through the pelvis.
As a provider of pelvic floor physical therapy in Kansas City, we use tools like the Miles Circuit not as a magic trick, but as a way to maximize efficiency and alignment. Because when baby is in a more optimal position, labor is often shorter, smoother, and requires fewer interventions. Let’s unpack what the Miles Circuit is, how it works biomechanically, and why you’ll want it in your birth prep toolbox—whether you're birthing at home, a birth center, or a hospital.
What Is the Miles Circuit?
The Miles Circuit is a three-part series of maternal positions developed by doulas and birth workers to help reposition the baby during late pregnancy or early labor. The goal isn’t just to make you “more comfortable,” but to encourage the baby into a more ideal position—specifically LOA (left occiput anterior), the position most favorable for vaginal birth.
The three parts of the Miles Circuit include:
Open-knee chest (30 minutes): Similar to an exaggerated child’s pose. This position helps unweight the pelvis and let baby lift up and out of a less ideal position (like OP or “sunny side up”).
Side-lying release (30 minutes on each side): This uses the weight of your top leg to lengthen and balance the pelvic floor and soft tissues.
Upright and asymmetrical movements (30 minutes or more): This could be walking lunges, curb walking, or moving on a birth ball. It helps baby descend and rotate through the pelvis with gravity and movement.
It’s recommended to cycle through the circuit once or twice daily in late pregnancy (37 weeks and beyond) or use it in early labor when contractions are still manageable.
Why the Miles Circuit Works: The Biomechanics of Birth
Let’s get nerdy for a second—because this is where the magic happens. Babies don’t just drop into the pelvis and plop out. Birth is a dynamic, spiraling dance. Your baby has to rotate, tuck their chin, flex their body, and navigate three different levels of the pelvis: the inlet, midpelvis, and outlet. If there’s tension, torsion, or tightness in your pelvic floor, psoas, or sacrum, it can restrict movement and slow labor.
The Miles Circuit is brilliant because it works with your biomechanics. Here’s how:
Open-knee chest helps lift baby out of a less-than-ideal spot (like OP or asynclitic) by using gravity to unweight the cervix and lower uterine segment. This gives baby room to reposition.
Side-lying release lengthens the pelvic floor and surrounding ligaments, especially the uterosacral ligaments and obturator internus muscles. When done correctly (with proper support under the belly and hip), this can create symmetry in the pelvis and soften restrictive patterns.
Upright, asymmetrical movement uses dynamic motion to open the midpelvis and outlet, especially if done with intentional hip shifting or lunges. That internal rotation of the femur? That’s not just movement—it’s a game-changer for pelvic outlet space.
💡 In our practice at enCORE Therapy, we incorporate these principles into sessions daily. When paired with pelvic floor therapy, moms feel more in tune with their bodies and better equipped to navigate labor efficiently.
Research Behind Fetal Positioning
Fetal positioning is one of the most underrated drivers of birth outcomes. Studies show that babies in OP (occiput posterior or "sunny side up") positions are associated with longer labors, higher rates of epidural use, and more operative deliveries—including C-sections.
A study published in the Journal of Midwifery & Women's Health found that maternal positioning significantly affects fetal rotation and descent. In another study, side-lying release was specifically cited as improving alignment and balance in the pelvis, contributing to more spontaneous births and fewer interventions (Spinning Babies Research Summary).
What’s powerful about the Miles Circuit is that it uses movement and intentional positioning to give the baby their best shot at navigating the pelvis—something we often overlook in favor of timing contractions or checking dilation.
When to Use the Miles Circuit
The Miles Circuit isn’t just for when labor stalls. It can be used proactively, starting around 36–37 weeks, as part of your birth prep. It’s especially helpful for:
Moms with a history of long labors or back labor
Suspected OP, asynclitic, or unengaged babies
Those planning for VBAC
Anyone who wants to optimize their pelvic mechanics before labor
In early labor (when contractions are still far apart or irregular), using the circuit may help encourage a more favorable fetal position before labor really kicks in. Think of it as pre-game warmup for your pelvis and baby!
And if you're already in labor and things feel slow, it's a great time to pull out the circuit—especially side-lying release—to get baby unstuck and rebalanced.
How Pelvic Floor PT Enhances the Miles Circuit
Here’s the thing: If your pelvic floor is tight or unbalanced, your baby may have a harder time engaging, rotating, or descending. That’s where pelvic floor physical therapy in Kansas City and pelvic floor therapy in Overland Park come in.
At Encore Physical Therapy, we use internal and external techniques to assess and release tightness, optimize alignment, and educate moms on how to move for their pelvis. We also look at:
Pelvic asymmetry or rotation
Hip and sacral mobility
Core and breath coordination
Psoas tightness, which can tug on the uterus and make it harder for baby to get into position
So while the Miles Circuit is powerful on its own, when layered with targeted pelvic floor work, it becomes part of a holistic prep strategy that supports not just baby’s positioning—but your comfort, confidence, and control.
Real Talk: Why This Matters
Let’s be honest. Most moms aren’t told this stuff in their OB appointments. You get a checklist of "what to bring to the hospital" but not how to help your baby find the best path out. And that’s a problem.
Because when baby’s head is tilted, flexed wrong, or pushing into the pelvis crooked—it’s not just uncomfortable, it can impact:
How long you labor
Whether you need Pitocin
If you push for 10 minutes or 3 hours
Your chance of tearing
And whether you birth vaginally or by cesarean
The Miles Circuit gives you back some agency. It’s a way to say, “Hey body, let’s create space for this baby to move through.”
It doesn’t guarantee anything. But it stacks the odds in your favor—and that’s something every mom deserves.
Bottom Line: Don't Sleep on the Miles Circuit
The Miles Circuit is more than a set of exercises—it’s a biomechanical tool that aligns beautifully with what we do in pelvic floor therapy. It’s accessible, effective, and empowering. You don’t need fancy equipment or medical approval (though always check with your provider if you have special circumstances).
Want to make sure you’re doing it right? Want a pro to assess your pelvic alignment before birth? Book an evaluation with us at Encore Therapy. We proudly serve families looking for pelvic floor physical therapy in Kansas City and pelvic floor therapy in Overland Park, and we’re passionate about helping moms feel strong, supported, and informed heading into labor.
Because knowledge isn’t just power—it’s freedom.
