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Volume 20, Issue 1
  • ISSN: 1574-8871
  • E-ISSN: 1876-1038

Abstract

Background

Maternal position during delivery can affect the physiology of labour and the mechanics of childbirth.

Objective

The study aimed to evaluate the impact of an upright position during the first stage of labour on maternal outcomes.

Methods

This parallel group randomised control trial was conducted from April to June 2020 among 60 women (30 each in the experimental and control groups) admitted to the selected hospital in Punjab, India. Women who entered the active stage of labour naturally with a single live foetus in cephalic presentation, aged 18-45 years, and with normal body mass index were randomly assigned either to the experimental or control group using a concealed envelope method. Women in the experimental group were informed and encouraged to adopt the upright position, while those in the control group received the standard routine care during the first stage of labour. The effectiveness of upright positions during the first stage of labour was assessed in terms of duration of the first, second, and third stages of labour, mode of delivery, and perineal lacerations. Outcome assessors were blinded to the intervention. The differences in the groups were evaluated by mean, median, frequency, percentage, Chi-square, and t-test.

Results

The results of 60 women were analysed. Women in the experimental group experienced a significant reduction in the incidence of instrumental delivery ( =0.005), perineal laceration ( =0.001), and duration of the first stage ( =0.0001) and third stage ( =0.0001) of labour compared to those in the control group. No harm was reported across the study groups.

Conclusion

This study urges nurses and midwives to recommend the use of upright positions during the first stage of labour to reduce the duration of labour and incidence of perineal laceration among women.

Clinical Trial Registration Number

CTRI/2022/04/041740.

© 2025 Bentham Science Publishers
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2024-09-04
2025-04-13

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References

  1. SinghN.P. PrajapatiA.K. KumarV. SoniK. JainP. Ruchi Prevalence of high-risk pregnancy among pregnant women enrolled under Pradhan Mantri Surakshit Matritva Abhiyan in government health facilities of district Etawah, Uttar Pradesh: A cross-sectional study.J. Family Med. Prim. Care20221151876188210.4103/jfmpc.jfmpc_1636_2135800511
     [Google Scholar]
  2. GaudernackL.C. MichelsenT.M. EgelandT. VoldnerN. LukasseM. Does prolonged labor affect the birth experience and subsequent wish for cesarean section among first-time mothers? A quantitative and qualitative analysis of a survey from Norway.BMC Pregnancy and Childbirth. BioMed Central Ltd202020
     [Google Scholar]
  3. YoungC. BhattacharyaS. WoolnerA. IngramA. SmithN. RajaE.A. BlackM. Maternal and perinatal outcomes of prolonged second stage of labour: A historical cohort study of over 51,000 women.BMC Pregnancy Childbirth202323146710.1186/s12884‑023‑05733‑z37349683
     [Google Scholar]
  4. SunX. FanX. CongS. WangR. ShaL. XieH. HanJ. ZhuZ. ZhangA. Psychological birth trauma: A concept analysis.Front. Psychol.202313106561210.3389/fpsyg.2022.106561236710822
     [Google Scholar]
  5. GoldenbergR.L. McClureE.M. SaleemS. Improving pregnancy outcomes in low- and middle-income countries.Reproductive Health.BioMed Central Ltd.201815
     [Google Scholar]
  6. MselleL.T. EustaceL. Why do women assume a supine position when giving birth? The perceptions and experiences of postnatal mothers and nurse-midwives in Tanzania.BMC Pregnancy Childbirth20202013610.1186/s12884‑020‑2726‑431931780
     [Google Scholar]
  7. World Health Organization WHO recommendations on intrapartum care for a positive childbirth experience.World Health Organization2018
     [Google Scholar]
  8. KibukaM PriceA OnakpoyaI TierneyS ClarkeM Evaluating the effects of maternal positions in childbirth: An overview of cochrane systematic reviews.Eur. J. Midwifery20215114
     [Google Scholar]
  9. HuangJ ZangY RenLH LiFJ LuH A review and comparison of common maternal positions during the second-stage of labor.Int. J. Nurs. Sci.2019646046710.1016/j.ijnss.2019.06.007
     [Google Scholar]
  10. SiccardiM. ValleC. Di MatteoF. Dynamic external pelvimetry test in third trimester pregnant women: Shifting positions affect pelvic biomechanics and create more room in obstetric diameters.Cureus2021133: e1363110.7759/cureus.1363133816030
     [Google Scholar]
  11. GormanJ. RobertsC.A. NewshamS. BentleyG.R. Squatting, pelvic morphology and a reconsideration of childbirth difficulties.Evolution, Medicine and Public HealthOxford University Press202224325510.1093/emph/eoac017
     [Google Scholar]
  12. GarbelliL. LiraV. Maternal positions during labour: Midwives’ knowledge and educational needs in Northern Italy.Eur J Midwifery202151910.18332/ejm/13642334046561
     [Google Scholar]
  13. da RochaB.D. ZamberlanC. PivettaH.M.F. SantosB.Z. AntunesB.S. Upright positions in childbirth and the prevention of perineal lacerations: A systematic review and meta-analysis. Nursing School Magazine.202054111
     [Google Scholar]
  14. AtsaliE.N. RussellK. Hospital midwives’ barriers when Facilitating upright positions during a Normal second stage of labour.Afr. J. Nurs. Midwifery201820110.25159/2520‑5293/2189
     [Google Scholar]
  15. Al AryaniZ. OrabiA. FoulyH. Examining the impact of upright and recumbent positions on labor outcomes in Saudi Arabia: A quasi-experiment.Belitung Nurs. J.20228431632410.33546/bnj.211437546496
     [Google Scholar]
  16. ZangY. LuH. ZhangH. HuangJ. ZhaoY. RenL. Benefits and risks of upright positions during the second stage of labour: An overview of systematic reviews.Int. J. Nurs. Stud.202111410381210.1016/j.ijnurstu.2020.10381233217662
     [Google Scholar]
  17. ZangY LuH ZhangH HuangJ RenL LiC Effects of upright positions during the second stage of labour for women without epidural analgesia: A meta-analysis.J. Adv. Nurs.2020763293330610.1111/jan.14587
     [Google Scholar]
  18. LawrenceA. LewisL. HofmeyrG.J. StylesC. Maternal positions and mobility during first stage labour.Cochrane Database of Systematic Reviews.John Wiley and Sons Ltd201310.1002/14651858.CD003934.pub3
     [Google Scholar]
  19. MiqueluttiM.A. CecattiJ.G. MakuchM.Y. Upright position during the first stage of labor: A randomised controlled trial.Acta Obstet. Gynecol. Scand.200786555355810.1080/0001634060118525117464583
     [Google Scholar]
  20. WalkerK.F. KibukaM. ThorntonJ.G. JonesN.W. Maternal position in the second stage of labour for women with epidural anaesthesia.Cochrane Database of Systematic Reviews.201810.1002/14651858.CD008070.pub4
     [Google Scholar]
  21. EmamA.M.M. Al-ZahraniA.E. Upright versus recumbent position during first stage of labor among primipara women on labor outcomes.J. Nurs. Educ. Pract.20188711310.5430/jnep.v8n7p113
     [Google Scholar]
  22. SharmaM. PareekS. The effects and outcomes of different maternal positions on the second stage of labor.2022Avialable from: www.mrimsjournal.com
    [Google Scholar]
  23. GonzalezM. N. TrehanG. KamelI. Pain management during labor: Part 1—pathophysiology of labor pain and maternal evaluation for labor analgesia.Top. Pain Manag.20213711810.1097/01.TPM.0000767384.20129.5c
     [Google Scholar]
  24. OndeckM. Healthy birth practice #2: Walk, move around, and change positions throughout labor.J. Perinat. Educ.2019282818710.1891/1058‑1243.28.2.8131118544
     [Google Scholar]
  25. KaramanÖ.E. YildizH. The effect on birth pain and process of the freedom of movement in the first stage of labor: A randomized controlled study.Clin Exp Health Sci202212373073810.33808/clinexphealthsci.1016033
     [Google Scholar]
  26. RossA.J. Promoting alternative and evidence-supported birthing options in promoting alternative and evidence-supported birthing options in healthcare facilities healthcare facilities.2023https://digitalcommons.gardner-webb.edu/nursing-msn
  27. BaranowskaB PawlickaP KiersnowskaI MisztalA KajdyA SysD Woman’s needs and satisfaction regarding the communication with doctors and midwives during labour, delivery and early postpartum.Healthcare20219410.3390/healthcare9040382
     [Google Scholar]
  28. ChristiaensW. BrackeP. Assessment of social psychological determinants of satisfaction with childbirth in a cross-national perspective.BMC Pregnancy Childbirth2007712610.1186/1471‑2393‑7‑2617963491
     [Google Scholar]
  29. TildenEL CaugheyAB LeeCS EmeisC The effect of childbirth self-efficacy on perinatal outcomes.J. Obstet. Gynecol. Neonatal Nurs.20164546548010.1016/j.jogn.2016.06.003
     [Google Scholar]
/content/journals/rrct/10.2174/0115748871320194240820202103
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Impact of Upright Position during the First Stage of Labour on Maternal Outcomes: A Randomized Controlled Trial
Rev. Recent Clin. Trials 20, 52 (2025); https://doi.org/10.2174/0115748871320194240820202103
/content/journals/rrct/10.2174/0115748871320194240820202103
/content/journals/rrct/10.2174/0115748871320194240820202103
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  • Article Type:     Research Article
Keyword(s): Childbirth; instrumental delivery; labour; maternal outcomes; perineal laceration; upright position

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