The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women

Moraloğlu, Özlem; Kansu-Celik, Hatice; Taşçı, Yasemin; Karakaya, Burcu Kisa; Yilmaz, Y; Çakır, Ebru; Yakut, Halil İbrahim

doi:10.3109/14767058.2016.1169525

Cited by 42 publications

(60 citation statements)

References 18 publications

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“…In the present study 38/200, 19% women opted out of the kneeling group as they were not comfortable in that position, this is higher than the 8% dropout rate reported by Regnar et al but lower than 49% reported by Gardosi et al 8,9 [15][16][17][18][19][20] However, some authors failed to observe any change in the second stage of labour whereas longer labour duration has also been reported by others. [9][10][11][12][13][14] Cochrane pregnancy childbirth systemic review of randomized trials by Gupta et al reported a small but significant decrease of second stage duration in women delivering in the upright position (all combined) compared to supine position, -6.16; 95% CI -9.74, -2.59.…”

Section: Discussioncontrasting

confidence: 50%

“…16 The Cochrane review 2017 also observed the duration of labour to be reduced by -10.64 minutes; 95% CI -20.15 to -1.12, in women using birth cushions for delivery compared to supine position. 21 The present study found a difference in favor of normal vaginal delivery and a decrease in the operative vaginal delivery in the kneeling position compared to the supine position; however, the difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

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Upright kneeling position during second stage of labor: a pilot study

Dabral

Pawar

Bharti

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONThere is no ideal position for labour and delivery, the standard recommendation is to encourage and support the parturient to deliver in the position she feels most comfortable in.1,2 Although international guidelines advice against being recumbent or supine for long periods of time during labour, women are motivated to deliver in the supine position at most delivery centres in India. Women delivering in the supine position experience comparatively painful prolonged labors with increased incidence of foetal distress due to more aortocaval compression by the gravid uterus.1-5 However, supine position in the second stage of labour is favoured by most obstetricians as they are trained to take delivery in this position. It allows them to monitor the labour process better with ease of providing anaesthesia, enables them to give proper perineal support in the second stage of labour, and conduct operative vaginal deliveries.Upright labour positions have several physiological advantages over the supine position. Historically women were instinctively adopting upright positions for delivery as they experienced stronger, more efficient and less ABSTRACT Background: Women delivering in upright position have shorter labour due to efficient and stronger contractions with faster descent of foetal head. The present study aimed to find out effect of upright kneeling position in the second stage of labour on maternal and foetal outcome and assess patients' satisfaction. Methods: The study was carried out in a tertiary care hospital of North India from October 2012 to February 2014. Low risk women admitted in early labour were divided into two groups, women delivering in kneeling position and in supine position. The outcome measures studied were, duration of second stage of labour, mode of delivery, 2 nd degree perineal tears, Apgar scores at 5 minutes, NICU admission rate and patient satisfaction. Results: The mean duration of second stage of labour in kneeling group was shorter by 14.901 minutes. The rate of vaginal delivery was comparable for both primigravidas and multigravida in kneeling and supine groups, RR: 2.275, 95% CI (0.7872-6.5831) and RR: 1.633, 95% CI (0.393-6.775). Primigravidas had more 2 nd degree perineal tears in kneeling group as compared to supine, RR 4.191, 95% CI (1.54 to 11.41). No difference in Apgar scores >7 at 5 minutes was observed in both groups, however, significantly lesser babies in kneeling group were admitted in NICU, RR 0.246, 95% CI (0.079 to 0.761). There was no difference on comparing satisfaction scores of primigravidas and multigravida in both supine and kneeling position. Conclusions: Kneeling position reduces the duration of second stage of labour and NICU admissions.

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Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Upright kneeling position during second stage of labor: a pilot study

Dabral

Pawar

Bharti

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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“…The review showed that using a flexible sacrum position can reduce the duration of the second stage of labor by 21.12. The reduction was contributed mainly by a large reduction in the three studies of the birthing ball, flexible sacrum and squatting positions reduce 25.9, 29.7 and 34.38 minutes respectively (22,27,28). The reduction in duration is in line with other review and meta-analysis conducted both in UK in different times (29,30), in contrast other meta-analysis done in Australia and UK, didn't show any reduction in duration of second stage (14,31).…”

Section: Discussionsupporting

confidence: 79%

“…All the included studies were conducted in health facilities. Among the 8 included studies, two studies compare squatting position Vs supine (21,22), two studies compare sitting position Vs supine, (23,24) one compare keeling Vs supine (25), two studies compare flexible sacral position Vs supine (26,27) and one study compare ambulation and birthing ball with supine position. Two studies allowed laboring women for free choice of birthing position (26,27).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Effect of maternal birth positions on duration of second stage of labor: Systematic review and meta-analysis

Badi

Lindgren

Christensson

et al. 2019

Preprint

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Background: it is believed that giving birth in an upright position is beneficial for both mother and the infant for several physiologic reasons. An upright positioning helps the uterus to contract more strongly and efficiently, the baby gets in a better position and thus can pass through the pelvis faster. Upright and lateral positions enables flexibility in the pelvis and facilitates the extension of the outlet. Before implementing a change in birthing positions in our clinics we need to review evidences available and context valid related to duration of second stage of labor and birthing positions. Objective: The aim of this review was to examine the effect of maternal flexible sacrum birth position on duration of second stage of labor. Method: The research searched articles using bibliographical Databases: Medline/PUBMED, SCOPUS, Google scholar and Google. All study designs were considered while investigating the impact of maternal flexible sacrum birthing positioning in relation duration of second stage of labor. Studies including laboring mothers with normal labor and delivery. A total of 1,985 women were included in the reviewed studies. We included both qualitative and quantitative analysis. Results: We identified 1,680 potential citations, of which 8 articles assessed the effect of maternal upright birth positioning on the reduction during the duration of second stage of labor. Two studies were excluded because of incomplete reports for meta analysis. The result suggested a reduction in duration of second stage of labor among women in a flexible sacrum birthing position, with a mean duration from 3.2-34.8. The pooled weighted mean difference with random effect model was 21.118(CI: 11.839-30.396) minutes, with the same significant heterogeneity between the studies (I2=96.8%, p<000). Conclusion: The second stage duration was reduced in cases of a flexible sacrum birthing position. Even though the reduction in duration varies across studies with considerable heterogeneity, laboring women should be encouraged to choose her comfortable birth position. Researchers who aim to compare different birthing positions should consider study designs which enable women to choose birthing position. Prospero registration number [CRD42019120618]

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“…Agregou-se na definição operacional a posição de cócoras, após sugestão de uma especialista, visto que essa é uma das posições assumidas pelas mulheres em processo de parto. (23,106,107)…”

Section: Auxílio E/ou Estímulo Para Mudanças De Posição Desejadas Durunclassified

Desenvolvimento e validação de conteúdo do resultado de enfermagem "Satisfação da cliente: processo de parto"

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The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women

Cited by 42 publications

References 18 publications

Upright kneeling position during second stage of labor: a pilot study

Upright kneeling position during second stage of labor: a pilot study

Effect of maternal birth positions on duration of second stage of labor: Systematic review and meta-analysis

Desenvolvimento e validação de conteúdo do resultado de enfermagem "Satisfação da cliente: processo de parto"

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