Use Of Different Positions Research Articles

Prospective study of different postures during the second stage of labour and their outcome

Background: For centuries, there has been controversy around whether being upright (sitting, birthing stools, chairs, squatting) or lying down have advantages for women delivering their babies. To assess the benefits and risks of the use of different positions during the second stage of labour (i.e. from full dilatation of the cervix).Aim of the study: To study the effect of various postures during the second stage of labour. To compare the duration of the second stage of labour, maternal and fetal outcome in different postures. Materials and Methods: 400 women in labour are studied as to the labour pattern and delivery in different postures. All subjects are matched according to age and parity.Study Design: Prospective Study. Results and Conclusion: Women in squatting position and sitting position had number so intact perineum and no one had episiotomy especially multigravida. Pain perception using the visual analog scale was found to be more in supine, knee elbow position. Overall satisfaction was found better in squatting position than sitting, knee-elbow position in decreasing order. Age group preferred equally position between 26 – 30 years. Multigravida patients preferred squatting posture than any other postures, due to their previous birth experience in the supine position. Primigravida patients preferred the supine position mostly. Blood loss in each posture compared by using under buttock drape. No one presented with postpartum haemorrhage. More comfortable posture during the second stage of labour can be chosen by a mothers by using this study. Because the preference of birthing posture is a basic right of the patient. Duration of the second stage of labour is reduced in squatting and sitting position.

What influences women\u2019s movement and the use of different positions during labour and birth: a systematic review protocol

BackgroundWomen want to give birth in a safe and supportive environment where they are free to move and adopt different positions. Moving freely and using different positions in labour results in a range of physical and psychological benefits for women. However, many women report that they are restricted from moving freely during labour and birth and it is important to understand the factors that are influencing this.MethodsA mixed-methods systematic review will be undertaken. Qualitative, quantitative and mixed-methods primary empirical studies will be identified by systematically searching seven electronic databases using a search strategy that includes medical subject headings (MeSH) and keywords to cover synonyms and related terms. In addition, reference-tracking will be undertaken, and expert researchers will be contacted to locate relevant studies. Two reviewers will be involved in the assessment of the studies against eligibility criteria, formal quality appraisal and data extraction. A results-based convergent synthesis will be undertaken, using narrative synthesis if the quantitative data are too heterogeneous for meta-analysis, meta-ethnography for the synthesis of the qualitative data and the production of a line of argument synthesis. Finally, confidence in the findings will be formally assessed and conclusions drawn.DiscussionThe findings of this review will allow researchers, practitioners and policy makers to better understand the factors influencing women’s movement and the use of different positions during labour and birth. This will inform future research and the development of maternity services designed to implement best-evidence concerning movement and positioning during labour and birth into clinical practice.Systematic review registrationIn accordance with the PRISMA-P guidelines (Moher et al. Syst Rev 4:1, 2015), the systematic review protocol was registered with the International Prospective Register of Systematic reviews (PROSPERO) on July 17, 2018 (CRD42018103354).

Malawi women's knowledge and use of labour and birthing positions: A cross-sectional descriptive survey.

Despite research evidence supporting use of upright birthing positions, most women give birth in supine position. Little is known about women's knowledge and use of labour and birthing positions. Specifically, there is a lack of evidence on Malawi women's knowledge and use of birthing positions, and this limits the possibility of improvement in childbirth practices. To assess women's knowledge and use of different positions during labour and birthing. The study used a cross-sectional descriptive survey in a Malawi maternity unit where 373 low-risk postnatal women participated in face-to-face exit interviews, using a structured questionnaire. A descriptive analysis of the categorical variables was conducted to examine frequencies and percentages. The majority of women knew about walking (66.4%) and lateral (60.6%) as labour positions, whereas 99.2% knew about the supine as a birthing position. Half of the women (50%) walked during labour and the majority (91.4%) gave birth whilst in supine position. Midwives were the main source of information on positions used during childbirth. Education about different birthing positions is needed for women who deliver at the maternity unit so that they can make informed decisions on their own options for childbirth. However, midwives must have the competence to encourage and assist women give birth in different positions, so professional development of midwives in childbirth positions is a priority. Childbirth education should include information on the various labour and birthing positions. Midwives should be equipped with appropriate skills to help women use different positions during childbirth.

Position for women during second stage of labour.

For centuries, there has been controversy around whether being upright (sitting, birthing stools, chairs, squatting) or lying down have advantages for women delivering their babies. To assess the benefits and risks of the use of different positions during the second stage of labour (i.e. from full dilatation of the cervix). We searched the Cochrane Pregnancy and Childbirth Group trials register (16 April 2003). Trials that used randomised or quasi-randomised allocation and appropriate follow up and compared various positions assumed by pregnant women during the second stage of labour. We independently assessed the trials for inclusion and extracted the data. Results should be interpreted with caution as the methodological quality of the 19 included trials (5764 participants) was variable. Use of any upright or lateral position, compared with supine or lithotomy positions, was associated with: reduced duration of second stage of labour (10 trials: mean 4.29 minutes, 95% confidence interval (CI) 2.95 to 5.64 minutes) - this was largely due to a considerable reduction in women allocated to the use of the birth cushion; a small reduction in assisted deliveries (18 trials: relative risk (RR) 0.84, 95% CI 0.73 to 0.98); a reduction in episiotomies (12 trials: RR 0.84, 95% CI 0.79 to 0.91); an increase in second degree perineal tears (11 trials: RR 1.23, 95% CI 1.09 to 1.39); increased estimated blood loss greater than 500 ml (11 trials: RR 1.68, 95% CI 1.32 to 2.15); reduced reporting of severe pain during second stage of labour (1 trial: RR 0.73, 95% CI 0.60 to 0.90); fewer abnormal fetal heart rate patterns (1 trial: RR 0.31, 95% CI 0.08 to 0.98). The tentative findings of this review suggest several possible benefits for upright posture, with the possibility of increased risk of blood loss greater than 500 ml. Women should be encouraged to give birth in the position they find most comfortable. Until such time as the benefits and risks of various delivery positions are estimated with greater certainty, when methodologically stringent trials' data are available, women should be allowed to make informed choices about the birth positions in which they might wish to assume for delivery of their babies.

Maternal posture in labour

The position adopted naturally by women during birth has been described as early as 1882 by Engelmann. He observed that primitive woman, not influenced by Western conventions would try to avoid the dorsal position and was allowed to change position as and when she wished. Different upright positions could be achieved using posts, slung hammock, furniture, holding on to a rope, knotted piece of cloth, or the woman could kneel, crouch, or squat using bricks, stones, a pile of sand, or a birth stool. Today the majority of women in Western societies deliver in a dorsal, semi-recumbent or lithotomy position. It is claimed that the dorsal position enables the midwife/obstetrician to monitor the fetus better and thus to ensure a safe birth. This paper examines the historical background of the different postions used and its evolution throughout the decades. We have reviewed the available evidence about the effectiveness, benefits and possible disadvantages for the use of different positions during the first and second stage of labour.

Woman's position during second stage of labour.

For centuries, there has been controversy around whether being upright (sitting, birthing stools, chairs, squatting) or lying down have advantages for women delivering their babies. The objective of this review was to assess the benefits and risks of the use of different positions during the second stage of labour (i. e. from full dilatation of the cervix). Relevant trials are identified from the register of trials maintained by the Cochrane Pregnancy and Childbirth Group, and from the Cochrane Controlled Trials Register. Trials were included which compared various positions assumed by pregnant women during the second stage of labour. Randomised and quasi-randomised trials with appropriate follow-up were included. Trials were independently assessed for inclusion, and data extracted, by the two authors. Disagreements would have been resolved by consensus with an editor. Meta-analysis of data is performed using the RevMan software. Results should be interpreted with caution as the methodological quality of the 18 trials was variable. Use of any upright or lateral position, compared with supine or lithotomy positions, was associated with: 1. Reduced duration of second stage of labour (12 trials - mean 5.4 minutes, 95% confidence interval (CI) 3.9 - 6.9 minutes). This was largely due to a considerable reduction in women allocated to use of the birth cushion. 2. A small reduction in assisted deliveries (17 trials - odds ratio (OR) 0.82, 95% CI 0.69 - 0.98). 3. A reduction in episiotomies (11 trials - OR 0.73, 95% CI 0.64 - 0.84). 4. A smaller increase in second degree perineal tears (10 trials - OR 1.30, 95% CI 1.09 - 1.54). 5. Increased estimated risk of blood loss > 500ml (10 trials - OR 1.76, 95% CI 1.34 - 3.32). 6. Reduced reporting of severe pain during second stage of labour (1 trial - OR 0.59, 95% CI 0.41 - 0.83). 7. Fewer abnormal fetal heart rate patterns (1 trial - OR 0.31, 95% CI 0.11 - 0.91). The tentative findings of this review suggest several possible benefits for upright posture, with the possibility of increased risk of blood loss > 500ml. Women should be encouraged to give birth in the position they find most comfortable. Until such time the benefits and risks of various delivery positions are estimated with greater certainty when methodologically stringent trials data are available, then women should be allowed to make informed choices about the birth positions in which they might wish to assume for delivery of their babies.