Comparison of the maternal experience and duration of labour in two upright delivery positions--a randomised controlled trial.

Abstract

To compare two upright delivery positions at the second stage of labour in healthy primiparous women with regard to duration of the second stage of labour and maternal experience. A randomised controlled trial. A county hospital delivery ward. Primiparous subjects (n=271) were randomly allocated to a kneeling (n=138) or a sitting (n=133) position during the second stage of labour. A postpartum questionnaire was answered by 264/271 women (97%) participating in the trial. Primiparous subjects were randomised to a kneeling or sitting delivery position during second stage of labour. Analysis was performed on an intention-to-treat basis. Duration of the second stage of labour. A comparison of the duration of the second stage of labour (kneeling 48.5 minutes+/-27.6 SD, sitting 41 minutes+/-23.4 SD) revealed no significant difference between the groups. A sitting position during the second stage of labour was associated with a higher level of delivery pain (P<0.01), a more frequent perception of the second stage as being long (P=0.002), less comfort for giving birth (P=0.03) and more frequent feelings of vulnerability (P=0.05) and exposure (P=0.02). There were no significant differences in the frequency of sphincter ruptures although a sitting position was associated with a higher degree of postpartum perineal pain (P<0.001) (Table 3). Kneeling and sitting upright during the second stage of labour do not significantly differ from one another in duration of the second stage of labour. In healthy primiparous women, a kneeling position was associated with a more favourable maternal experience and less pain compared with a sitting position.