Maternal positions and mobility during first stage labour

Walking and upright positions in the first stage of labour may reduce the length of labour and do not seem to be associated with increased intervention or negative effects on mothers’ and babies’ wellbeing.

A Cochrane review included 25 studies with a total of 5 218 subjects. Overall, the first stage of labour was approximately one hour and 22 minutes shorter for women randomised to upright and ambulant positions as opposed to recumbent positions (average MD -1.36, 95% CI -2.22 to -0.51; 15 studies, n=2503, I²=93%). Women randomised to upright positions were less likely to have caesarean section (RR 0.71, 95% CI 0.54 to 0.94; 14 studies, n=2682) or epidural analgesia (RR 0.81, 95% CI 0.66 to 0.99, 9 studies, n=2107, I²=61%). There were no differences between groups for other outcomes including length of the second stage of labour,or other outcomes related to the wellbeing of mothers and babies.

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and by inconsistency (heterogeneity in interventions and outcomes).

Ədəbiyyat

1. Lawrence A, Lewis L, Hofmeyr GJ et al. Maternal positions and mobility during first stage labour. Cochrane Database Syst Rev 2013;(8):CD003934 [Review content assessed as up-to-date: 18 April 2013].