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

Abstract

Objective: 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.

Design: A randomised controlled trial.

Setting: A county hospital delivery ward.

Sample: 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.

Methods: 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.

Main outcome measure: Duration of the second stage of labour.

Results: 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).

Conclusions: 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.