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Randomized Controlled Trial
. 2012 Aug;207(2):133.e1-5.
doi: 10.1016/j.ajog.2012.06.043. Epub 2012 Jun 23.

A randomized trial of birthing with and without stirrups

Marlene M Corton  1 , Janice C Lankford, Rebecca Ames, Donald D McIntire, James M Alexander, Kenneth J Leveno
Affiliations
Randomized Controlled Trial

A randomized trial of birthing with and without stirrups

Marlene M Corton et al. Am J Obstet Gynecol. 2012 Aug.

Abstract

Objective: The objective of the study was to determine whether bed delivery without stirrups reduces the incidence of perineal lacerations compared with delivery in stirrups.

Study design: In this randomized trial, we compared bed delivery without stirrups with delivery in stirrups in nulliparous women. The primary outcome was any perineal laceration (first through fourth degree).

Results: One hundred eight women were randomized to delivery without stirrups and 106 to stirrups. A total of 82 women randomized to no stirrups (76%) sustained perineal lacerations compared with 83 in women allocated to stirrups (78%) (P = .8). There was no significant difference in the severity of lacerations or in obstetric outcomes such as prolonged second stage of labor, forceps delivery, or cesarean birth. Similarly, infant outcomes were unaffected.

Conclusion: Our results do not incriminate stirrups as a cause of perineal lacerations. Alternatively, our findings of no difference in perineal lacerations suggest that delivering in bed without stirrups confers no advantages or disadvantages.

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Conflict of interest statement

DISCLOSURE: The authors report no conflict of interest

Figures

Figure 1
Figure 1
Delivery positions randomly allocated when the fetal head visibly distended the vulva. Shown are an artist’s rendition made from photographs taken prior to the study. A. shows delivery with stirrups and B. delivery position without stirrups.
Figure 2
Figure 2
Classification of perineal lacerations. A. First-degree laceration: superficial tear that involves the vaginal mucosa and/or perineal skin; B. Second-degree: tear extends into the muscles that surround the vagina; C. Third-degree: tear extends into the striated anal sphincter muscle; D. Fourth-degree: tear extends into the anorectal lumen.
Figure 3
Figure 3
Flow diagram of women enrolled in this trial.
See this image and copyright information in PMC

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