Biodynamic Interventions in Labor: A State of the Science Review

Abstract

Biodynamic interventions are targeted suggestions for postural changes thought to quicken the progress or ease the discomfort of labor and birth, especially when fetuses are not in the optimal position. Although biodynamic interventions carry almost no risks and come from a rich anecdotal body of evidence, they have generally not been subject to rigorous evaluation. Current clinical practice guidelines support the use of intravenous oxytocin and manual or instrumental rotation for delayed labor progress and fetal malposition; however, these interventions are associated with increased risks of maternal and neonatal morbidities. The use of biodynamic interventions may be an effective alternative to optimizing fetal position and labor progress, with fewer associated risks. This state of the science review examines research describing the efficacy of various biodynamic interventions on labor progress, fetal malposition, and mode of birth within specific clinical contexts. The review also seeks to draw out key findings for clinical practice and identify gaps in the literature for future research.