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Best Birth Position Without Epidural Anesthesia

Cochrane; ePub 2017 May 25; Gupta, et al

Women who give birth in the upright position without epidural anesthesia may benefit from a reduction in duration of second stage when compared with supine positions, according to a Cochrane review of 30 randomized, quasi-randomized, or cluster-randomized controlled trials involving 9,015 women of any upright position assumed by pregnant women during the second stage of labor compared with supine or lithotomy positions. Reviewers found:

  • In 19 trials (n=5,811) women who gave birth in the upright position had the length of time they were pushing reduced by ~6 minutes when compared to supine positions.
  • In 21 trials, (n=6,481), fewer women had an assisted delivery.
  • In 16 trials (n=5,439), the number of women having a cesarean delivery did not differ.
  • Fewer women had an episiotomy, although there was a tendency for more women to have perineal tears.
  • In 15 trials (n=5,615) women were more likely to have a blood loss of ≥500 mL in the upright position.
  • There was no difference in the number of admissions to the neonatal unit.

Citation:

Gupta JK, Sood A, Hofmeyr GJ, Vogel JP. Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database of Systematic Reviews. 2017, Issue 5. Art. No.: CD002006. doi:10.1002/14651858.CD002006.pub4.