There may be little or no difference in operative birth between women who adopt recumbent or supine positions during the second state of labor with an epidural analgesia, according to a recent Cochrane review. Researchers assessed the effects of different birthing positions (upright or recumbent) during the second stage of labor, on maternal and fetal outcomes for women with epidural analgesia. All selected randomized or quasi-randomized trials included pregnant women in the second stage of induced or spontaneous labor receiving epidural analgesia of any kind. 8 randomized controlled trials involving 4,464 women were included in the review. Among the determinations:
- Overall, there may be little or no difference between upright and recumbent positions for the combined primary outcome of operative birth.
- However, high-quality evidence showed better outcomes for women moving between lying-down on the side positions that avoided lying flat on the back.
- These positions resulted in more normal births, a better experience and no harm to mother or baby when compared with an upright position.
Walker KF, Kibuka M, Thornton JG, Jones NW. Maternal position in the second stage of labour for women with epidural anaesthesia. Cochrane Database of Systematic Reviews 2018, Issue 11. Art. No.: CD008070. doi:10.1002/14651858.CD008070.pub4.