Thursday, 14 September 2017

Upright or lying down?

The traditional image of a woman giving birth is lying down on her back but other positions are possible, for example, squatting. Essentially the choice seems to be between being upright or lying down and it has, largely, been considered a matter of choice or comfort. But does it matter for birth outcomes? That was the subject of this review from Turkey by Deliktas and Kukulu (2017) titled: 'A Meta-Analysis of The Effect On Maternal Health Of Upright Positions During The Second Stage Of Labour, Without Routine Epidural Analgesia' and published in JAN

The aim of the study was to: 'detect the effect on maternal health of upright positions during the second stage of labour' and 22 articles met the review criteria. The results suggest that episiotomy (a surgical incision to avoid tearing) and instrumental labour (eg the use of forceps) was reduced when women used the upright positoin but that bleeding may be increased.

The authors concluded: 'The upright position applied to mothers without routine epidural analgesia during the second stage of labour probably slightly decreases the risk to the mother of instrumental birth and episiotomy. The reductions in such risks have some effects on the improvement of the comfort of birth. However, it is also concluded that the upright position may slightly increase the ratio of postpartum haemorrhage. For this reason, researchers are recommended to conduct concrete studies with well-designed methodology to quantitatively measure the postpartum haemorrhage amount.

You can listen to this as a podcast

Reference

Deliktas, A. and Kukulu, K. (2017), A Meta-Analysis of The Effect On Maternal Health Of Upright Positions During The Second Stage Of Labour, Without Routine Epidural Analgesia. J Adv Nurs.  doi:10.1111/jan.13447

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