Upright versus recumbent position during first stage of labor among primipara women on labor outcomes

Abstract

Objective: The aim of this study was to assess the effect of upright versus recumbent position during the active phase of first stage of labor among primipara women on labor outcomes in term of progress, duration of labor, method of delivery, neonatal outcome and maternal satisfaction with assumed position.

Methods: Quasi experimental design was used. The study was conducted in the labor unit in obstetric department at Benha University Hospital. A purposive sample of 100 parturient women in 1st stage of labor were recruited in the study, they divided into two groups; upright group (50) and recumbent group (50). Data were collected through four main tools: Structured Interviewing questionnaire sheet, Structured Observational Checklist include (Partograph and Apgar score), Visual analogue pain intensity scale and maternal satisfaction with assumed position questionnaire.

Results: It revealed that high statistical significant difference between the upright and recumbent groups in term of decreases interval and increases duration, frequency and intensity of uterine contraction, cervical dilatation and fetal head descent/fifth among the upright group. While the recumbent group showed less progress. Moreover, the recumbent group expressed more pain score, consume longer duration of 1st, 2nd, 3rd stage of labor than the upright group and statistical significant difference in Apgar score of the neonate during both first and fifth minute. In addition, the upright group had higher satisfaction scores compared to those assumed recumbent positions (p < .001).

Conclusions: Upright position had positive effect on progress of labor, decreased duration of the three stages of labor, better neonatal outcomes and improving parturient women's satisfaction with assumed position. The study recommended that all parturient women in low-risk labor should be informed about the benefits of assuming upright positions during first stage of labor, and be encouraged and supported to use them.