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Stand and Deliver? Upright Labor Positions Reduce Pain, Speed Birth

Posted Jun 22 2009 11:34am
Ok, so here's the big evidence-based study on what midwives already know! Also, Newtonian physics would also suggest the upright position--hello, gravity, duh. So why is the hospital policy that you have to stay IN BED and tethered to the fetal monitor?

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Newswise — Women who walk, sit, kneel or otherwise avoid lying in bed during early labor can shorten the first stage of labor by about an hour, according to a new Cochrane evidence review. Women who labored out of bed during the early stages were also 17 percent less likely to seek pain relief through epidural analgesia, the review found.

“This shortens labor by about an hour and, for a lot of women, an hour would be really important,” said Teri Stone-Godena, director of midwifery at the Yale School of Nursing, who had no affiliation with the review.

Fortunately, the review did not find any differences in birth outcomes for mothers or babies due to labor position. There were no differences in terms of interventions like birth by Caesarian section. “I think this means that women can be reassured that any position that they want to get into is OK,” Stone-Godena said.

Overall, the review included 21 studies, examining 3,706 births.

It appears in the latest issue of The Cochrane Library, which is a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

So why would staying out of bed shorten labor and reduce pain?

“Women who are upright and mobile are able to change their positions more easily,” said Annemarie Lawrence, lead review author and a research midwife at the Institute of Women’s and Children’s Health at Townsville Hospital in Queensland, Australia.

“The ability to change positions, to utilize a wider variety of positions, and try other options, such as hot showers, birthing balls and beanbag supports, may help reduce overall pain and give women a greater sense of control over the progress of their labor,” she said.
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