DOES POSITION MATTER?

In the 51-hospital observational study, all women delivered while lying flat on their backs. Is there merit to this practice? In a systematic Review done by Lawrence et al. In the Townsville Hospital in Queensland, Australia using the Cochrane Pregnancy Childbirth Group Trials Register (2008), the effects of encouraging women to assume different upright positions (including walking, sitting, standing and kneeling) versus recumbent positions (supine, semi-recumbent and lateral) for women in the first stage of labor in terms of length of labor, type of delivery and other important outcomes for mothers and babies were assessed. With a population of 3706, which includes 21 randomized and quasi - randomized trials, they found no differences between 2 groups for outcomes including length of the second stage of labor, mode of delivery, or other outcomes related to the well – being of mothers and babies. Overall, the first stage of labor was approximately one hour shorter for women randomized to upright as opposed to
recumbent positions (MD -0.99, 95% CI -1.60 to -0.39). For women who had epidural analgesia, there were also no differences between those randomized to upright versus recumbent positions for any of the outcomes examined in the review. However, little information on maternal satisfaction was collected, and none of the studies compared different upright or recumbent positions. In the absence of such complications and since there is no evidence that women in strict bed rest and supine position are better off in terms of length of labor and type of delivery, women should be allowed to assume whatever position they find most comfortable.