This week, I have had babies on the brain. I think this might have something to do with the fact that I spent a large part of the weekend with a very good friend who is heavily pregnant with her first child. We spent a little time talking about her plans for the birth. The aim is to give birth at home, and my friend also remarked that her desire is to stay as upright as possible during labour. While it is customary in the UK for women to go through labour lying down, my friend believes that standing and squatting are far more natural and appropriate positions during the birthing process.
This conversation was still fresh in my mind when earlier this week I came across a report on a review of maternal position during labour. One of the outcomes assessed was the length of the first two stages of labour. Stage one is said to start when the cervix is 3 cm dilated, and ends once it is fully dilated. Stage two starts at this point and ends with the birth of the baby. Typically, the first stage of labour lasts about eight hours in women giving birth to their first child, but lasts about half this length in subsequent labours.
The review in question was conducted by scientists from the Cochrane collaboration (an international group of scientists specialising in systematic reviews of health-related interventions), and was published last week.
The review of 21 studies found that being upright during labour’s appeared to reduce the duration of the first stage of labour by about an hour. Maternal position did not seem to affect the length of the second stage of labour. Neither did it appear to influence the mode of delivery or other outcomes related to the well-being of the mother or her baby. However, in addition to appearing to reduce the length of the first stage of labour, being upright was also associated with a 17% reduced risk of having epidural analgesia.
The authors of the review concluded: There is evidence that walking and upright positions in the first stage of labour reduce the length of labour and do not seem to be associated with increased intervention or negative effects on mothers’ and babies’ wellbeing. Women should be encouraged to take up whatever position they find most comfortable in the first stage of labour. You can read more about this study and its findings here.