Effect of continuous epidural block combined with free positions on genital tract injury in parturient undergoing vaginal delivery

Objectives: We aimed to evaluate the effect of continuous epidural block combined with free positioning on the genital tract injury in parturients undergoing vaginal delivery. Material and methods: A total of 146 women who underwent vaginal delivery between January 2021 and December 2022 were divided into control and research groups (n = 73) using a random number table. Based on continuous epidural block, vaginal delivery was performed in a routine obstetric position for the control group and in free positions (sitting, walking, standing, kneeling, squatting, and lying on the side) for the research group. The duration of labor, neonatal asphyxia rate, genital tract injury rate, delivery outcomes, sense of control during childbirth, fear of childbirth, and postpartum fatigue were compared. Results: The research group had significantly shorter first stage of labor, second stage of labor, third stage of labor and total stage of labor than those of the control group (p < 0.05). The two groups had similar Apgar scores of neonates (p > 0.05). In the research group, the neonatal asphyxia rate and genital tract injury rate were significantly lower than those of the control group (p < 0.05). The research group had a higher natural delivery rate and lower rates of conversion to cesarean section and assisted vaginal delivery than those of the control group (p < 0.05). The score of internal control sense, score of external control sense and total score of control sense of the research group were higher than those of the control group (p < 0.05). In the research group, the scores of fears of neonatal health, delivery control, pain and hospital intervention and total score of fear were lower than those of the control group (p < 0.05). The research group had lower scores of immediate postpartum fatigues, 1-h postpartum fatigue, and 2-h postpartum fatigue than those of the control group (p < 0.05). Conclusions: Continuous epidural block combined with free positions can significantly shorten the duration of labor, reduce the incidence rate of genital tract injuries , increase the sense of control during childbirth, and ease the fear of childbirth and postpartum fatigue.