Maternal positions and mobility during first stage labour

BACKGROUND: It is more common for women in the developed world, and those in low-income countries giving birth in health facilities, to labour in bed. There is no evidence that this is associated with any advantage for women or babies, although it may be more convenient for staff. Observational studies have suggested that if women lie on their backs during labour this may have adverse effects on uterine contractions and impede progress in labour. OBJECTIVE: The purpose of the review is to assess 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 labour on length of labour, type of delivery and other important outcomes for mothers and babies. CRITERIA FOR CONSIDERING STUDIES FOR THIS REVIEW: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2008). SELECTION CRITERIA: Randomised and quasi-randomised trials comparing women randomised to upright versus recumbent positions in the first stage of labour. DATA COLLECTION AND ANALYSIS: We used methods described in the Cochrane Handbook for Systematic Reviews of Interventions for carrying out data collection, assessing study quality and analysing results. A minimum of two review authors independently assessed each study.