DR. E. SHILPALAKSHMI PRASAD,DR. SHANTHI E,DR. P. DURGA DEVI
DOI: https://doi.org/Background:Birthing position during the second stage of labor can significantly influence maternal and neonatal outcomes. While the supine or lithotomy position is commonly used in institutional settings, alternative positions such as squatting, kneeling, or lateral postures may offer physiological advantages. However, evidence from resource-constrained and provider-led contexts like India remains limited.
Objective:To evaluate and compare maternal and neonatal outcomes associated with alternative versus conventional birthing positions during the second stage of labor.
Methods:This quasi-experimental study was conducted at Saveetha Medical College & Hospitals with 48 term pregnant women in active second stage of labor. Participants were alternately assigned to Group A (alternative birthing positions: squatting, kneeling, lateral, birthing stool) or Group B (conventional supine/lithotomy position). Maternal outcomes assessed included duration of second stage, pain score (VAS), maternal satisfaction (Likert scale), perineal status, and estimated blood loss. Neonatal outcomes included Apgar scores, NICU admission, and birth weight. Data were analyzed using SPSS v25.0 with p< 0.05 considered significant.
Results:Both groups were comparable at baseline in terms of maternal age, parity, gestational age, and birth weight. The mean duration of second stage was significantly shorter in Group A (36.4 ± 7.8 minutes) compared to Group B (45.2 ± 10.3 minutes; p = 0.004). Pain scores were lower in the alternative position group (6.1 ± 1.2 vs. 7.0 ± 1.3; p = 0.021), and maternal satisfaction was significantly higher (p = 0.016). Perineal integrity was better preserved in Group A, with fewer third-degree tears and lower episiotomy rates (p = 0.028). Neonatal outcomes, including Apgar scores and NICU admissions, were comparable between groups (p> 0.05), indicating no compromise in neonatal safety.
Conclusion:Alternative birthing positions offer significant maternal benefits in terms of reduced labor duration, lower pain, higher satisfaction, and improved perineal outcomes without affecting neonatal safety. Integrating position choice into labor protocols could enhance individualized, woman-centered care in institutional birth settings.
