Surprise: Laboring Upright Isn't Necessarily Most Effective

In a U.K. study of nulliparous women in labor with low-dose epidurals, spontaneous vaginal births were more likely in a recumbent position than an upright position.

Conventional wisdom suggests an upright labor position can improve the odds and progression of spontaneous vaginal birth. To assess the effects of maternal position on labor outcomes in nulliparous women with low-dose epidural analgesia, investigators in the U.K. randomized 3093 women with singleton pregnancies to labor in an upright (walking, standing, sitting upright, kneeling) or recumbent (lying on the left or right side) position.

Likelihood of spontaneous vaginal birth was significantly lower in women who were upright than in those who were lying down (35% vs. 41%; adjusted risk ratio, 0.86; 95% confidence interval, 0.78–0.94). Rates of instrumental delivery (forceps or vacuum) were similarly very high in both groups (55% and 51%) and …

Reviewing Author

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Surprise: Laboring Upright Isn't Necessarily Most Effective

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Reviewing Author