Various birthing positions and their effects on fetomaternal outcome during labour: a comprehensive review

Abstract

Labour and delivery are major challenges globally, especially in developing countries. Labouring women should be allowed to choose their preferred positions and avoid staying in supine position for prolong periods as per WHO recommendation. However, studies indicate that most of the women still give birth in a lying or semi-sitting position. This research focuses on determining the most effective birthing positions than the supine one and empowering women to select the most comfortable posture during labour. We have searched a thorough electronic database, including Google Scholar, PubMed, and the Cochrane Library, using key terms such as "labour positions", “alternate birthing positions” and "fetomaternal outcomes." After applying inclusion and exclusion criteria, we integrated total 41 studies into this review. Upright positions, birth stool, birth chair, squatting and peanut ball positions improve labour outcomes for both mother and fetus compared to supine or lithotomy positions, but may increase risk of perineal laceration, episiotomy rate and blood losses in mother. Birthing and Swiss balls have a positive effect on feto-maternal outcomes, although they may not be suitable for all women. Semi-sitting and lateral positions have mixed effects. Whereas Water birth benefits the mother but may result in lower fetal Apgar score. Many women still deliver in traditional lithotomy or semi-recumbent positions in developing countries despite the benefits of different alternative birthing positions. Health systems must adopt policies to support these positions and integrate them into midwifery education, with ongoing research to evaluate their effects and address barriers to implementation