The Vertical Position During Labor: Pain And Satisfaction [posição Vertical Durante O Trabalho De Parto: Dor E Satisfação]

Abstract

Objectives: to evaluate the vertical position adopted by nulliparous women during labor in terms of pain and satisfaction with the position. Methods: the study was based on a secondary efficacy analysis of data from 107 nulliparous women enrolled in a randomized controlled trial in which the vertical position adopted during the dilation phase of labor was evaluated. The analysis involved comparing the median percentages of the duration for which women remained in the vertical position for each of the variables studied. The Kruskal-Wallis and Mann-Whitney tests were used to determine the differences between the groups. Statistical significance was set at p7 (p=0.02). At 4 and 6 cm of dilation, the women who reported greater satisfaction remained more than 50% of the time in the vertical position (p=0.02 and p=0.03, respectively). Conclusions: the vertical position helped relieve labor pain and increased comfort and patient satisfaction.94393398(2001) Delivery, Abortion and Post-partum: Humanized Care to Woman, , Brasil. Ministério da Saúde, Brasília, DFMiquelutti, M.A., Cecatti, J.G., Makuch, M.Y., Upright position during the first stage of labor: A randomized controlled trial (2007) Acta Obstet Gynecol Scand, 86, pp. 553-558Carlson, J.M., Diehl, J.A., Sachtleben-Murray, M., McRae, M., Friedman, E.A., Maternal position during parturition in normal labor (1986) Obstet Gynecol, 68, pp. 443-447Souza, J.P., Miquelutti, M.A., Cecatti, J.G., Makuch, M.Y., Maternal position during the first stage of labor: A syste-matic review (2006) Reprod Health, 3, p. 10Liu, Y.C., Effect of an upright position during labor (1974) Am J Nurs, 74, pp. 2202-2205Flynn, A.M., Kelly, J., Hollins, G., Lynch, P.F., Ambulation in labour (1978) Br Med J, 2, pp. 591-593Diaz, A.G., Schwarcz, R., Fescina, R., Caldeyro-Barcia, R., Vertical position during the first stage of the course of labor and neonatal outcome (1980) Eur J Obstet Gynecol Reprod Biol, 11, pp. 1-7Stewart, P., Calder, A.A., Posture in labor: Patients' choice and its effect on performance (1984) Br J Obstet Gynaecol, 91, pp. 1091-1095Andrews, C.M., Chrzanowski, M., Maternal position, labor and comfort (1990) Appl Nurs Res, 3, pp. 7-13McManus, T.J., Calder, A.A., Upright posture and the efficiency of labor (1978) Lancet, 1, pp. 72-74Williams, R.M., Thom, M.H., Studd, J.W., A study of the benefits and acceptability of ambulation in spontaneous labour (1980) Br J Obstet Gynaecol, 87, pp. 122-126Bloom, S.L., McIntire, D.D., Kelly, M.A., Beimer, H.L., Burpo, R.H., Garcia, M.A., Leveno, K.J., Lack of effect of walking on labor and delivery (1998) N Engl J Med, 339, pp. 76-79Hemminki, E., Saarikoski, S., Ambulation and delayed amniotomy in the first stage of labor (1983) Eur J Obstet Gynecol Reprod Biol, 15, pp. 129-139Hemminki, E., Lenck, M., Saarikoski, S., Henriksson, L., Ambulation versus oxytocin in protracted labour: A pilot study (1985) Eur J Obstet Gynecol Reprod Biol, 20, pp. 199-208Albers, L.L., Anderson, D., Cragin, L., Daniels, S.M., Hunter, C., Sedler, K.D., Teaf, D., The relationship of ambulation in labor to operative delivery (1997) J Nurse Midwifery, 42, pp. 4-8Read, J.A., Miller, F.C., Paul, R.H., Randomized trial of ambulation versus oxytocin for labor enhancement: A preliminary report (1981) Am J Obstet Gynecol, 139, pp. 669-672Roberts, J.E., Mendez-Bauer, C., Blackwell, J., Carpenter, M.E., Marchese, T., Effects of lateral recumbency and sitting on the first stage of labor (1984) J Reprod Med, 29, pp. 477-481Huskisson, E.C., Measurement of pain (1974) Lancet, 2, pp. 1127-1131Sampieri, R.H., Collado, C.F., Lucio, P.B., (1998) Metodologìa De La Investigacion, pp. 255-292. , Second edition. Mexico: Mc Graw-HillMéndez-Bauer, C., Arroyo, J., Garcia Ramos, C., Menéndez, A., Lavilla, M., Izquierdo, F., Villa Elízaga, I., Zamarriego, J., Effects of standing position on spontaneous uterine contractility and other aspects of labor (1975) J Perinat Med, 3, pp. 89-100Melzack, R., Bélanger, E., Lacroix, R., Labor pain: Effect of maternal position on front and back pain (1991) J Pain Symptom Manage, 6, pp. 476-480Adachi, K., Shimada, M., Usui, A., The relationship between the parturient's positions and perceptions of labor pain intensity (2003) Nurs Res, 52, pp. 47-51Spiby, H., Slade, P., Escott, D., Henderson, B., Fraser, R.B., Selected coping strategies in labor: An investigation of women's experiences (2003) Birth, 30, pp. 189-194Dundes, L., The evolution of maternal birthing position (1987) Am J Public Health, 77, pp. 636-641Russell, J., Moulding of the pelvic outlet (1969) J Obstet Gynaecol Br Commonw, 76, pp. 817-820Simkin, P., Maternal positions and pelves revisited (2003) Birth, 30, pp. 130-132Green, J.M., Baston, H.A., Feeling in control during labor: Concepts, correlates and consequences (2003) Birth, 30, pp. 235-247Slade, P., Macpherson, S.A., Hume, A., Maresh, M., Expectations, experiences and satisfaction with labour (1993) Br J Clin Psychol, 32, pp. 469-48