Influence of the position of the mother at delivery over some maternal and neonatal outcomes

Objective: Evaluate possible advantages or disadvantages of the sitting over the horizontal position during the second stage of labor. Design and methods: Clinical trial randomly selecting 127 volunteers for the sitting position and 121 for the horizontal position during the second stage of labor. Duration of the second stage and of expulsion of the placenta, vulvo vaginal and perineal lacerations, blood lost and Apgar score were evaluated. Results: There was a non-significant decrease of 3.4 min in the duration of the second period in the vertical position in comparison with the horizontal position. There was a similar difference in the duration of delivery of the placenta, but also non-significant. Blood loss was slightly greater among women delivering in vertical position, but the difference did not reach significance. Breastfeeding did not show any influence on blood loss and on the time for delivering the placenta. The incidence of perineal trauma was 44.1% for vertical position and 47% for horizontal position in the whole group and of 47.8% and 71.2% in the group with history of episiotomy. This last difference was statistically significant. The results of this study are in the line of other studies that suggest some advantages and possible disadvantages of the vertical position. Conclusions: Mothers should be given the choice of the posture to be assumed during parturition. The supine position should not be imposed and episiotomy should not be a routine. (C) 1998 International Federation of Gynecology and Obstetrics.