DELIVERY IN AN OBSTETRIC BIRTH CHAIR - A RANDOMIZED CONTROLLED TRIAL

Objective - To determine whether nulliparae whose second stage of labour is conducted in an obstetric birth chair have a lower incidence of instrumental delivery than those using a conventional delivery bed. Design - Randomized controlled trial using sealed, opaque envelopes for allocation. Setting - Delivery ward in a busy teaching hospital. Patients - 1250 nulliparae with a singleton live fetus with cephalic presentation, without epidural anaesthesia, who had achieved full dilatation. Intervention - Intention to conduct second and third stages of labour in either the Birth-EZ chair or the conventional delivery bed, as randomly allocated. Main outcome measures - Primary measure: vaginal operative delivery; principal secondary measures: duration of second stage, perineal trauma, blood loss, women's views, and neonatal status. Results - Delivery in the birth chair did not result in a reduction in operative delivery, overall. However, there was a reduction in vaginal operative delivery for fetal heart rate abnormality. There was no beneficial effect on perineal trauma or puerperal perineal pain. Post-partum haemorrhage was more frequent in the birth chair group. Conclusions - Delivery in the birth chair does not offer any obvious advantage to women over delivery on a bed.