Peer-reviewed article
Effects of Lateral Positions in Second-Stage Labour on Maternal and Neonatal Outcomes: An Observational Study Using Propensity Score Matching Analysis.
Huang J, Lu H, Wang J, Yang M, Hu Y et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines how different birthing positions during labour affect mothers and newborns. Researchers in China compared women who used lateral (side-lying) positions versus lithotomy (flat on back) positions during the second stage of labour. The study found that lateral positions reduced the need for episiotomy and severe perineal tears in first-time mothers, but were associated with longer labour duration and increased blood loss.
Key points
- Lateral positions reduced episiotomy use by 21% among first-time mothers
- First-time mothers using lateral positions had significantly reduced risks of moderate perineal tears
- Lateral positions increased the second stage of labour duration by 10 minutes in first-time mothers
- Both first-time and experienced mothers using lateral positions had greater postpartum blood loss
- No significant differences were found in mode of birth or severe complications between positions
Limitations
This study is about obstetric management and maternal health outcomes rather than child well-being per se. While neonatal outcomes (Apgar scores) were measured, the focus is on labour management techniques and maternal complications, which falls outside the scope of child well-being research.
Abstract
Aim This study aims to examine the effects of lateral positions during the second stage of labour on maternal and neonatal outcomes. Design A prospective observational study was conducted in three Chinese hospitals from June to November 2020. Methods Eligible women were divided into groups based on their use of lithotomy or lateral positions during the second stage of labour. Propensity score matching (PSM) was employed to assess the effects of lateral positions on maternal outcomes (perineal tears, episiotomy use, postpartum blood loss, duration of the second stage of labour, and mode of birth) and neonatal outcomes (Apgar scores at one and 5 min postpartum). Results After PSM matching, lateral positions were associated with a 21% reduced risk of episiotomy use among primiparous women. Primiparous women adopting lateral positions also had significantly reduced risks of moderate perineal tears. There were no significant differences in the duration of the second stage of labour, mode of birth or rates of blood loss over 500 mL at 2 h postpartum. However, lateral positions increased the duration of the second stage of labour by 10 min among primiparous women who adopted lateral positions in this study, and both primiparous and parous women using lateral positions had greater postpartum blood loss. Cases of Apgar scores less than seven and severe perineal tears were rare. Conclusion This prospective observational study indicates that lateral positions during the second stage of labour may offer protective benefits for the perineum among primiparous women. However, their use requires careful clinical judgement, as they may not be suitable for primiparous women experiencing slower labour progress, and additional attention should be given for monitoring postpartum blood loss, regardless of parity.