Authors (including presenting author) :
Ngai WL(1), Yim PP(1), Chan LSL(1), Chung SFC(1), Tang KY(1), Lau WL(1)
Affiliation :
(1) Obstetrics and Gynecology, Kwong Wah Hospital
Introduction :
Maternal positions act as a nursing intervention may facilitate optimal maternal and neonatal outcomes during labour. Flexible sacrum positions are suggested as an evidence based practice for childbirth that are beneficial to take the weight off the tailbone, conducive to expand pelvic outlet and favor fetal head descent which facilitate spontaneous pushing in physiological childbirth.
Lateral position, one of the flexible sacrum positions, is a relax position for avoiding maternal exhaustion, and sustains the reassuring fetal status by protecting the major veins from being compressed during labour. In addition, it takes pressure off the perineum during birth, promoting better perineal outcome.
Objectives :
To assess the effects of lateral birthing position (flexible sacrum position) on duration of the second stage of labor, perineal outcomes, postpartum hemorrhage, and neonatal outcome by Apgar scores.
Methodology :
A retrospective review included the examination of hospital records from 332 normal vaginal delivered women with the maturity between 37-42 weeks of gestation in Kwong Wah Hospital from June to August 2022. The effects of the duration of second stage, perineal outcomes and blood loss were investigated between lateral position(flexible sacrum position) and semi-recumbent position (non-flexible sacrum position) for delivery through Pearson’s chi-square.
Result & Outcome :
21 women gave birth in lateral position while 311 women in semi-recumbent position. The lateral position was associated with significantly less episiotomies than the semi-recumbent position (p=0.003, 95% CI). Moreover, the lateral birth position was correlated with reducing severity of perineal wound condition, resulted in decreasing blood loss. However, there was no significant different in duration of second stage, postpartum hemorrhage and Apgar score between flexible and non-flexible sacrum position.
Conclusions: Childbirth in the flexible sacrum position resulted in less perineal trauma when compared with the non-flexible sacrum position. The results support the use of flexible sacrum positions for childbirth. With the protective effect of perineum, women with a normal birth and minimal or no perineal trauma will have the best postpartum recovery, less perineal pain and better physical functioning.
Relevance to clinical practice: The goal of intrapartum care includes both a safe birth and optimal health of the new mother. The hospital could encourage midwives to provide evidence-based midwifery practice and adequate information on various birth positions to labouring women in a respectful manner; empower women, and attain women-centered care and a positive childbirth experience.
