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No reducation in instrumental vaginal births and no increased risk for adverse perineal outcome in nulliparous women giving birth on a birth seat: results of a Swedish randomized controlled trial

Thies-Lagergren, Li LU ; Kvist, LInda LU ; Christensson, Kyllike and Hildingsson, Ingegerd (2011) In BMC Pregnancy and Childbirth 11(22).
Abstract
Abstract

Background: The WHO advises against recumbent or supine position for longer periods during labour and birth

and states that caregivers should encourage and support the woman to take the position in which she feels most

comfortable. It has been suggested that upright positions may improve childbirth outcomes and reduce the risk

for instrumental delivery; however RCTs of interventions to encourage upright positions are scarce. The aim of this

study was to test, by means of a randomized controlled trial, the hypothesis that the use of a birthing seat during

the second stage of labor, for healthy nulliparous women, decreases the number of instrumentally assisted births

and... (More)
Abstract

Background: The WHO advises against recumbent or supine position for longer periods during labour and birth

and states that caregivers should encourage and support the woman to take the position in which she feels most

comfortable. It has been suggested that upright positions may improve childbirth outcomes and reduce the risk

for instrumental delivery; however RCTs of interventions to encourage upright positions are scarce. The aim of this

study was to test, by means of a randomized controlled trial, the hypothesis that the use of a birthing seat during

the second stage of labor, for healthy nulliparous women, decreases the number of instrumentally assisted births

and may thus counterbalance any increase in perineal trauma and blood loss.

Methods: A randomized controlled trial in Sweden where 1002 women were randomized to birth on a birth seat

(experimental group) or birth in any other position (control group). Data were collected between November 2006

and July 2009. The primary outcome measurement was the number of instrumental deliveries. Secondary outcome

measurements included perineal lacerations, perineal edema, maternal blood loss and hemoglobin. Analysis was by

intention to treat.

Results: The main findings of this study were that birth on the birth seat did not reduce the number of

instrumental vaginal births, there was an increase in blood loss between 500 ml and 1000 ml in women who gave

birth on the seat but no increase in bleeding over 1000 ml and no increase in perineal lacerations or perineal

edema.

Conclusions: The birth seat did not reduce the number of instrumental vaginal births. The study confirmed an

increased blood loss 500 ml - 1000 ml but not over 1000 ml for women giving birth on the seat. Giving birth on a

birth seat caused no adverse consequences for perineal outcomes and may even be protective against

episiotomies.

Trial registration number: ClinicalTrials.gov.ID: NCT01182038 (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
birth* seat, childbirth, instrumental delivery, upright position
in
BMC Pregnancy and Childbirth
volume
11
issue
22
publisher
BioMed Central
external identifiers
  • scopus:79953096878
ISSN
1471-2393
DOI
10.1186/1471-2393-11-22
language
English
LU publication?
yes
id
b4a4d044-ec43-4903-bd42-b4839f13fc6d (old id 1939404)
alternative location
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071335/
http://www.biomedcentral.com/1471-2393/11/22
http://www.ncbi.nlm.nih.gov/pubmed/21435238
date added to LUP
2013-05-14 15:46:04
date last changed
2017-06-18 03:56:26
@article{b4a4d044-ec43-4903-bd42-b4839f13fc6d,
  abstract     = {Abstract<br/><br>
Background: The WHO advises against recumbent or supine position for longer periods during labour and birth<br/><br>
and states that caregivers should encourage and support the woman to take the position in which she feels most<br/><br>
comfortable. It has been suggested that upright positions may improve childbirth outcomes and reduce the risk<br/><br>
for instrumental delivery; however RCTs of interventions to encourage upright positions are scarce. The aim of this<br/><br>
study was to test, by means of a randomized controlled trial, the hypothesis that the use of a birthing seat during<br/><br>
the second stage of labor, for healthy nulliparous women, decreases the number of instrumentally assisted births<br/><br>
and may thus counterbalance any increase in perineal trauma and blood loss.<br/><br>
Methods: A randomized controlled trial in Sweden where 1002 women were randomized to birth on a birth seat<br/><br>
(experimental group) or birth in any other position (control group). Data were collected between November 2006<br/><br>
and July 2009. The primary outcome measurement was the number of instrumental deliveries. Secondary outcome<br/><br>
measurements included perineal lacerations, perineal edema, maternal blood loss and hemoglobin. Analysis was by<br/><br>
intention to treat.<br/><br>
Results: The main findings of this study were that birth on the birth seat did not reduce the number of<br/><br>
instrumental vaginal births, there was an increase in blood loss between 500 ml and 1000 ml in women who gave<br/><br>
birth on the seat but no increase in bleeding over 1000 ml and no increase in perineal lacerations or perineal<br/><br>
edema.<br/><br>
Conclusions: The birth seat did not reduce the number of instrumental vaginal births. The study confirmed an<br/><br>
increased blood loss 500 ml - 1000 ml but not over 1000 ml for women giving birth on the seat. Giving birth on a<br/><br>
birth seat caused no adverse consequences for perineal outcomes and may even be protective against<br/><br>
episiotomies.<br/><br>
Trial registration number: ClinicalTrials.gov.ID: NCT01182038},
  articleno    = {9},
  author       = {Thies-Lagergren, Li and Kvist, LInda and Christensson, Kyllike and Hildingsson, Ingegerd},
  issn         = {1471-2393},
  keyword      = {birth* seat,childbirth,instrumental delivery,upright position},
  language     = {eng},
  number       = {22},
  publisher    = {BioMed Central},
  series       = {BMC Pregnancy and Childbirth},
  title        = {No reducation in instrumental vaginal births and no increased risk for adverse perineal outcome in nulliparous women giving birth on a birth seat: results of a Swedish randomized controlled trial},
  url          = {http://dx.doi.org/10.1186/1471-2393-11-22},
  volume       = {11},
  year         = {2011},
}