Effectiveness of nulliparous women's different childbirth positions during the second stage of labor: A systematic review and network meta-analysis.
Hongyan Liu, Lingling Li, Xiaojiao Wang and 5 others
PMID 40529452WHAT IT FOUND
Upright and free positions were ranked as most likely to shorten the second stage of labor in first-time mothers, compared with lithotomy.
Semirecumbent and lateral positions also ranked ahead of lithotomy.
Key findings
01Free position and upright position were reported as more effective than lithotomy for reducing second-stage duration.
02The probability ranking for best effectiveness was upright 87.4%, free 81.1%, semirecumbent 70.0%, and lateral 62.3%.
03The review measured only second-stage duration and did not assess mode of delivery, blood loss, neonatal asphyxia, or epidural use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only duration of the second stage was analyzed; mode of delivery, blood loss, neonatal asphyxia, and epidural use were not included. Most included studies were rated as low quality, and several risk-of-bias domains were not rated low risk in all trials. Some included studies had small sample sizes. The review did not evaluate costs of different positions. The ranking gives probability of being best for duration, not certainty of a clinically important or safe effect. Safety outcomes mentioned elsewhere in the paper, such as postpartum hemorrhage, perineal trauma, shoulder dystocia, and neonatal asphyxia, were not measured in this review.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not treat the ranking as proof that upright or free positions are safest or improve birth mode or baby outcomes. The review measured only second-stage duration, and the authors did not assess mode of delivery, blood loss, neonatal asphyxia, or epidural use.