Evidence Based Midwifery: December 2009
Li Thies-Lagergren MMid RM, RN. Linda J Kvist2 PhD, MScN, RM.
Linda J Kvist: care development manager and senior lecturer
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Abstract
Background. Previous research has shown advantages of upright birthing positions; however, randomised controlled trials (RCTs) of interventions to encourage this are limited. The objectives of this feasibility study were to assess the possibility of a full-scale trial to test the hypothesis that birthing on a birth seat would result in a reduction in instrumental birth for women who had previously planned a vaginal birth.
Methods. This feasibility study was carried out as an RCT in Sweden to study birth outcomes of women planning a first vaginal birth. In total, 68 women were randomised to birth on the seat (experimental group) or birth in any other
position (control group). The primary outcome measurement was the number of instrumental deliveries. Secondary outcome
measurements included administration of oxytocin for augmentation of labour, length of the second stage of labour, perineal trauma, perineal oedema, maternal blood loss, haemoglobin, APGAR scores, umbilical cord pH and transfers to the neonatal intensive care unit (NICU).
Results. There were no significant differences between the birth seat group (the experimental group) and the control group for any of the outcome measurements.
Conclusions. The size of this feasibility study limits the generalisability of the findings. It has been considered that a
full-scale trial is feasible if lessons learned about a number of methodological problems, including the internal drop-out rate are addressed.
Key words: Birthing seat, childbirth, instrumental delivery, upright position, evidence-based midwifery
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