Evidence based Comparison of merits and Demerits of different Birthing Positions and Practices- Narrative Review

Birth position can be influenced by many different factors including setting, mother's choice, caregiver preference, or medical intervention. The position assumed by women during birth is influenced by several complex factors. Historically, mothers used physiologically appropriate labor positions such as squatting, sitting up right, and even standing in the birthing process. Currently in obstetric practice, these alternative positions infrequently are used during labor while the supine position has come to be accepted as ‘best practice’ in hospital-based deliveries. Over the past century western medicine has designated pregnancy as a medical diagnosis, along with technology have led to replacing more natural obstetrical positions with the reclining lithotomy position during labor. Many caregivers around the world still prefer non-upright positions today, even though current obstetric textbooks state that it is beneficial, especially for first-time mothers, to push in upright positions. (15) Since no much evidence exists to support the most ideal maternal positions for every woman, the maternal position has been controversial over a long period. Although many researches have shed light on the use of different maternal position during the second-stage of labor, but the pros and cons of each position might not be apparent. This review aims to review and compare common positions during this stage of labour with recent research evidences to get the full picture of the benefits and risks of these positions, which might support optimal labor and improve midwifery practice.