Effectiveness of Upright vs. Lithotomy Birthing Position on Maternal and Newborn Outcomes

NCT ID: NCT06670235

Last Updated: 2024-11-01

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 124 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-11-10
• Study Completion Date: 2026-09-01

Brief Summary

This study investigates the effectiveness of upright versus lithotomy birthing positions on maternal and newborn outcomes. Conducted at the Maternity Teaching Hospital in Erbil City, it employs a quasi-experimental design with 62 women in each group (Intervention and control), comparing outcomes for those encouraged to use upright positions with those in standard lithotomy. Maternal and newborn outcomes will be assessed to provide evidence on how birthing positions impact labor progression, comfort, and delivery results. The findings aim to inform clinical practice and policy, enhancing midwifery care and supporting patient-centered approaches to childbirth. Does the upright birthing position effect on maternal and newborn outcomes? Does the lithotomy birthing position effect on maternal and newborn outcomes? The expected outcomes will decrease the rate of perineal tear , episiotomy , post partum hemorrhage and decreasing the rate of admission to Neonatal Intensive Care Unit (NICU) in newborn.

Detailed Description

This quasi-experimental study assesses the impact of upright versus lithotomy birthing positions on maternal and newborn outcomes, aiming to contribute evidence-based recommendations for optimal birthing practices. As childbirth management increasingly prioritizes maternal comfort and positive birth experiences, this research seeks to fill gaps in understanding the clinical efficacy and maternal satisfaction associated with each position.

Conducted at the Maternity Teaching Hospital in Erbil City, the study will recruit 124 pregnant women, divided equally into two groups: one encouraged to adopt upright positions (e.g., squatting) during labor and delivery, and the other following standard lithotomy position practices. A non probability convenience sampling method is employed, with participants meeting specific inclusion criteria such as gestational age, health status, and labor progression factors.

The intervention includes the promotion of upright positions in the experimental group, while both groups receive standardized maternal care. Data on maternal outcomes-such as labor duration, pain levels, and delivery type-and newborn outcomes, including Apgar scores and need for resuscitation, will be collected and analyzed pre- and post-intervention.

The study's goal is to identify whether upright positions correlate with enhanced labor outcomes, reduced intervention rates, and increased maternal satisfaction. Findings are expected to guide clinical guidelines, informing both practitioners and patients on effective, patient-centered birthing positions. This research further aims to influence midwifery education and policy, advocating for practices that align with women's preferences and cultural contexts, ultimately enhancing maternal and neonatal health outcomes through evidence-based childbirth management.

Conditions

Maternal Outcomes; Newborn Complication

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Upright Birthing Position Group

Participants assigned to the Upright Birthing Position Arm will be encouraged to maintain an upright position during labor and delivery. The upright position includes a squatting. This arm aims to assess the potential benefits of the upright position, such as improved maternal outcomes (e.g., shorter labor duration, reduced need for interventions) and favorable newborn outcomes (e.g., higher Apgar scores, better oxygenation).

To evaluate the effects of upright positioning on both maternal and newborn outcomes compared to the traditional lithotomy position.

Group Type: EXPERIMENTAL

Upright Birthing Position

Intervention Type: BEHAVIORAL

This intervention involves encouraging participants to use an upright position during labor and delivery, which may include : squatting, based on their preference and comfort level. Healthcare staff will support the participants in maintaining an upright position throughout labor as much as possible to evaluate its effects on maternal and newborn outcomes.

Lithotomy Birthing Position

Participants in the Lithotomy Position Arm will follow the standard hospital practice of delivering in the lithotomy position, where the mother is lying on her back with legs supported in stirrups. This position is widely used in clinical settings and serves as the control arm to compare with the outcomes from the upright birthing position.

To serve as a control group to provide a comparative measure of maternal and newborn outcomes against the upright birthing position. Outcomes will include maternal comfort, labor duration, intervention requirements, and newborn health indicators.

Group Type: ACTIVE_COMPARATOR

Lithotomy Birthing Position

Intervention Type: BEHAVIORAL

Participants in this arm will be positioned in the lithotomy position during labor and delivery, which is a common practice in clinical settings. In this position, the mother lies on her back with her legs supported in stirrups. This intervention serves as the control condition to provide a baseline comparison for evaluating outcomes against the upright birthing position.

Interventions

Upright Birthing Position

This intervention involves encouraging participants to use an upright position during labor and delivery, which may include : squatting, based on their preference and comfort level. Healthcare staff will support the participants in maintaining an upright position throughout labor as much as possible to evaluate its effects on maternal and newborn outcomes.

Intervention Type: BEHAVIORAL

Lithotomy Birthing Position

Participants in this arm will be positioned in the lithotomy position during labor and delivery, which is a common practice in clinical settings. In this position, the mother lies on her back with her legs supported in stirrups. This intervention serves as the control condition to provide a baseline comparison for evaluating outcomes against the upright birthing position.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Pregnant women with singleton pregnancies;
• Gestational age ranges from (≥37 to 41+6 weeks);
• Spontaneous labor with no contraindications to upright positions;
• Active phase of first stage labor;
• Age 18-35 years old;
• Normal size fetus with occipito-anterior position;
• Communicate normally and participate voluntary.

Exclusion Criteria

• Abnormal fetal position (malpresentation) (e,g., persistent occipital-transverse and occipital-posterior position, etc.);
• Risky pregnancy or childbirth complications, such as (preeclampsia, eclampsia, heart disease, cephalic presentation dystocia, antepartum hemorrhage, fetal distress, intra-uterine growth restriction, intra-amniotic infection); and free from any chronic diseases (heart disease, epilepsy, hypertension, diabetes mellitus and renal disease)
• Multiple gestation;
• Cephalopelvic disproportion (CPD);
• Precipitate labor;
• Antenatally diagnosed fetal anomalies;
• Current history of a leg injury, fracture, and deep vein thrombosis.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

Hawler Medical University

OTHER

Sponsor Role: lead

Responsible Party

WAHIDA ABDULLAH IBRAHIM

Lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Hawler Medical University, Erbil, Kurdistan region 44001

Erbil, , Iraq

Countries

Iraq

Central Contacts

Wahida Ibrahim, Master

Role: CONTACT

Wahida.ibraheem@hmu.edu.krd

009647509663311

Dr. Kazhan Mahmood, PhD

Role: CONTACT

kazhan.mahmood@hmu.edu.krd

009647504491331

Facility Contacts

Zhian Mahmoud Dezayee, professor

Role: primary

zhian.dezayee@hmu.edu.krd

0662273383

References

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Other Identifiers

Birth Position

Identifier Type: -

Identifier Source: org_study_id