Effectiveness of Upright vs. Lithotomy Birthing Position on Maternal and Newborn Outcomes
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexFemale
Age18-35
SponsorHawler Medical University
About this trial
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.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
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;
Disqualifiers
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);
Trial design
Design model
Parallel
Treatments tested in this trial
Upright Birthing Position
BehavioralThis 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
BehavioralParticipants 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.
Treatment groups
124 Participants
are divided into 2 treatment groupsGroup A: Upright Birthing Position GroupExperimental treatment 1 intervention
Group B: Lithotomy Birthing PositionActive comparator 1 intervention
Trial outcomes
Primary outcomes
1
Maternal Labor Duration
The total time from the onset of active labor until delivery. Measurement Method: Measured in minutes and seconds recording by using the stopwatch from mobile clock.
Time frame
Assessed continuously from the onset of active labor until delivery.2
Newborn Apgar score
Apgar score at 1 , 5 and 10 minutes post-delivery, Measurement Method: from 0 to 2, with a maximum total score of 10, (Color, Heart rate, Reflex, Muscle Tone, Breath). Total Score Interpretation 7-10: Generally normal; baby is likely to be in good health. 4-6: Intermediate; may need some help with breathing or other care. 0-3: Critical; immediate resuscitative efforts are typically required.
Time frame
Immediately after delivery , Assessed at 1 minute , 5 minutes and 10 minutes post-deliverySecondary outcomes
1
Maternal Perception of Pain and Comfort
Maternal self-reported pain level and comfort during labor and delivery, Measurement Method: Visual Analog Scale (VAS) for pain; Likert scale for comfort. A 0 to 10 Likert scale for pain perception provides more granularity and allows patients to more precisely indicate their pain level. Higher scores generally indicate worse outcomes, meaning more intense pain. Lower scores indicate better outcomes or less pain. 0 - No Pain 1 to 3 - Mild Pain: Minimal discomfort . 4 to 6 - Moderate Pain 7 to 9 - Severe Pain 10 - Worst Possible Pain
Time frame
Assessed during labor (intervals to be specified, e.g., every 2 hours) and immediately after delivery.2
Postpartum Hemorrhage (PPH)
Estimated blood loss during and after delivery. Measurement methods estimation by (measured in milliliters). Measuring blood loss after labor and delivery is critical in assessing maternal health and identifying postpartum hemorrhage (PPH), a leading cause of maternal mortality. Here are common methods for measuring blood loss in a clinical setting: Traditionally, healthcare providers visually assess blood loss by observing and estimating the amount of blood in pads, towels, drapes, and other materials. Though commonly used, visual estimation is often inaccurate, tending to underestimate actual blood loss. Less than 500 ml is indicated normal and more than 500 ml Indicate severe blood loss or significant intervention needs, signaling a worse outcome and potentially requiring immediate medical action.
Time frame
Estimated immediately following delivery and up to 2 hours postpartum.3
Maternal Satisfaction with the Birth Experience
Maternal satisfaction with the birth experience is a crucial indicator of quality in maternity care, reflecting the mother's perceptions, emotions, and overall satisfaction with the care received during labor and delivery. A positive birth experience can enhance maternal confidence, strengthen the mother-infant bond, and promote mental health, while a negative experience may contribute to postpartum depression, anxiety, and even trauma. Measuring Maternal Satisfaction Maternal satisfaction is often assessed using validated questionnaires, such as the Childbirth Experience Questionnaire (CEQ) by using this items : Highly Dissatisfied, Dissatisfied, Neutral, Satisfied, Highly Satisfied with good outcomes is highly satisfied but bad outcomes is highly dissatisfied.
Time frame
Assessed within the first 2 hours postpartum, typically before hospital discharge.Sponsors and contacts
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Source ClinicalTrials.gov
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