Abstract
Purpose
Current data regarding the effects of alternative freestyle delivery positions are insufficient to determine optimal delivery methods used by pregnant women, nurse midwives, and physicians. This study aims to confirm the safety of freestyle delivery positions in comparison with that of dorsal lithotomy in terms of maternal and neonatal physical risks.
Methods
We analyzed 219 healthy mothers with normal singleton pregnancies and cephalic spontaneous vaginal deliveries at term and included 50 mothers who delivered in the dorsal lithotomy position (lithotomy group) and 50 who delivered in a freestyle position (freestyle group) in our matched case-control study.
Results
The Apgar score at 1 min was lower in both primiparous and multiparous women in the freestyle group compared with those in the lithotomy group (p<0.001), whereas the umbilical artery pH level was higher in multiparous women (p<0.001). In primiparous women, the duration of the second stage of labor was longer (p<0.001) and postpartum blood loss at 2 h was greater (p=0.01) in the freestyle group compared with the lithotomy group. Neonatal birth weight at 1 month after birth was not significantly different between the groups. In addition, the extent of midwive's practical experience significantly affected the duration of the third stage of labor in primiparaous women in the freestyle group (R2=0.23, p=0.01).
Conclusions
Our results verified the positive effects of delivery in a freestyle position on respiration and circulation of the neonates and the necessity to safety manage postpartum blood loss at 2 h in primiparous women who deliver in this position.
