March 7, 2006

Delivery less painful in kneeling position

NEW YORK (Reuters Health) - First-time pregnant women who
give birth in a kneeling position experience less pain than
those who deliver in a seated position, researchers in Sweden
report. However, the duration of the active phase of labor (the
time spent pushing) is similar with the two approaches,
according to the study, published in BJOG: An International
Journal of Obstetrics and Gynecology.

Several studies have already reported the advantages of an
upright delivery position compared to one lying down, such as
less pain and more efficient contractions. However, this is the
first time researchers compared the two most common upright
delivery positions -- kneeling and sitting.

Lead by I. Ragnar, from the University of Malardalen, in
Vasteras, the team followed 271 healthy first-time mothers,
whom they randomly divided into two groups: one that prepared
for labor in a kneeling position, the other for a seated
position. After delivery the women filled out a questionnaire
describing their experience.

The results revealed no major differences between the two
groups in the duration of labor, the authors report. The
pushing phase lasted 48.5 minutes for women who kneeled and
41.0 minutes for women who sat.

On the other hand, the two groups reported significantly
different labor experiences. Women in a seated position
reported a higher level of pain, less comfort giving birth, and
"more frequent feelings of vulnerability and exposure" than
women in the kneeling position, the authors write.

The researchers also found no difference in the frequency
of sphincter ruptures between the two groups.

However, women in the kneeling position reported
significantly less pain after delivery than those in the
sitting position. "This might be explained by the kneeling
position being more flexible when it comes to moving the lower
back, diverting some of the pressure toward the lower spine,"
the authors suggest.

In addition, the researchers detected no adverse effects on
the fetus for either delivery position.

SOURCE: BJOG: An International Journal of Obstetrics,
February 2006.