Influence on birthing positions affects women's sense of control in second stage of labour

Midwifery. 2013 Nov;29(11):e107-14. doi: 10.1016/j.midw.2012.12.007. Epub 2013 Feb 15.


Objective: to explore whether choices in birthing positions contributes to women's sense of control during birth.

Design: survey using a self-report questionnaire. Multiple regression analyses were used to investigate which factors associated with choices in birthing positions affected women's sense of control.

Setting: midwifery practices in the Netherlands.

Participants: 1030 women with a physiological pregnancy and birth from 54 midwifery practices.

Findings: in the total group of women (n=1030) significant predictors for sense of control were: influence on birthing positions (self or self together with others), attendance of antenatal classes, feelings towards birth in pregnancy and pain in second stage of labour. For women who preferred other than supine birthing positions (n=204) significant predictors were: influence on birthing positions (self or self together with others), feelings towards birth in pregnancy, pain in second stage of labour and having a home birth. For these women, influence on birthing positions in combination with others had a greater effect on their sense of control than having an influence on their birthing positions just by themselves.

Key conclusions: women felt more in control during birth if they experienced an influence on birthing positions. For women preferring other than supine positions, home birth and shared decision-making had added value.

Implications for practice: midwives can play an important role in supporting women in their use of different birthing positions and help them find the positions they feel most comfortable in. Thus, contributing to women's positive experience of birth.

Keywords: Birthing position; Choice; Sense of control; Shared decision-making.

MeSH terms

  • Adult
  • Choice Behavior
  • Decision Making
  • Female
  • Humans
  • Labor Stage, Second / psychology*
  • Midwifery / methods*
  • Natural Childbirth / nursing*
  • Netherlands
  • Nurse-Patient Relations
  • Patient Positioning* / methods
  • Patient Positioning* / psychology
  • Patient Preference
  • Pregnancy
  • Pregnant Women / psychology*
  • Surveys and Questionnaires