The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women

J Matern Fetal Neonatal Med. 2017 Jan;30(2):245-249. doi: 10.3109/14767058.2016.1169525. Epub 2016 Apr 19.


Objectives: To assess the effects on neonatal and maternal outcomes of different pushing positions during the second stage of labor in nulliparous women.

Methods: This prospective study included 102 healthy, pregnant, nulliparous women who were randomly allocated to either of two positions: a squatting using bars (n = 51), or a supine position modified to 45 degree of semi-fowler (n = 51) during the second stage of labor. Duration of the second stage of labor, maternal pain, postpartum blood loss, abnormal fetal heart rate patterns that required intervention, and newborn outcomes were compared between the two groups.

Results: The trial showed that women who adopted the squatting position using bars experienced a significant reduction in the duration of the second stage of labor; they were less likely to be induced, and their Visual Analog Scale score was lower than those who were allocated the supine position modified to 45 degree of semi-fowler during second stage of labor (p < 0.05). There were no significant differences with regard to postpartum blood loss, neonatal birth weight, Apgar score at one and five minutes, or admission to the Neonatal Intensive Care Unit.

Conclusions: In healthy nulliparous women, adopting a squatting position using bars was associated with a shorter second stage of labor, lower Visual Analog Scale score, more satisfaction, and a reduction in oxytocin requirements compared with adopting the supine position. For Turkish women, the squatting position is easy to adopt as it is more appropriate in terms of Turkish social habits and traditions.

Keywords: Pushing; second stage of labor; squatting position; supine position; visual Analog Scale.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Delivery, Obstetric / methods*
  • Female
  • Humans
  • Infant, Newborn
  • Labor Stage, Second / physiology*
  • Pregnancy
  • Prospective Studies
  • Supine Position*
  • Time Factors
  • Turkey
  • Young Adult