Maternal and New-Born Outcomes When Using Upright and Supine Birth Positions During Labour and Delivery: A Quasi-Experimental Study

Advera V Mtatina, Lilian Teddy Mselle, D. Mwakawanga, D. Sando, D. Mkoka
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Abstract

Purpose: The purpose of the study is to assess the effects of upright and supine birth positions on maternal and new-born outcomes including maternal blood losses, duration of labor, perineum tear or intact, and APGAR score of the new-born in the first and fifth minutes in two District hospitals in Tanzania. Methodology: A quasi-experimental study design using a quantitative approach was conducted to assess the maternal and new-born outcomes in the in intervention study group (upright) and non-intervention group (supine). A convenient sample of 150 parturient were included, among them 73 formed an intervention group and 77 were in the non-intervention group. Data analysis was done using SPSS version 23 whereby STATA software was used to assess the effect of the independent variables (birth positions) to the dependent variables (maternal and new-born outcomes). Results were compared using chi-square test at P-value <0. 05 Findings: Among of women who assumed upright birth position were experienced good maternal and new-born outcomes more than those in supine position. 93% and 96% of women in upright had short labour in 1st and 2nd stage respectively compered 24.68% and 44% in supine respectively (P-value <0.001). Maternal blood loss and perineum status had no significant differences in both positions while the APGAR score of the new-born in upright (p=0.018) were more advanced than those in supine group. The study revealed that, Upright birth positions provides positive effects to maternal and new-born more than supine positions.  The findings of this study will help pregnant women to have choice on birthing position they feel comfortable to use during labour and delivery. Recommendation: The Ministry of Health should build capacity of midwives to be able to conduct labour using alternative birthing positions including upright position.
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在分娩和分娩过程中使用直立和仰卧分娩姿势的产妇和新生儿结局:一项准实验研究
目的:本研究的目的是评估坦桑尼亚两家区县医院直立和仰卧分娩体位对产妇和新生儿结局的影响,包括产妇失血、分娩时间、会阴撕裂或完整以及新生儿第1分钟和第5分钟APGAR评分。方法:采用准实验研究设计,采用定量方法评估干预组(直立)和非干预组(仰卧)的产妇和新生儿结局。方便抽样150例产妇,其中干预组73例,不干预组77例。数据分析使用SPSS 23版,其中使用STATA软件评估自变量(出生位置)对因变量(产妇和新生儿结局)的影响。比较结果采用卡方检验,p值<0。05研究结果:与仰卧位相比,采用直立体位分娩的妇女产妇和新生儿的结局更好。仰卧位产妇第一、二期短产率分别为24.68%和44% (p值<0.001),直立位产妇短产率分别为93%和96%。产妇失血量和会阴状态两种体位差异无统计学意义,而新生儿仰卧位APGAR评分高于仰卧位(p=0.018)。研究表明,直立分娩比仰卧分娩对产妇和新生儿有更积极的影响。这项研究的结果将有助于孕妇在分娩和分娩过程中选择她们觉得舒适的分娩姿势。建议:卫生部应建设助产士的能力,使其能够使用包括直立体位在内的其他分娩体位进行分娩。
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