Comparison the Effect of Sitting and Kneeling Positions during the Second Stage of Labor on Pain and Duration of Second Stage of Labor in Nulliparous Women

Document Type : Original Article

Authors

1 Lecturer of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 M.Sc. of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Associate Professor, Department of Obstetrics and Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Associate Professor, Department of Biostatistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: One of the most severe pain that women experience during their life is the labor pain especially in its second stage. This pain causes labor dysfunction and prolonged second stage of labor and lead mother to severe fear of vaginal delivery, so cesarean section rate increases among pregnant women.
One way to reduce pain and duration of second stage of labor is using the upright positions. But not significant what upright position is more appropriate. So this study was conducted to compare pain and duration of second stage of labor in kneeling and sitting and routine positions in nulliparous women.
Methods: This clinical trial was conducted on 90 nulliparous women who referred to “Omolbanin” hospital of Mashhad in year 2011-2012. They were selected by convenience sampling method. Participants filled the demographic questionnaire and received routine care in first stage of labor. After full cervix dilation, cases were randomly divided into three group; kneeling, sitting and supine positions. Pain intensity was recorded at the end of each contraction by using a visual analog scale and duration of second stage of labor until fetus’ feet exit. Data were analyzed by using SPSS software version 16 and ANOVA, Kruskal Wallis and independent t-test. P value less than 0.05 was considered statistically significant.
Results: Mean of pain intensity in second stage of labor in kneeling position (65.32±13.27) was less than sitting (81.08±11.29) and routine (90.20±13.93) positions (p<0.001). Duration of second stage of labor in kneeling position was less than sitting and routine positions (p<0.001) but no significant difference was found between kneeling and sitting positions in this regard (p=0.656).
Conclusion: Kneeling position in nulliparous women associate with less pain intensity and shorter duration of second stage of labor compared with sitting and routine positions.
 

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