For first-time mothers on a low-dose epidural, lying down during labour results in less need for intervention, study shows.
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Attention moms-to-be mulling over labour positions for the big day: You might want to try lying down on your side to lower your chances of needing intervention while you're on a low-dose epidural.
A large study by the University of Birmingham that was published in the British Medical Journal (BMJ) has found significantly fewer interventions, such as forceps and vacuums, are needed when first-time labouring women adopt a lying down position—specifically on their sides. (Lying flat on your back isn’t usually recommended, because it puts pressure on a major artery that restricts blood flow to the baby.)
Expectant mothers on low-dose epidural (for pain relief that allows them to still feel sensation in their legs) are often encouraged to “work with gravity” while adopting a sitting, standing or kneeling position in later stages of labour for a more comfortable delivery and to get baby into the best birth position. But it seems lying on your side might actually be the best way to promote a complication-free delivery.
The randomized study included 3,093 expectant mothers with singleton pregnancies in 41 British hospitals from 2010 to 2014.
Women in the study who lied down during labour were 5.9 times more likely to have a vaginal birth without the need for forceps or a vacuum than women who stood.
The study looked specifically at women who had not previously given birth and did not include subsequent pregnancies, multiples, or those without an epidural. It was funded by the National Institute for Health Research.
It was previously known that women who have an epidural for pain relief in labour are more likely to need intervention. However, the new research implies that could be due to the fact that those who receive low-dose epidural in the UK and elsewhere are often urged to take more active, upright positions in the second stage of labour.
This new study clearly backs a policy of lying down instead.
“The intervention seems to be easy to adopt and is cost free,” say the authors of the study. “This evidence will allow pregnant women, in consultation with their healthcare providers, to make informed choices about their position in the second stage of labour.”
Other interventions, such as C-sections, were also lower in the lying down group, albeit only by about one percent.
The duration of the active second stage of labour was also about seven minutes shorter for women lying down.
Read more:
Guide to labour-pain management
The stages of labour
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