New study says women should give birth lying on their side

Women should lie on their side while giving birth rather than adopting an upright position, say experts.

Expectant mothers are often told to stay active in labour or adopt upright positions to prevent slowing down delivery, ease pain and reduce the chance of needing intervention such as forceps.

But a new study has found that women are actually more likely to have a natural birth without any intervention if they lay on their side.

The length of labour was also slightly shorter when women were lying down and they were no more likely to need a suction device or forceps delivery, Cesarean section or to suffer tearing.

At present, UK guidelines say women having an epidural should stay upright in the second stage of labour to reduce the chance they will need ventouse or forceps.

But the new study, the largest to date on the issue, questions this.

New research challenges current guidelines that say women having an epidural should stay upright (stock photo)

Professor Peter Brocklehurst, from the University of Birmingham, who worked on the study, said to cause distress to the baby and should not be recommended.

said: ‘We are now designing the next trial to look at position in labour among women without epidural.

‘If you look at the evidence saying upright is best, then yes, it should be questioned.’

However, he warned women not to lay flat on their backs in labour, as this is known to cause distress to the baby.

HAVING AN EPIDURAL DOES NOT SLOW DOWN LABOUR

Women who have an epidural when giving birth do not slow down their labour, despite NHS warnings.

The pain relief injection has been said to make the second stage of labour last around an hour longer.

Women are told this delay can raise their risk of excessive bleeding, infection and their baby being delivered with forceps.

However a new study of 400 first-time mothers has found those given an epidural spend no longer in labour, and the existing advice could be out of date.

Around a third of British women choose an epidural when they give birth, particularly if it is a long or painful labour.

The NHS Choices website warns couples that ‘epidurals can prolong the second stage of labour’, and many doctors cut women off from the local anaesthetic at this point.

But Dr Philp Hess, a senior author of the latest research, from Harvard Medical School, said: ‘We found that exchanging the epidural anaesthetic with a saline placebo made no difference in the duration of the second stage of labour.’

Key findings

The randomised controlled trial, published in the British Medical Journal (BMJ), looked at 3,093 women having a low-dose epidural. who gave birth in 41 UK hospitals between October 2010 and January 2014.

Women were randomly allocated an upright or lying down position (lying on the left or right side) during the later stages of labour.

The study found there were fewer spontaneous vaginal births in women in the upright group (35.2 per cent), compared with women in the lying down group (41.1 per cent).

Professor Brocklehurst said researchers could only speculate on the reasons why lying down increased the chance of a spontaneous vaginal birth.

‘However, the evidence we have found from this large trial group provides an easy and cost-free intervention in our labour wards,’ he said.

‘Pregnant women, in consultation with their healthcare providers, can now make informed choices about their position in the second stage of labour.’

He said that given the clear benefit of the lying down position, ‘perhaps all women who have an epidural should be offered the choice of adopting a lying down position in the second stage until we know otherwise’.

The team plan to replicate the clinical trial in women not having an epidural. The study was funded by the National Institute for Health Research.

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