BIRTH IN STANDING POSITION - A HIGH-FREQUENCY OF 3RD-DEGREE TEARS

Background. During the past years a major change in the use of deliver y position has occurred in Sweden. Recumbent delivery positions have b een replaced by a variety of positions: squatting, standing, lateral, kneeling and quadruped. The consequences of this shift in obstetrical practice for development of perineal lacerations are largely unknown. Method. Retrospective comparison of uncomplicated deliveries in standi ng (n=650) and sitting (n=264) position with respect to third degree l acerations. Results. The standing and sitting delivery group were simi lar with respect to maternal, infant and delivery characteristics. The frequency of third degree tears was 2.50% in standing and 0.38% in si tting birth position (p<0.05). In nulliparous women, third degree tear s occurred in 4.2% in standing and 1.0% in sitting position. Conclusio n. The present data implies that the risk of third degree lacerations is considerably higher (7 x) in standing than in sitting birth positio ns.