Maternal posture in labour

The position adopted naturally by women during birth has been described as early as 1882 by Engelmann. He observed that primitive woman, not influence d by Western conventions would try to avoid the dorsal position and was all owed to change position as and when she wished. Different upright positions could be achieved using posts, slung hammock, furniture, holding on to a r ope, knotted piece of cloth, or the woman could kneel, crouch, or squat usi ng bricks, stones, a pile of sand, or a birth stool. Today the majority of women in Western societies deliver in a dorsal, semi-recumbent or lithotomy position. It is claimed that the dorsal position enables the midwife/obste trician to monitor the fetus better and thus to ensure a safe birth. This paper examines the historical background of the different postions use d and its evolution throughout the decades. We have reviewed the available evidence about the effectiveness, benefits and possible disadvantages for t he use of different positions during the first and second stage of labour. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.