Clinical and Experimental Health Sciences

Abstract

Objective: To assess the effect of the upright positions on childbirth types

in woman who did not receive routine epidural analgesia during the first

stage of labor

Methods: In this meta-analysis, articles, master’s theses, and PhD theses

published between 1970 and 2015 in 10 databases were reviewed for keywords

and inclusion criteria. The bias risks of the studies were assessed

according to Cochrane Handbook for Systematic Reviews of Interventions,

and the overall effect size analysis, heterogeneity tests, and sensitivity analysis

were performed with the publication bias, risk ratio effect size, and random

effects model.

Results: The criteria for the meta-analysis were met by 13 intervention

studies (n=2441). According to the random effect model, the overall effect

size of vaginal birth was 1.035 (95% CI=0.961–1.115), that of instrumental

vaginal birth was 0.871 (95% CI=0.591–1.285), and that of cesarean birth

was 0.625 (95% CI=0.416–0.940). After sensitivity analysis, it revealed that

the risk ratio for the cesarean delivery rate was statistically insignificant

with 0.602 (95% CI=0.319–1.134), but effect size and the heterogeneity of

cesarean delivery effect size were wider.

Conclusion: In women who did not receive routine epidural analgesia at

the first stage of labor, the effect of the upright position on vaginal and instrumental

vaginal births was insignificant; however, the rate of cesarean

delivery was less in the upright position. This study should be repeated in the

clinical setting with an appropriately designed experimental framework. The

methodology of the research subject should be conducted in an appropriately

designed experimental work. Women should be encouraged to use the

upright position while giving birth because the absence of any harm in the

upright position is important in reducing the rate of cesarean birth, but the

individual factors of the positions should be taken into consideration