The effects of upright and supine birth positions on maternal and newborn outcomes in simiyu region-tanzania, A quasi-experimental study

Abstract

Background: Long time ago, Tanzanian women have preferred to give birth in upright as it fitted their culture. The upright position is associated with minimal complications on maternal and new-born outcomes. Midwives and obstetrician prefer parturient to confirm in supine position, since it is easy for them to monitor and assist labour and delivery while the position is related to maternal and new-born complications including perineal trauma and low Apgar score. Objective: This study compared the effects of upright and supine birthing positions on maternal and new-born outcomes at Bariadi and Maswa hospitals in Simiyu Region in Tanzania. Methods: A quasi-experimental study design using a quantitative approach was used. This design used for comparison of two groups one for intervention and another for non-intervention group at Bariadi and Maswa district hospital in labour room. Data were collected from 30th June to 23rd July 2020.A total of 150 parturient were included, 73 in interventional and 77 as non-interventional group. The main independent variable were birth positions (supine and upright) and the dependent variables were duration of labour, perineum status, maternal outcome and Apgar score of the new born. Data was recorded and analysed by using SPSS version 23. Results were compared using chi-square test by maintaining the P-value <0.05 as statistical significant differences. Results: Majority of women (93%) who assumed upright position during labour and delivery had faster dilatation of the cervix compared to those assumed supine position with the p-value <0.001. Faster expulsion of the baby occurred in 96% (n=70) of women used upright position while in the group of women assumed supine were 44% (n= 34%) with P-value <0.001. Only 11 participants experience perineum tear when in upright position compared to 17% (n=13) of those in supine position with the P-value < 0.429. Further, only 6% of women in upright position had blood loss of >500mls compared to 14% of women assumed supine position with P-value <0.278. There was a slight significant differences of 0.056 was identified in new born Apgar score among parturient in upright and supine groups.