Upright maternal position in second stage labour assessed
News release from NETSCC, HTA
02 February 2010
New research commissioned by the National Institute for Health Research Health Technology Assessment programme (NIHR HTA) will assess whether adopting an upright position during the late stage of labour with an epidural, gives a greater chance of having a straightforward birth.
Epidurals are the most effective method of relieving pain in labour. About 150,000 women have epidurals during childbirth in the UK each year and they consistently report high levels of satisfaction. However, epidurals do have some disadvantages. Studies have shown that they increase the chance of women needing help to deliver their baby using forceps or vacuum suction, although modern “mobile” epidurals reduce these disadvantages compared with traditional methods.
This £2.6m study, led by Professor Peter Brocklehurst of the University of Oxford, will recruit around 3000 women through participating hospitals in the UK. Women who are in labour for the first time and who have had an effective mobile epidural, and for whom no complications are expected, will be asked to give their consent to take part. Participants will then be randomly allocated to one of two groups. Group one will be encouraged by the midwife to adopt an upright posture (this would include walking, standing, sitting out of bed or sitting bolt upright in bed) right up to their baby's birth. Group two will be asked to adopt a lying down position. The health of participating mothers and babies will be measured up to one year after birth with a postal questionnaire.
“Epidural analgesia, despite high maternal satisfaction with pain relief, does have unwanted side effects,” says Professor Brocklehurst. “It is chosen by up to 30 per cent of women in the UK each year but has been associated with an increased risk of instrumental vaginal delivery (IVD). We know that IVD may lead to problems such as increasing the chances of having an episiotomy, later bowel problems and painful sexual intercourse. If we can reduce the rate of IVD, this will have a beneficial effect for both women and their babies.”
To view full details about this project visit: http://www.hta.ac.uk/2084
Notes for editors
1. The National Institute for Health Research Health Technology Assessment (NIHR HTA) programme commissions research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 530 issues published to date. The journal’s 2009 Impact Factor (6.91) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, www.hta.ac.uk
2. The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. www.nihr.ac.uk
Contact details
Naomi Williams, Programme Manager (Communications)
Telephone: 02380 595 646, Email: N.E.Williams@southampton.ac.uk
Kelly Waterman, Assistant Programme Manager (Communications)
Telephone: 02380 597 376, Email: k.waterman@southampton.ac.uk
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