Midwives’ views on upright birthing positions

Abstract

Upright birthing positions (UBPs) are positions which can be adopted by women during the second stage of labour. These positions are known to benefit both the mother and the foetus in ways which are not offered by the supine and lithotomy positions. The aim of this study was to explore the midwives’ views on UBPs. The objectives sought to determine the midwives’ knowledge on UBPs, to investigate midwives’ perspectives on the use of upright positions during the second stage of labour and to identify what encourages or discourages midwives to support women in adopting UBPs. The study adopted a descriptive quantitative research design whereby data was collected through a one-time, semi-structured questionnaire. The tool used was self-designed and included both open- and closed-ended questions. Participants were recruited through convenience sampling and the study population consisted of midwives working at the Central Delivery Suite and Obstetrics Relieving Pool. A total of forty-four midwives participated in this study (response rate – 88%). The data collected was inputted in Microsoft excel and analysed using both descriptive statistics and content analysis and presented using bar graphs, pie charts and tables. Findings revealed that locally, most midwives promote the use of UBPs and are knowledgeable on the effects of UBPs on maternal outcomes. However, participants need more education to increase their knowledge on the foetal and birth outcomes. This study identified that most midwives are conscious of their influence on the birth position that women adopt and claimed that they are always willing to accept maternal choice and assist them in their preferred upright position. Participants reported that clinical training on UBPs, a relationship between the midwife and the mother and support at the workplace encouraged them the most to assist women in adopting UBPs. However, midwives’ lack of confidence, medicalisation of labour, and the lack of equipment available were some of the discouraging factors mentioned by participants. In the conclusion, the strengths and limitations were outlined whilst various recommendations were put forward such as the need for more training and educational sessions on the benefits of UBPs, together with the promotion of midwifery-led care to ultimately increase the rates of UBPs in the local practice. It is also recommended that further studies are done to allow comparison between the midwives’ and mothers’ views.