Factors influencing the fulfillment of women’s preferences for birthing positions during second stage of labor

Abstract

Having choices and being involved in decision making contributes to women’s positive childbirth experiences. During a physiological birth, women’s preferences can play a leading role in the choice of birthing positions. In this study, we explored women’s preferences with regard to birthing positions during second stage of labor, with a special focus on women who preferred positions other than common supine positions. A questionnaire survey was conducted among women in 54 Dutch midwifery practices. Of the 1154 women in the study, 58.9% preferred supine positions, 19.6% preferred other positions (e.g. sitting or standing), and 21.5% had no distinct preference. Women who preferred supine positions gave birth in these positions more often than women with preferences for other positions. Among the women having a preference for other positions, the actual fulfillment of their preference was related to longer duration of second stage of labor, higher levels of education, the strength of the preference, and giving birth at home. These results demonstrate differences in women’s use of preferred positions during childbirth. Midwives can contribute to women-centered care by proactively exploring women’s preferences for birthing positions throughout pregnancy and birth, supporting women in developing well-informed choices and facilitating these choices where possible.

Keywords::

• Patient preference
• choice behavior
• decision making
• birthing positions
• home birth
• midwifery
• women-centered care

Acknowledgments

The authors thank the participating midwives, student-midwives and pregnant women in the 54 Dutch midwifery practices who made this study possible.

Declaration of interest: The authors report no declarations of interest.

Current knowledge on this subject

• Involvement in decision making contributes to women’s positive birth experiences.

• In a physiological birth, women should be encouraged to give birth in positions they find most comfortable.

What this study adds

• Women who prefer other than supine birthing positions were less likely to use these positions.

• Factors related to fulfillment of preference when preferring other than supine positions were as follows: longer duration of second stage, higher levels of education, strength of preference and home birth.