Maternal position during parturition in normal labor.

While controversy exists as to the relationship between maternal position in labor and such measures as the labor duration, subjective discomfort, and fetal outcome, little appears to be known about the positions women assume in labor when they are permitted to do so without coercion or instruction. To learn more about maternal position in labor, we observed 80 consecutive patients with uncomplicated normal spontaneous vaginal delivery over the course of labor to ascertain the positions volitionally chosen by each. Data were collected on position preferences and phase of labor. All labors were analyzed; a codified lexicon was established to describe the position pattern in each phase and the principal positions the patient assumed over the course of labor. The frequencies and distributions were determined for nulliparas and multiparas separately and rates of position change were assessed. It was found that gravidas chose a number of different principal positions in the early phases of labor, but that they became more narrowly selective in the deceleration phase and second stage; at the same time, they tended to change position more often in late labor.

Long-term effects of labor and delivery on offspring: a matched-pair analysis.

An investigation was undertaken in an effort to learn whether the type of delivery or the pattern of labor progression has any lasting effect on the infant. Paired-data design was chosen to ensure that the comparisons between homogeneous groups would be valid. Our objective was to reduce potential bias based on unequal distribution of patient characteristics that might be more or less commonly associated with abnormal labors or with difficult deliveries. Seven-year intelligence quotient data for matched pairs of cases showed significant long-range adverse impact from midforceps operations but not from low-forceps procedures. Comparable paired-data analysis for the effect of labor disorder on the infant verified a similar deleterious influence from both arrest and protraction patterns.