Effect of Semi-squatting Position with Spontaneous Pushing on Duration of Second Stage of Labour and Perineal Tear Degree in Primiparous Parturients
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Abstract
Purpose: To compare the duration of second stage of labour and perineal tear degree in primiparous parturients between the group arranged in the semi-squatting position with spontaneous pushing and the group arranged in the supine position with controlled pushing.
Design: Randomized controlled trial research design.
Methods: The participants are 81 primiparous women in the labour stage at Charoenkrung Pracharak hospital. The participants were randomly assigned by a computer program into two groups: the experimental group (41) and control group (40). The experimental group was encouraged to do semi-squatting position and spontaneous pushing, while the control group was instructed to engage in dorsal recumbent position and controlled pushing according to routine nursing care. The data were collected through demographic data questionnaires and delivery record form. Descriptive statistics, independent t-test, ANCOVA, chi-square and relative risk were computed for the data analysis.
Main findings: The result showed that the duration of second stage of labour between the control and the experimental groups was not significantly different (F = .58 p = .448) when controlling for the baby weight. The perineal tears degree between the experimental and the control groups was not significantly different (p = .65). Nonetheless, more locations of tearing were significantly found in the control group (p = .009); as a result, the control group had 4.10 times greater probability of tearing (RR = 4.10; 95%CI = 1.25, 13.49) compared to the experimental group.
Conclusion and recommendations: Semi-squatting position does not shorten the duration of second stage of labour but helps reduce tearing in other areas of the birth canal. Thus, midwives should implement the semi-squatting position with spontaneous pushing as an alternative care during the second stage of labour.
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