Program
Nurse-Midwifery M.S.
Number of Pages
44
Year Approved
2025
First Advisor
Wu, Katrina
Second Reader
Paige Hardy
Abstract
Introduction: Perineal lacerations remain a common occurrence amongst vaginal deliveries. While there are some recommendations for supportive techniques throughout the literature, position is typically not included in these. Perineal trauma can have a lasting effect on the individual and increase health care costs. The purpose of this review is to identify what birthing positions are most effective at preventing perineal injury.
Methods: A formalized search of the literature was conducted via PubMed, CINAHL, Google Scholar, and SCOPUS databases. Of the 344 articles identified, 22 original studies met the inclusion and exclusion criteria for this review. A literature matrix and quality appraisal were completed to summarize the studies included.
Results: It was found that despite the generalized terminology of flexible sacrum and non-flexible sacrum positions, there was a discrepancy of classification across the studies. Even though most birthing individuals utilized a non-flexible sacral position, the results from the majority of the studies demonstrated a more protective effect in a flexible sacral position. Increased rates of episiotomies were found among those in non-flexible sacrum positions. There was an underlying relationship between satisfaction of the birthing person and the ability to assume the position they found most comfortable.
Discussion: This review supports the encouragement of women to assume a flexible sacrum position or whatever position they find most comfortable during the second stage of labor. More research is needed to solidify a recommendation. Introduction: Perineal lacerations remain a common occurrence amongst vaginal deliveries. While there are some recommendations for supportive techniques throughout the literature, position is typically not included in these. Perineal trauma can have a lasting effect on the individual and increase health care costs. The purpose of this review is to identify what birthing positions are most effective at preventing perineal injury. Methods: A formalized search of the literature was conducted via PubMed, CINAHL, Google Scholar, and SCOPUS databases. Of the 344 articles identified, 22 original studies met the inclusion and exclusion criteria for this review. A literature matrix and quality appraisal were completed to summarize the studies included. Results: It was found that despite the generalized terminology of flexible sacrum and non-flexible sacrum positions, there was a discrepancy of classification across the studies. Even though most birthing individuals utilized a non-flexible sacral position, the results from the majority of the studies demonstrated a more protective effect in a flexible sacral position. Increased rates of episiotomies were found among those in non-flexible sacrum positions. There was an underlying relationship between satisfaction of the birthing person and the ability to assume the position they found most comfortable. Discussion: This review supports the encouragement of women to assume a flexible sacrum position or whatever position they find most comfortable during the second stage of labor. More research is needed to solidify a recommendation.
Degree Name
M.S. Nurse-Midwifery
Document Type
Masterʼs thesis
Recommended Citation
Dalton, E. L., & Erlandson, T. R. (2025). The Role of Maternal Position During the Second Stage of Labor on Reducing Perineal Injury: An Integrative Review [Masterʼs thesis, Bethel University]. Spark Repository. https://spark.bethel.edu/etd/1190
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