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Bonn, Germany — In a groundbreaking study published in the journal Archives of Gynecology, researchers from the University Hospital Bonn (UKB), the University of Bonn, and the University of Cologne have explored the relationship between birthing positions and maternal satisfaction during childbirth. The findings reveal a significant correlation between a woman’s choice of birthing position and her overall satisfaction with the birth experience.

The study surveyed nearly 800 mothers who had given birth vaginally in a hospital setting. Participants were asked about their final birthing positions—whether lying on their backs, adopting an all-fours stance, sitting upright, or squatting—and how satisfied they felt with the birth overall. Notably, the researchers focused on whether these positions were chosen voluntarily or imposed by medical staff.

Historically, the supine position, where women lie on their backs, has been the predominant birthing position in Western countries, primarily to facilitate obstetric access. However, various cultures favor upright positions, such as sitting or squatting. The best birthing position for mothers and infants remains a subject of ongoing debate in medical literature. According to Prof. Dr. Nadine Scholten, head of the UKB’s Research Unit for Health Communication and Health Services Research, current guidelines generally recommend that women adopt their preferred birthing position while also encouraging upright positions during the final stages of labor.

The study’s results indicate that approximately 75% of mothers gave birth while lying on their side or back. Among these women, nearly 40% reported that they had not voluntarily chosen their position, with many citing directives from medical personnel as the primary reason. Interestingly, women who were able to select their position voluntarily expressed higher satisfaction levels, particularly when choosing the supine position themselves. Conversely, dissatisfaction was notably higher among those whose positions were dictated by medical staff, especially when pain relief methods, such as epidurals, limited their options.

“The significant number of women who felt they did not choose their birthing position, coupled with their lower satisfaction rates, highlights an important gap in maternal care,” stated Prof. Strizek, Director of the Clinic for Obstetrics and Prenatal Medicine at the UKB. The researchers emphasize that enhancing women’s autonomy in choosing their birthing positions could lead to improved satisfaction.

Prof. Scholten noted, “To enhance women’s subjective satisfaction with their birth experiences, it is crucial to empower them with the opportunity to choose their preferred positions. This requires increased awareness and communication among medical staff about respecting and facilitating these preferences.”

In conclusion, this study underscores the importance of self-determination during childbirth. Future efforts in obstetric care should focus on creating an environment where expectant mothers feel empowered to express and implement their preferences regarding birthing positions.

For further details, refer to the journal article: Scholten, N., et al. (2024). Birthing positions and mothers’ satisfaction with childbirth: a cross-sectional study on the relevance of self-determination. Archives of Gynecology. doi.org/10.1007/s00404-024-07770-1.

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