Determinants and Outcomes of Birth Positions among Women Giving Birth at Nakuru County Referral Hospital Kenya
Abstract
Introduction: Birth position is a common determinant for the comfort of the mother and the neonate. Further, birthing positions influence maternal and neonatal outcomes. Birth position may reduce labor augmentation, operative delivery, hospital stay, and therefore the cost in general.
Objectives: To determine birth positions and outcomes, identify factors influencing the choice among women giving birth and explore the perceptions and practices of midwives in Nakuru County Referral Hospital.
Method: A hospital-based prospective cohort study design, carried out at the Nakuru County Referral Hospital (NCRH).A total of 240 low risk pregnant women in established labor were systematic sampled for quantitative aspect of the study and 12 midwives working in the labor ward purposively sampled for the qualitative aspect of the study. Questionnaires and observation checklist were used to collect quantitative data while an interview guide was used to collect qualitative data. Data were analyzed using both descriptive and inferential statistics.
Results: The study has showed that the common position used for birth is supine. Majority of the pregnant mothers gave birth in supine position (n=203) (84.6%).The main factors associated with birth positions adopted during labor are; knowledge p<0.001, antenatal training p<0.001, education p=0.004 and having delivered in the hospital p<0.001.Outcomes after birth mainly relate to perineal integrity and time taken to deliver. Majority of the mothers in supine position had perineal tears (n=103) (50.7%) and there was a difference in the meantime to delivery among the different positions. Majority of the midwives, 10 out of 12 had knowledge on other birthing positions but preferred supine position because of ease when examining their patients.
Conclusion: The main position adopted by birthing mothers at NCRH was supine position. There is inadequate knowledge among mothers on other birthing position. Perineal integrity is maintained in other birth positions compared to supine position. Midwives preferred supine as opposed to other birth position.
Key words: birth position, outcomes, determinants, preference.
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