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Maternal OutcomesNCT06670235

Effectiveness of Upright vs. Lithotomy Birthing Position on Maternal and Newborn Outcomes

A study testing Upright Birthing Position and Lithotomy Birthing Position in people with Maternal Outcomes and Newborn Complication, run by Hawler Medical University at 1 site in Iraq.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study investigates the effectiveness of upright versus lithotomy birthing positions on maternal and newborn outcomes. Conducted at the Maternity Teaching Hospital in Erbil City, it employs a quasi-experimental design with 62 women in each group (Intervention and control), comparing outcomes for those encouraged… Read more about this study

Who is it for?
Ages 18 to 35 years, women onlyHealthy volunteers can take part
Conditions the study is for
Maternal Outcomes, Newborn Complication
What is being tested?
Upright Birthing Position and Lithotomy Birthing Position
Could I receive a placebo?
No, everyone receives an active treatment
How many people
124 participants
Where
1 siteIraq
Study dates
10 Nov 2024to 1 Sep 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 35 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Pregnant women with singleton pregnancies;
  • Gestational age ranges from (≥37 to 41+6 weeks);
  • Spontaneous labor with no contraindications to upright positions;
  • Active phase of first stage labor;
  • Age 18-35 years old;
  • Normal size fetus with occipito-anterior position;
  • Communicate normally and participate voluntary.

Who cannot join

  • Abnormal fetal position (malpresentation) (e,g., persistent occipital-transverse and occipital-posterior position, etc.);
  • Risky pregnancy or childbirth complications, such as (preeclampsia, eclampsia, heart disease, cephalic presentation dystocia, antepartum hemorrhage, fetal distress, intra-uterine growth restriction, intra-amniotic infection); and free from any chronic diseases (heart disease, epilepsy, hypertension, diabetes mellitus and renal disease)
  • Multiple gestation;
  • Cephalopelvic disproportion (CPD);
  • Precipitate labor;
  • Antenatally diagnosed fetal anomalies;
  • Current history of a leg injury, fracture, and deep vein thrombosis.

Trial locations and contacts

1 site in 1 country.

Wahida Ibrahim, Master contact

009647509663311

Wahida.ibraheem@hmu.edu.krd

Dr. Kazhan Mahmood, PhD contact

009647504491331

kazhan.mahmood@hmu.edu.krd

Iraq1 site
  • Hawler Medical University, Erbil, Kurdistan region 44001

    Erbil, 44001

    Zhian Mahmoud Dezayee, professor, 0662273383, zhian.dezayee@hmu.edu.krd

    Wahida Abdullah Ibrahim, Master

Other trials in Iraq

About this study

Official title: Effectiveness of Using Upright Versus Lithotomy Birthing Position on Maternal and Newborn Outcomes: A Quasi Experimental Study

This study investigates the effectiveness of upright versus lithotomy birthing positions on maternal and newborn outcomes. Conducted at the Maternity Teaching Hospital in Erbil City, it employs a quasi-experimental design with 62 women in each group (Intervention and control), comparing outcomes for those encouraged to use upright positions with those in standard lithotomy. Maternal and newborn outcomes will be assessed to provide evidence on how birthing positions impact labor progression, comfort, and delivery results. The findings aim to inform clinical practice and policy, enhancing midwifery care and supporting patient-centered approaches to childbirth. Does the upright birthing position effect on maternal and newborn outcomes? Does the lithotomy birthing position effect on maternal and newborn outcomes? The expected outcomes will decrease the rate of perineal tear , episiotomy , post partum hemorrhage and decreasing the rate of admission to Neonatal Intensive Care Unit (NICU) in newborn.

Read the detailed description

This quasi-experimental study assesses the impact of upright versus lithotomy birthing positions on maternal and newborn outcomes, aiming to contribute evidence-based recommendations for optimal birthing practices. As childbirth management increasingly prioritizes maternal comfort and positive birth experiences, this research seeks to fill gaps in understanding the clinical efficacy and maternal satisfaction associated with each position.

Conducted at the Maternity Teaching Hospital in Erbil City, the study will recruit 124 pregnant women, divided equally into two groups: one encouraged to adopt upright positions (e.g., squatting) during labor and delivery, and the other following standard lithotomy position practices. A non probability convenience sampling method is employed, with participants meeting specific inclusion criteria such as gestational age, health status, and labor progression factors.

The intervention includes the promotion of upright positions in the experimental group, while both groups receive standardized maternal care. Data on maternal outcomes-such as labor duration, pain levels, and delivery type-and newborn outcomes, including Apgar scores and need for resuscitation, will be collected and analyzed pre- and post-intervention.

The study's goal is to identify whether upright positions correlate with enhanced labor outcomes, reduced intervention rates, and increased maternal satisfaction. Findings are expected to guide clinical guidelines, informing both practitioners and patients on effective, patient-centered birthing positions. This research further aims to influence midwifery education and policy, advocating for practices that align with women's preferences and cultural contexts, ultimately enhancing maternal and neonatal health outcomes through evidence-based childbirth management.

Being tested
Upright Birthing Position, Lithotomy Birthing Position
Keywords
Upright birthing position, Lithotomy position, Maternal outcomes in childbirth, Newborn outcomes in labor, Birth position comparison, Labor positions and delivery, Effectiveness of birth positions

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Upright Birthing PositionBehavioural

    This intervention involves encouraging participants to use an upright position during labor and delivery, which may include : squatting, based on their preference and comfort level. Healthcare staff will support the participants in maintaining an upright position throughout labor as much as possible to evaluate its effects on maternal and newborn outcomes.

  • Lithotomy Birthing PositionBehavioural

    Participants in this arm will be positioned in the lithotomy position during labor and delivery, which is a common practice in clinical settings. In this position, the mother lies on her back with her legs supported in stirrups. This intervention serves as the control condition to provide a baseline comparison for evaluating outcomes against the upright birthing position.

Study groups in NCT06670235
Study groupRoleWhat they receive
Upright Birthing Position GroupExperimentalParticipants assigned to the Upright Birthing Position Arm will be encouraged to maintain an upright position during labor and delivery. The upright position includes a squatting. This arm aims to assess the potential benefits of the upright position, such as improved maternal outcomes (e.g., shorter labor duration, reduced need for interventions) and favorable newborn outcomes (e.g., higher Apgar scores, better oxygenation). To evaluate the effects of upright positioning on both maternal and newborn outcomes compared to the traditional lithotomy position.
Receives: Behavioral: Upright Birthing Position
Lithotomy Birthing PositionActive comparatorParticipants in the Lithotomy Position Arm will follow the standard hospital practice of delivering in the lithotomy position, where the mother is lying on her back with legs supported in stirrups. This position is widely used in clinical settings and serves as the control arm to compare with the outcomes from the upright birthing position. To serve as a control group to provide a comparative measure of maternal and newborn outcomes against the upright birthing position. Outcomes will include maternal comfort, labor duration, intervention requirements, and newborn health indicators.
Receives: Behavioral: Lithotomy Birthing Position

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maternal Labor Duration

    The total time from the onset of active labor until delivery. Measurement Method: Measured in minutes and seconds recording by using the stopwatch from mobile clock.

    Measured: Assessed continuously from the onset of active labor until delivery.

  2. Newborn Apgar score

    Apgar score at 1 , 5 and 10 minutes post-delivery, Measurement Method: from 0 to 2, with a maximum total score of 10, (Color, Heart rate, Reflex, Muscle Tone, Breath).

    Total Score Interpretation 7-10: Generally normal; baby is likely to be in good health. 4-6: Intermediate; may need some help with breathing or other care. 0-3: Critical; immediate resuscitative efforts are typically required.

    Measured: Immediately after delivery , Assessed at 1 minute , 5 minutes and 10 minutes post-delivery

Secondary outcomes (3)
  1. Maternal Perception of Pain and Comfort

    Maternal self-reported pain level and comfort during labor and delivery, Measurement Method: Visual Analog Scale (VAS) for pain; Likert scale for comfort. A 0 to 10 Likert scale for pain perception provides more granularity and allows patients to more precisely indicate their pain level. Higher scores generally indicate worse outcomes, meaning more intense pain.

    Lower scores indicate better outcomes or less pain. 0 - No Pain

    1 to 3 - Mild Pain: Minimal discomfort . 4 to 6 - Moderate Pain 7 to 9 - Severe Pain 10 - Worst Possible Pain

    Measured: Assessed during labor (intervals to be specified, e.g., every 2 hours) and immediately after delivery.

  2. Postpartum Hemorrhage (PPH)

    Estimated blood loss during and after delivery. Measurement methods estimation by (measured in milliliters). Measuring blood loss after labor and delivery is critical in assessing maternal health and identifying postpartum hemorrhage (PPH), a leading cause of maternal mortality. Here are common methods for measuring blood loss in a clinical setting: Traditionally, healthcare providers visually assess blood loss by observing and estimating the amount of blood in pads, towels, drapes, and other materials.

    Though commonly used, visual estimation is often inaccurate, tending to underestimate actual blood loss.

    Less than 500 ml is indicated normal and more than 500 ml Indicate severe blood loss or significant intervention needs, signaling a worse outcome and potentially requiring immediate medical action.

    Measured: Estimated immediately following delivery and up to 2 hours postpartum.

  3. Maternal Satisfaction with the Birth Experience

    Maternal satisfaction with the birth experience is a crucial indicator of quality in maternity care, reflecting the mother's perceptions, emotions, and overall satisfaction with the care received during labor and delivery. A positive birth experience can enhance maternal confidence, strengthen the mother-infant bond, and promote mental health, while a negative experience may contribute to postpartum depression, anxiety, and even trauma.

    Measuring Maternal Satisfaction Maternal satisfaction is often assessed using validated questionnaires, such as the Childbirth Experience Questionnaire (CEQ) by using this items : Highly Dissatisfied, Dissatisfied, Neutral, Satisfied, Highly Satisfied with good outcomes is highly satisfied but bad outcomes is highly dissatisfied.

    Measured: Assessed within the first 2 hours postpartum, typically before hospital discharge.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Nov 2024
  2. Study start10 Nov 2024 (estimated)
  3. Primary completion25 Oct 2025 (estimated)
  4. Study completion1 Sep 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
124 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06670235
Sponsor's protocol ID
Birth Position
Status last verified
Oct 2024
First submitted
29 Oct 2024
Last updated
1 Nov 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Zhang H, Huang S, Guo X, Zhao N, Lu Y, Chen M, Li Y, Wu J, Huang L, Ma F, Yang Y, Zhang X, Zhou X, Guo R, Cai W. A randomised controlled trial in comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position in China. Midwifery. 2017 Jul;50:117-124. doi: 10.1016/j.midw.2017.03.022. Epub 2017 Mar 31.

    PubMed 28414983
  • Cook JA, Julious SA, Sones W, Hampson LV, Hewitt C, Berlin JA, Ashby D, Emsley R, Fergusson DA, Walters SJ, Wilson ECF, Maclennan G, Stallard N, Rothwell JC, Bland M, Brown L, Ramsay CR, Cook A, Armstrong D, Altman D, Vale LD. DELTA2 guidance on choosing the target difference and undertaking and reporting the sample size calculation for a randomised controlled trial. Trials. 2018 Nov 5;19(1):606. doi: 10.1186/s13063-018-2884-0.

    PubMed 30400926
  • Fu L, Huang J, Li D, Wang H, Xing L, Wei T, Hou R, Lu H. Effects of Using Sitting Position versus Lithotomy Position during the Second Stage of Labour on Maternal and Neonatal Outcomes and the Childbirth Experience of Chinese Women: A Prospective Cohort Study. Healthcare (Basel). 2023 Nov 20;11(22):2996. doi: 10.3390/healthcare11222996.

    PubMed 37998488
  • Elvander C, Ahlberg M, Thies-Lagergren L, Cnattingius S, Stephansson O. Birth position and obstetric anal sphincter injury: a population-based study of 113 000 spontaneous births. BMC Pregnancy Childbirth. 2015 Oct 9;15:252. doi: 10.1186/s12884-015-0689-7.

    PubMed 26453177
  • Abdolahian S, Ghavi F, Abdollahifard S, Sheikhan F. Effect of dance labor on the management of active phase labor pain & clients' satisfaction: a randomized controlled trial study. Glob J Health Sci. 2014 Mar 30;6(3):219-26. doi: 10.5539/gjhs.v6n3p219.

    PubMed 24762366

Questions about this trial

What is this clinical trial studying?

A study testing Upright Birthing Position and Lithotomy Birthing Position in people with Maternal Outcomes and Newborn Complication, run by Hawler Medical University at 1 site in Iraq.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 1 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Iraq. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Wahida Ibrahim, Master (009647509663311, Wahida.ibraheem@hmu.edu.krd), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maternal Labor Duration (time frame: Assessed continuously from the onset of active labor until delivery.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06670235, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Nov 2024.

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