Maternal and newborn outcomes of upright versus supine birthing position in Sub-Saharan Africa: A systematic review

https://doi.org/10.53730/ijhs.v9nS1.15788

Authors

  • Egeh Perpetua Chinasa University of Port Harcourt, Port Harcourt, Nigeria https://orcid.org/0009-0003-6465-3764
  • Halima Musa Abdul Ahmadu Bello University, Zaria, Nigeria
  • David Lekpa Kingdom University of Port Harcourt, Port Harcourt, Nigeria
  • Celine Chibuzor Agonsi University of Port Harcourt, Port Harcourt, Nigeria

Keywords:

Upright position, supine position, maternal birth outcomes, foetal birth outcomes, second stage of labour, childbirth, Sub-Saharan Africa

Abstract

Background: Maternal positioning during the second stage of labour, such as the supine (including lithotomy) or upright (like sitting) positions, plays a significant role in influencing both maternal and fetal outcomes during delivery. Aim: The aim of this systematic review is to compare maternal and neonatal outcomes between upright and supine birthing positions during labour. Methods: A search was done across various research databases but only three research databases (PubMed, Scopus and Google Scholar) yield articles carried out in sub-Saharan Africa. The Search was done to identify related studies carried out within Sub-Saharan Africa, for the past twenty-year period (2004-2024), in English language or translated to English. In addition, manual searches were conducted on the reference lists of the identified studies. Out of all searched literature, five studies retrieved (1quantitative comparative study1 prospective study, 1 quasi-experimental, 1 three-arm, open-label, randomized controlled trial. Results: Five studies involving 3,376 laboring women from diverse Sub- Saharan African countries, including Tanzania, Ethiopia, Benin, Nigeria, and South Africa, met the inclusion criteria. The literature review highlighted five key themes: duration of the second stage of labor, mode of delivery, maternal labor pain, fetal outcomes, and the most prevalent theme—perineal tears and the performance of episiotomies.

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References

Agunda, S. D. (2022). Effect of upright (‘all fours’) versus lithotomy birth position on obstetric outcomes among low-risk parturients at Kenyatta National Hospital: A mixed method study (Doctoral dissertation, University of Nairobi).

Badi, M. B., Abebe, S. M., Weldetsadic, M. A., Christensson, K., & Lindgren, H. (2022). Effect of flexible sacrum position on maternal and neonatal outcomes in public health Journal of Environmental Research and Public Health, 19(15), 9637. https://doi.org/10.3390/ijerph19159637 DOI: https://doi.org/10.3390/ijerph19159637

Berta, M., Lindgren, H., Christensson, K., Mekonnen, S., & Adefris, M. (2019). Effect of maternal birth positions on duration of second stage of labor: Systematic review and meta-analysis. BMC Pregnancy and Childbirth, 19(1), 466. https://doi.org/10.1186/s12884-019-2620-0 DOI: https://doi.org/10.1186/s12884-019-2620-0

Dénakpo, J., Lokossou, A., Tonato-Bagnan, J. A., Alao, J., Hounkpatin, B., Komongui, D. G., Tamou-Tabé, D. A., & Perrin, R. X. (2012). Delivery in free position perhaps a solution to change delivery in traditional position in delivery rooms in Africa: Results of a prospective study in Cotonou in Bénin. Journal of Obstetrics and Gynaecology Canada, 34(10), 947–953. https://doi.org/10.1016/S1701-2163(16)35377-7 DOI: https://doi.org/10.1016/S1701-2163(16)35408-1

Diorgu, F., & Steen, M. (2018). Mothers' and healthcare stakeholders' views and experiences of birthing positions and perineal injuries during childbirth in a low-resource setting in Nigeria. Evidence Based Midwifery, 16(3), 94–100.

Hofmeyr, G. J., Vogel, J. P., Singata, M., Habib, N. A., Landoulsi, S., & Gülmezoglu, A. M. (2018). Does gentle assisted pushing or giving birth in the upright position reduce the duration of the second stage of labour? A three-arm, open-label, randomised controlled trial in South Africa. BMJ Global Health, 3(3), e000906. https://doi.org/10.1136/bmjgh-2018-000906 DOI: https://doi.org/10.1136/bmjgh-2018-000906

Krywko, D. M., & King, K. C. (2021). Aortocaval compression syndrome. In StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430759/

Mtatina, A. V., Mselle, L. T., Mwakawanga, D., Sando, D., & Mkoka, D. A. (2022). Maternal and new-born outcomes when using upright and supine birth positions during labour and delivery: A quasi-experimental study. American Journal of Health, Medicine and Nursing Practice, 7(8), 28–39. DOI: https://doi.org/10.47672/ajhmn.1076

Muhammed, A., Habibu, H. S., Ibrahim, A. H., & Abdulrashid, I. (2023). Effect of upright positioning on the process and outcome of labour among parturient in primary health care setting. Nursing & Midwifery Research Journal, 19(3), 121–129. DOI: https://doi.org/10.1177/0974150X231195178

Poinsett, P. M. (Ed.). (2020). Birth asphyxia and cerebral palsy. Retrieved November 10, 2020, from https://www.cerebralpalsyguidance.com/cerebral-palsy/causes/birth-asphyxia

Sarkis-Onofre, R., Catalá-López, F., Aromataris, E., & Lockwood, C. (2021). How to properly use the PRISMA Statement. Systematic Reviews, 10(1), 1–3. DOI: https://doi.org/10.1186/s13643-021-01671-z

World Health Organization. (2015). Maternal health in Nigeria: Generating information for action. Retrieved November 3, 2020, from https://www.who.int/reproductivehealth/maternal-health-nigeria/en/

World Health Organization. (2018). WHO recommendations on intrapartum care for a positive childbirth experience. World Health Organization

Published

30-09-2025

How to Cite

Chinasa, E. P., Abdul, H. M., Kingdom, D. L., & Agonsi, C. C. (2025). Maternal and newborn outcomes of upright versus supine birthing position in Sub-Saharan Africa: A systematic review. International Journal of Health Sciences, 9(S1), 589–603. https://doi.org/10.53730/ijhs.v9nS1.15788

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Section

Peer Review Articles