Kelly FW. A review of alternative birthing positions . J Am Osteopath Assoc 1999;99(9):470–474. doi: 10.7556/jaoa.1918.104.22.1680.
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This article reviews a number of nonevidenced-based studies that have been conducted on the different physical positions of labor and delivery. A review of the literature disclosed that the traditional supine position appeared to be associated with a prolonged second stage of labor and persistence of occiput posterior presentations. However, the supine and left lateral positions are excellent for providing anesthesia and access, although there may be a little added benefit for the parturient's comfort. The sitting, squatting, and hands-and-knees positions offer superior patient participation. The squatting position held for a long time may be physically stressful. The sitting and standing positions are known for occasional excessive hemorrhage and added expense. The hands-and-knees position offers the advantages of the gravitation effect of the upright positions and may be associated with less perineal damage. Overall, there has been no report of any harm to the infant when alternative positions are used.
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