ArticleBMC pregnancy and childbirth2015
Birth position and obstetric anal sphincter injury: a population-based study of 113 000 spontaneous births.
Article in BMC pregnancy and childbirth, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06670235 (Effectiveness of Using Upright Versus Lithotomy Birthing Position on Maternal and Newborn Outcomes), which is not on this map. Cited by 22 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of Using Upright Versus Lithotomy Birthing Position on Maternal and Newborn Outcomes: A Quasi Experimental Study
Who cites it
22 citing papers in PubMed, 86 citations in OpenAlex.
- Upright versus lying down position in second stage of labour in nulliparous women with low dose epidural: BUMPES randomised controlled trial.BMJ (Clinical research ed.) · 2017Trial
- Is amniotomy a risk factor for severe perineal trauma? -A Swedish nationwide register study.BMC pregnancy and childbirth · 2026Article
- Maternal positions adopted during the expulsive second stage of labour in homebirth: a cross-sectional study in a rural Northern Nigerian community.BMC pregnancy and childbirth · 2026Article
- Effects of Lateral Positions in Second-Stage Labour on Maternal and Neonatal Outcomes: An Observational Study Using Propensity Score Matching Analysis.International journal of nursing practice · 2026Observational
- Improving apgar scores and reducing perineal injuries through midwife-led quality improvements: an observational study in Uganda.BMC public health · 2025Observational
- The updated understanding of advanced maternal age.Fundamental research · 2024Review
- 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, Switzerland) · 2023Article
- Risk factors associated with severe perineal lacerations during vaginal delivery: a 10-year propensity score-matched observational study.AJOG global reports · 2023Article
- Management of Third and Fourth-Degree Perineal Tears After Vaginal Birth. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/079, December 2020).Geburtshilfe und Frauenheilkunde · 2023Article
- Promoting normal childbirth: Research status and application of upright positions in the second stage of labour.International journal of nursing sciences · 2023Article
- Birthweight difference between deliveries and the risk of obstetric anal sphincter injury in parous women.International urogynecology journal · 2022Article
- The clinical characteristics of perineal tears: A study carried out on 14 pregnant women in a tertiary center: Case series.Annals of medicine and surgery (2012) · 2022Article
- 3D Ultrasound in Pelvic Floor: Is It Useful as a Prognostic Tool in Type of Labor Development and Subsequent Pelvic Floor Diseases?International journal of environmental research and public health · 2022Observational
- Effect of Flexible Sacrum Position on Maternal and Neonatal Outcomes in Public Health Facilities, Amhara Regional State, Ethiopia: A Quasi-Experimental Study.International journal of environmental research and public health · 2022Article
- Obstetric anal sphincter injury following previous vaginal delivery.International urogynecology journal · 2021Article
- Women's experiences of the OASI Care Bundle; a package of care to reduce severe perineal trauma.International urogynecology journal · 2021Article
- Risk factors for perineal and vaginal tears in primiparous women - the prospective POPRACT-cohort study.BMC pregnancy and childbirth · 2020Article
- A review and comparison of common maternal positions during the second-stage of labor.International journal of nursing sciences · 2019Review
- Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study.Birth (Berkeley, Calif.) · 2018Article
- Risk of obstetric anal sphincter injury increases with maternal age irrespective of parity: a population-based register study.BMC pregnancy and childbirth · 2017Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe association between birth position and obstetric anal sphincter injury (OASIS) in spontaneous vaginal deliveries is unclear.
methodsThe study was based on the Stockholm-Gotland Obstetric Database (Sweden) from Jan 1(st) 2008 to Oct 22(nd) 2014 and included 113 279 singleton spontaneous vaginal births with no episiotomy. We studied risk of OASIS with respect to the following birth positions: a) sitting, b) lithotomy, c) lateral, d) standing on knees, e) birth seat, f) supine, g) squatting, h) standing and i) all fours. All analyses were stratified for parity. General linear models were used to calculate risk ratios (RR) adjusted for maternal, pregnancy and fetal characteristics.
resultsThe rates of OASIS among nulliparous women, parous women and women undergoing vaginal birth after a caesarean (VBAC) were 5.7%, 1.3% and 10.6%, respectively. The rates varied by birth position: from 3.7 to 7.1% in nulliparous women, 0.6% to 2.6% in parous women and 5.6% to 18.2% in women undergoing VBAC. Regardless of parity, the lowest rates were found among women giving birth in standing position and the highest rates among women birthing in the lithotomy position. Compared with sitting position, the lithotomy position involved an increased risk of OASIS among nulliparous (adjusted RR 1.17, 95% CI 1.06-1.29) and parous women (adjusted RR 1.66, 95% CI 1.35-2.05). Birth seat and squatting position involved an increased risk of OASIS among parous women (adjusted RR [95% CI] 1.36 [1.03-1.80] and 2.16 [1.15-4.07], respectively). Independent risk factors for OASIS were maternal age, head circumference ≥35 cm, birth weight ≥4000 g, length of gestation ≥ 40 weeks, prolonged second stage of labour, non-occiput anterior presentation and oxytocin augmentation.
conclusionsCompared with sitting position, lateral position has a slightly protective effect in nulliparous women whilst an increased risk is noted among women in the lithotomy position, irrespective of parity. Squatting and birth seat position involve an increase in risk among parous women.
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