ReviewFrontiers in medicine2026
Free positions in the second stage of labor for pelvic floor protection: a narrative review.
Review in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- A Mobilisation Protocol in the Management of Posterior Foetal Presentations: A Multicentre Observational Pilot Study.Healthcare (Basel, Switzerland) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: This narrative review synthesizes current evidence on free positions delivery during the second stage of labor, evaluating its impact on pelvic floor protection, key clinical outcomes, and maternal experience, while also exploring underlying biomechanical and molecular mechanisms. Methods: A comprehensive but non-systematic literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science from inception to July 2025., using keywords including "free positions delivery," "upright position," "second stage of labor," "pelvic floor dysfunction," "perineal trauma," and related terms. Studies were selected based on relevance to maternal position during the second stage and outcomes related to pelvic floor protection, clinical efficiency, and maternal experience. Both observational and interventional studies were included, with priority given to recent systematic reviews, meta-analyses, and high-quality clinical trials. Evidence certainty was narratively assessed using principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results: Free positions are associated with favorable trends in short-term obstetric outcomes, including reduced duration of the second stage and lower rates of perineal trauma. Maternal satisfaction, sense of autonomy, and comfort are consistently improved. For pelvic floor health, the certainty of evidence differs by time horizon: findings suggest a reduction in early postpartum urinary incontinence, but data supporting a long-term protection against pelvic floor dysfunction remain insufficient. Conclusion: Current evidence supports consideration of free positions during the second stage of labor as a low-intervention strategy that may improve short-term labor outcomes and maternal experience. Successful implementation requires targeted training for healthcare providers and comprehensive patient education. Future research should prioritize longitudinal studies with standardized outcome measures to strengthen the evidence base for long-term pelvic floor protection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.