A Randomized Trial of Birthing Stool or Conventional Semirecumbent Position for Second-Stage Labor


  • Ulla Waldenström R.N.M., Ph.D.,

    Corresponding author
    1. Ulla Waldenström is a researcher at the Swedish Medical Research Council and the director of an in-hospital birth center at Södersjukhuset, Stockholm, Sweden. At the time of the study she was a researcher at the Centre of Caring Sciences, University Hospital, Uppsala, Sweden.
    Search for more papers by this author
  • Karin Gottvall R.N.M.

    1. Karin Gottvall is a midwife at the Department of Obstetrics and Gynaecology, University Hospital, Uppsala, Sweden.
    Search for more papers by this author

Address correspondence to Ulla Waldenström, R.N.M., Ph.D., Citronvägen 36, S-741 31 Knivsta, Sweden.


ABSTRACT: Two hundred ninety-four women were randomly allocated to a group in which the use of a birthing stool (experimental group) or a conventional semirecumbent position (control group) was encouraged. The birthing stool was 32 cm high and allowed the parturient to sit upright and to squat. The husband could sit close behind his wife and support her back. No differences were observed between the two groups regarding mode of delivery, length of the second stage of labor, oxytocin augmentation, perineal trauma, labial lacerations, or vulvar edema. Infant outcome measured by Apgar scores at 1 and 5 minutes postpartum and numbers of neonatal intensive care unit transfers was the same in both groups. Mean estimated blood loss and the number of mothers with a postpartum hemorrhage 600 ml or more were greater in the experimental group than in the control group. Women in the experimental group reported less pain during the second stage of labor, and they and their spouses were more satisfied with the birth position than were parents in the control group. Midwives were less satisfied with their working posture in the experimental group.