Does posture for occiput posterior position in labour reduce operative births? A feasibility study.

Category

Health and Environmental Sciences

Description of research project

Evidence on the use of maternal posture to improve birth outcomes of occiput posterior (OP) or ‘back-to-back’ fetal position in labour was uncertain in the 2022 Cochrane Review, with more trials needed. The POPPIL (Posture for Occiput Posterior Position in Labour) feasibility study that assesses the feasibility of a randomized trial of Sims posture (lying laterally and tilted forwards) compared to free posture (excluding Sims) using a sample size of 50 or more over a 6-month period. Information will be collected on recruitment rates, consent and screening processes, acceptability for consumers and staff, barriers and enablers for adherence to the study intervention, and a range of maternal and infant outcomes including operative birth and admission to neonatal intensive care. A scan is offered to determine fetal position before consented whānau are randomized to the intervention or control group. All other care continues as usual. Mothers are invited to participate in a maternal satisfaction survey on discharge home. Participants will receive a $50 voucher as koha for their generous contribution towards the study. The findings will inform the design of a later effectiveness trial.

Inclusion and/or exclusion criteria

Inclusion criteria are: Age ≥16 years, ≥37 weeks’ gestation, singleton, cephalic presentation, cervical dilatation ≥6 cm, and OP malposition confirmed by ultrasound scan.
Exclusion criteria are: Major fetal anomalies, uterine anomalies (e.g., bicornuate uterus, uterine septum defect, fibroid ≥5cm), or being unable to adopt the intervention posture.

Statement of ethics approval

Approved by the Health and Disability Ethics Committee on 2024-02-13 for 6 months from study start date.

HDEC approval number

2024 FULL 19149

Contact person

Jennifer Barrowclough, jennifer.barrowclough@aut.ac.nz

Participant information sheet

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