Study designs of evaluations included in the review
Randomised controlled trials (RCTs) were eligible for inclusion.
Specific interventions included in the review
Trials comparing upright with recumbent positions were eligible. An upright position was defined as standing, walking, kneeling, squatting, or sitting more than 60 degrees from the horizontal. In one included study, standing or walking for more than 30 minutes per hour was compared with being recumbent in bed or sitting in a chair. In the second study, walking, sitting in a chair or reclining in a semi-supine position was compared with being restricted in bed in supine, semi-supine or a lateral position.
Participants included in the review
Trials of women in the second stage of labour who had received epidural anaesthesia were eligible for inclusion. One study was of first-time pregnancies and the second was mixed parity.
Outcomes assessed in the review
The primary outcome of interest was instrumental delivery. The secondary maternal outcomes of interest were Caesarean section, length of the second stage, foetal malposition, perineal trauma, postpartum haemorrhage, adequacy of pain relief, satisfaction with care, and long-term outcomes such as urinary or faecal incontinence and dyspareunia. Infant outcomes were also of interest. Outcomes where more than 20% of participants were lost to follow-up were not considered.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.