Effects of standing position on spontaneous uterine contractility and other aspects of labor.

The aim of this paper has been to compare the uterine contractility, pain produced by contractions and comfort of the patients between standing and supine position. The study has been performed in twenty normal nulliparae who were changed from supine to standing position and viceversa at intervals of approximately thirty minutes. Intrauterine pressure and fetal heart rate were continuously monitored. Cervial dilatation was evaluated every thirty minutes. No medication was given to the patients. They were asked to assess the pain produced by uterine contractions in each one of both positions and which was the more comfortable. It has been found: 1. That the intensity of contractions was significantly higher in fifteen out of the twenty patients in standing position. 2. Frequency of contractions diminished significantly in one third of the patients. 3. Uterine activity increased significantly in half of them. 4. Consistently, less pain accompanied uterine contractions in standing position. 5. Patients reported more comfort in this position. The average duration of labor was 3 hrs 55 min. This duration is short, compared with standard clinical experience and with published data. No complications occurred, by the use of standing position during labor, on the mother or fetus. The physiological mechanisms responsible for the above mentioned effects of standing position are unknown. It is condluced that there are no clear arguments against the use of standing position during labor and that this position should be used more frequently in clinical obstetrics, provided obstetrical conditions are similar to those reported in this paper.