Maternal upright posture and mobility in labor--a review.

There has been a relatively recent interest in alternative birthing techniques, including increased maternal mobility during labor. This literature review was pursued to evaluate the effect of upright maternal posture and ambulation on the first stage of labor. Although previous reviews frequently assume that maternal ambulation speeds labor progress, the data presented in this review are not conclusive as to whether the upright maternal posture or ambulation during the first stage of labor shortens labor length or improves fetal outcome. However, it is clear that ambulation in labor is not harmful either to the mother or fetus. In addition, many investigators have reported that mobility in labor results in greater maternal comfort and ability to tolerate labor and decreased use of anesthesia and analgesia. Thus, acceptance of mobility in labor by patients and staff is generally reported. This information can serve as a guide to clinical management. However, there is a need for further analysis of the effect of maternal ambulation during labor, and specific suggestions for research are presented.