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Epidural, Labor, Nursing care, Upright positioning



  1. Mayberry, Linda J. PhD, RN, FAAN
  2. Strange, Laura B. PhD(c), RN
  3. Suplee, Patricia Dunphy PhD, CS, RNC
  4. Gennaro, Susan DSN, RN, FAAN


Purpose: To present research findings and related nursing implications from an observational study designed to evaluate the use of upright positioning during second stage labor with patients who had received low-dose epidural analgesia.


Study Design and Methods: This descriptive study evaluated outcomes from a sample of 74 healthy women having their first childbirth. They had all received epidural analgesia during the first and second stages of labor. Data were also collected by nurses on the use of birthing beds, and the extent of physical and emotional support the women needed while following the upright positioning study protocol.


Results: All women were able to maintain upright positions throughout the second stage of labor following epidural analgesia administration. No adverse neonatal outcomes or maternal problems (such as excessive vaginal bleeding) were documented.


Clinical Implications: Although women were capable of assuming upright positions during second stage, the study results indicated that constant physical and emotional support was necessary for most women. Future research on methods to prepare women for multiple position options after administration of low-dose epidural analgesia should be undertaken. In addition, nurses should evaluate the benefits of upright positioning in terms of facilitating progress of labor.