The relationship between the parturient's positions and perceptions of labor pain intensity

Background. While the effect of the maternal position on reducing labor pain has been studied, the data presented to date have not been conclusive. Objectives: To determine if maternal position reduced the intensity of labor pain during cervical dilatation from 6 to 8 centimeters. Method. Pain intensity was measured using the visual analogue scale (VAS) on 39 primiparous and 19 multiparous women (N = 58) who alternately assumed the sitting and supine positions for 15 minutes during cervical dilatation from 6 to 8 centimeters. Results: The pain scores for the sitting position were significantly lower than those for the supine position. The Wilcoxon signed-ranks test showed the VAS scores for the (a) total labor pain ("total" being defined as both abdominal and lumbar pain) during contraction (p = .011), (b) continuous total labor pain (p = .001), (c) lumbar pain during contraction (p < .001), and (d) continuous lumbar pain (p < .001) in the sifting position (significantly lower than in supine position). The diminished pain scores were greater than 13 millimeters, which is the minimum clinically significant change in patient pain severity as measured with the 100 millimeter VAS. The largest decrease occurred in lower back pain. No significant differences were found for abdominal pain scores in either the sitting or supine positions. Conclusion: The sifting position offers an effective method to relieve lower back labor pain during cervical dilatation from 6 to 8 centimeters. Similar relief was experienced for women who reported pain only on contraction as well as those with continuous pain.