What do systematic reviews say?

Self‐hypnosis or hypnotherapy vs all

• Hypnosis for pain management during labour and childbirth 2016 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 127 participants
  Low

Case notes vs control

Case notes showed no clear difference in epidural analgesia used in labour compared with control (low certainty).

• Giving women their own case notes to carry during pregnancy 2015 · Cochrane Headline outcomes only
  RR 1.43 [0.96, 2.13]
  1 study · 212 participants
  Low

Delayed pushing vs immediate pushing (all women with epidural)

Delayed pushing showed no clear difference in admission to neonatal intensive care compared with immediate pushing (all women with epidural) (low certainty).

• Pushing/bearing down methods for the second stage of labour 2017 · Cochrane Headline outcomes only
  RR 0.98 [0.67, 1.41]
  3 studies · 2197 participants
  Low

Delayed pushing vs immediate pushing (all women with epidural)

• Pushing/bearing down methods for the second stage of labour 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Delayed pushing vs immediate pushing (all women with epidural)

It is very uncertain whether delayed pushing changes 5‐minute Apgar score < 7 compared with immediate pushing (all women with epidural) (very low certainty).

• Pushing/bearing down methods for the second stage of labour 2017 · Cochrane Headline outcomes only
  RR 0.15 [0.01, 3]
  3 studies · 413 participants
  Very low

Delayed pushing vs immediate pushing (all women with epidural)

• Pushing/bearing down methods for the second stage of labour 2017 · Cochrane Headline outcomes only
  no estimate extracted
  11 studies · 2932 participants
  Very low

Delayed pushing vs immediate pushing (all women with epidural)

Delayed pushing probably leads to higher spontaneous vaginal delivery compared with immediate pushing (all women with epidural) (moderate certainty).

• Pushing/bearing down methods for the second stage of labour 2017 · Cochrane Headline outcomes only
  RR 1.07 [1.03, 1.11]
  12 studies · 3114 participants
  Moderate

Delayed pushing vs immediate pushing (all women with epidural)

• Pushing/bearing down methods for the second stage of labour 2017 · Cochrane Headline outcomes only
  no estimate extracted
  11 studies · 3049 participants
  Very low

Delayed pushing vs immediate pushing (all women with epidural)

Delayed pushing showed no clear difference in perineal laceration (3rd or 4th degree) compared with immediate pushing (all women with epidural) (moderate certainty).

• Pushing/bearing down methods for the second stage of labour 2017 · Cochrane Headline outcomes only
  RR 0.94 [0.78, 1.14]
  7 studies · 2775 participants
  Moderate

Upright position vs recumbent position

The review found no eligible studies for this question.

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Upright position vs recumbent position

Upright position probably leads to lower low cord pH compared with recumbent position (moderate certainty).

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 0.43 [0.2, 0.9]
  2 studies · 3159 participants
  Moderate

Upright position vs recumbent position

It is very uncertain whether upright position changes admission to neonatal intensive care unit compared with recumbent position (very low certainty).

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 0.54 [0.02, 12.73]
  1 study · 66 participants
  Very low

Upright position vs recumbent position

Upright position leads to higher operative birth (caesarean or instrumental vaginal) compared with recumbent position (sensitivity analyses ‐ studies at low risk of… (high certainty).

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 1.11 [1.03, 1.2]
  3 studies · 3609 participants
  High
• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 0.86 [0.7, 1.07]
  8 studies · 4316 participants
  Low

Upright position vs recumbent position

Upright position leads to higher caesarean section compared with recumbent position (sensitivity analyses ‐ studies at low risk of… (high certainty).

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 1.29 [1.05, 1.57]
  3 studies · 3609 participants
  High
• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 0.94 [0.61, 1.46]
  8 studies · 4316 participants
  Very low

Upright position vs recumbent position

Upright position showed no clear difference in instrumental vaginal birth compared with recumbent position (sensitivity analyses ‐ studies at low risk of… (low certainty).

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 1.08 [0.91, 1.3]
  3 studies · 3609 participants
  Low
• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 0.9 [0.72, 1.12]
  8 studies · 4316 participants
  Very low

Upright position vs recumbent position

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 456 participants
  Very low

Upright position vs recumbent position

Upright position showed no clear difference in trauma to birth canal requiring suturing compared with recumbent position (low certainty).

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 1 [0.89, 1.13]
  3 studies · 3266 participants
  Low

Upright position vs recumbent position

Upright position showed no clear difference in blood loss (greater than 500 mL) (trial authors defined it as PPH… compared with recumbent position (moderate certainty).

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 1.2 [0.83, 1.72]
  1 study · 3093 participants
  Moderate

Upright position vs recumbent position

The review found no eligible studies for this question.

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Upright position vs recumbent position

It is very uncertain whether upright position changes abnormal fetal heart rate patterns, requiring intervention compared with recumbent position (very low certainty).

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 1.69 [0.32, 8.84]
  1 study · 107 participants
  Very low