Factors influencing labour and birthing positions in Malawi

Abstract

Background/aims The World Health Organization encourages women in labour to ambulate and assume upright positions shown to be associated with favourable childbirth outcomes. However, the literature shows that most women in developed and developing countries, including Malawi, give birth in the supine position. There is a lack of research on factors that influence choice of birthing positions among women in Malawi. This study aimed to identify these factors. Methods A face-to-face descriptive survey was conducted on 373 low-risk postnatal women in Malawi. Bivariate and multivariate analyses were used to determine association between sociodemographic characteristics and choice of labour and birthing position, as well as to identify predictive factors. Results Walking during labour was significantly associated with age (P=0.018) and monthly family income (P=0.012). During birth, women who had received some degree of education were more likely to use the supine position than those who had not (93% vs 78%; P=0.011). However, women with a higher level of income were less likely to use the supine position than women with low income (82% vs 93%; P=0.005). Conclusions Age, income and education influence Malawian women's choices for labour and birthing position. There is a need for Malawian women to be informed about and encouraged to use different labour and birthing positions, regardless of their socioeconomic and demographic status, to promote positions that improve maternal and neonatal outcomes. Childbirth education sessions or classes during antenatal care should include information on different birthing positions.