Midwives’ views and experiences on birthing positions utilised during labour in maternity units: A scoping review of qualitative studies.

Mokgabodi LDM; Ngema; Masubelele

doi:10.51168/ypxgsg94

Authors

Mokgabodi LDM Tshwane University of Technology, Faculty of Science, Adelaide Tambo School of Nursing Science, Pretoria, South Africa
Ngema, S.A., RN, PhD Tshwane University of Technology, Faculty of Science, Adelaide Tambo School of Nursing Science, Pretoria, South Africa
Masubelele, N.A., RN, PhD Tshwane University of Technology, Faculty of Science, Adelaide Tambo School of Nursing Science, Pretoria, South Africa

DOI:

https://doi.org/10.51168/ypxgsg94

Keywords:

Midwives’ Views, Experiences on birthing positions, Labour, Maternity units

Abstract

Introduction:

Childbirth remains a personal experience for mothers giving birth globally. Maternal positions during childbirth significantly affect the birthing process and its outcomes. Midwives play a crucial role in facilitating these positions, directly supporting Sustainable Development Goal 3 by reducing maternal and neonatal mortality. Their expertise ensures safe, evidence-based care, promoting health and well-being for mothers and infants throughout the birthing process.

Aim:

To map the evidence from the published literature on midwives' views and experiences of birthing positions used during labour in maternity obstetric units.

Methods:

A comprehensive literature search was conducted across multiple search databases, including Scopus, Medline, PubMed, ProQuest, Springer, and Wiley. A scoping review was conducted in line with the steps of Arksey and O’Malley.

Results:

The search yielded 248 studies; six were selected for the final evaluation. The chosen review articles were all published between 2015 and 2025. Six qualitative studies were included in the final review. The thematic analysis identified seven key themes: 1) midwives' views and beliefs about birthing positions, 2) institutional and organisational obstacles, 3) power relations and professional hierarchies, 4) cultural competence and woman-centred care, 5) maternal autonomy and informed choice, 6) enablers of physiological birth, and 7) safety concerns and risk assessment.

Conclusion:

This review highlights the need to integrate midwives’ insights into practice to enhance maternal and neonatal outcomes and improve the overall childbirth experience.

Author Biographies

Mokgabodi LDM, Tshwane University of Technology, Faculty of Science, Adelaide Tambo School of Nursing Science, Pretoria, South Africa

is a student enrolled for the Master of Nursing Science at the Adelaide Tambo School of Nursing Science, Faculty of Science, Tshwane University of Technology, and a specialising midwife practitioner. She is passionate about Sustainable Development Goal 3 (SDG 3), which aims to ensure healthy lives and promote well-being for all ages, with explicit targets to improve maternal health and reduce deaths during and after childbirth.
Ngema, S.A., RN, PhD, Tshwane University of Technology, Faculty of Science, Adelaide Tambo School of Nursing Science, Pretoria, South Africa

is a lecturer, nephrology nurse specialist, research supervisor at the Adelaide Tambo School of Nursing Science, Faculty of Science, Tshwane University of Technology, and a specialised midwife practitioner. His research interests include Nephrology, Nursing, Midwifery, Quality Improvement and Management, Student-Centred Education and Training, NCDs & SDG No. 3.
Masubelele, N.A., RN, PhD, Tshwane University of Technology, Faculty of Science, Adelaide Tambo School of Nursing Science, Pretoria, South Africa

is the Head of Department of the Adelaide Tambo School of Nursing Science, Faculty of Science, Tshwane University of Technology, a nurse, and research supervisor. Her research interests include non-communicable diseases prevention and management, nursing, leadership and healthcare service management, participatory action research, ethics and midwifery.

References

1. Abdulle, A. A., Borrego, N., & Lundgren, I. (2023). Midwives' experiences of encountering immigrant women during labour and birth who do not master the host country's language: A lifeworld hermeneutic study. Scandinavian Journal of Caring Sciences, 37(4), 1136-1144. https://doi.org/10.1111/scs.13187

2. Ahmar, H., Sofyana, S., Suciati, S., Ernawati, E., & Liantanty, F. (2025). Labor position and its impact on the birth process: A literature review. Journal of Current Health Sciences, 5(2), 97-108. https://doi.org/10.47679/jchs.2025115

3. Amiri-Farahani, L., Gharacheh, M., Sadeghzadeh, N., Peyravi, H., & Pezaro, S. (2022). Iranian midwives' lived experiences of providing continuous midwife-led intrapartum care: A qualitative study. https://doi.org/10.1186/s12884-022-05040-z

4. Arksey, H., & O'Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. https://doi.org/10.1080/1364557032000119616

5. Carolan-Olah, M., Kruger, G., & Garvey-Graham, A. (2015). Midwives' experiences of the factors that facilitate normal birth among low-risk women at a public hospital in Australia. Women and Birth, 28(1). https://doi.org/10.1016/j.midw.2014.07.003

6. De Jonge, A., Rijnders, M. E., Van Diem, M. T., Scheepers, P. L., & Lagro-Janssen, A. L. (2009). Are there inequalities in choice of birthing position? Sociodemographic and labour factors associated with the supine position during the second stage of labour. Midwifery, 25(4), 439-448. https://doi.org/10.1016/j.midw.2007.07.013

7. Diaz, A. G., Schwarcz, R., Fescina, R., & Caldeyro-Barcia, R. (1980). Vertical position during the first stage of the course of labour, and neonatal outcome. European Journal of Obstetrics & Gynecology and Reproductive Biology, 11(1), 1-7. https://doi.org/10.1016/0028-2243(80)90046-5

8. Fatma, Z. H., Alvesson, H. M., Namazzi, G., Kyobe, J. B., & Ayebare, E. (2025). “This is like tradition, lie on your back, hold your leg, and push”: Understanding midwives' perspectives on their choice of labour positions in a Ugandan hospital. BMC Pregnancy and Childbirth, 25(1), 564. https://doi.org/10.1186/s12884-025-07657-2

9. Garbelli, I., & Lira, V. (2021). Maternal positions during labor: Midwives' knowledge and educational needs in northern Italy. European Journal of Midwifery. https://doi.org/10.18332/ejm/136423

10. Gupta, J. K., Sood, A., Hofmeyr, G. J., & Vogel, J. P. (2017). Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database of Systematic Reviews, (5). https://doi.org/10.1002/14651858.cd002006.pub4

11. Guzewicz, P., & Sierakowska, M. (2022). The role of midwives in the course of natural childbirth: Analysis of sociodemographic and psychosocial factors. A cross-sectional study. https://doi.org/10.3390/ijerph192315824

12. Hammond, A., Foureur, M., & Homer, C. (2014). The hardware and software implications of hospital birth room design: A midwifery perspective. https://doi.org/10.1016/j.midw.2013.07.013

13. Huang, J., Zang, Y., Ren, L. H., Li, F. J., & Lu, H. (2019). A review and comparison of common maternal positions during the second stage of labor. International Journal of Nursing Sciences, 6(4), 460-467. https://doi.org/10.1016/j.ijnss.2019.06.007

14. Huang, J., Wang, B., Sun, K., Zhang, H., Bai, F., Lian, H., Lei, C., Cheng, Y., Nie, K., & Zang, Y. (2025). Barriers and facilitators of implementing the practice programme for upright positions in the second stage of labour: A mixed-method study. Journal of Advanced Nursing, 81(11), 7266-7284. https://doi.org/10.1111/jan.15927

15. International Confederation of Midwives. (2021). ICM professional framework for midwifery. https://internationalmidwives.org/resources/professional-framework-for-midwifery-2021/

16. Levac, D., Colquhoun, H., & O'Brien, K. K. (2010). Scoping studies: Advancing the methodology. https://doi.org/10.1186/1748-5908-5-69

17. Lindgren, H., Erlandsson, K., Berta, M., Yimer, O., Blomgren, J., Lundberg, C., Dilnesa, T., Wells, M., & Hailemskel, S. (2024). The understanding of dynamic birth positions for women in labour and childbirth: A hybrid concept analysis. https://doi.org/10.1016/j.srhc.2024.101039

18. Lunda, P., Minnie, C. S., & Lubbe, W. (2024). Perspectives of midwives on respectful maternity care. BMC Pregnancy and Childbirth, 24(1), 721. https://doi.org/10.1186/s12884-024-06894-1

19. Martin, S., Filies, G. C., & Robertson, A. E. (2025). Quality midwifery care during childbirth at a midwife obstetric unit: A qualitative study. Curationis, 48(1), Article 2773. https://creativecommons.org/licenses/by/4.0/

20. Martano, G., Ambrosi, E., Poggianella, S., & Paoli, C. (2025). Advanced intrapartum midwifery practice: A scoping review. Midwifery, 104687. https://doi.org/10.1016/j.midw.2025.104687

21. Mselle, L. T., & Eustace, L. (2020). Why do women assume a supine position when giving birth? The perceptions and experiences of postnatal mothers and nurse-midwives in Tanzania. https://doi.org/10.1186/s12884-020-2726-4

22. Mohammed, O. Y., Erlandsson, K., Seyoum, T., Hailemeskel, S., Derseh, L., & Lindgren, H. (2025). Dynamic birth position, awareness and practice by midwives in Ethiopia: A parallel mixed-methods study. BMC Pregnancy and Childbirth, 25(1), 926. https://doi.org/10.1186/s12884-025-08051-8

23. Musie, M. R., Peu, M. D., & Bhana-Pema, V. (2019). Factors hindering midwives' utilisation of alternative birth positions during labour in selected public hospitals. https://doi.org/10.4102/phcfm.v11i1.2071

24. Musie, M. R., Peu, M. D., & Bhana-Pema, V. (2022). Culturally appropriate care to support maternal positions during the second stage of labour: Midwives' perspective in South Africa. https://doi.org/10.4102/phcfm.v14i1.3292

25. Ngema, S. A., Mahlangu, D. W., Mokonyane, S. B., Makgatho, L. M., Mokoena, S. D., Vannesa, M. L., ... & Shongwe, A. S. (2026). Hand hygiene intricacies in maternity departments in Sub-Saharan Africa: A scoping review. Student's Journal of Health Research Africa, 7(3), 7-7.https://doi.org/10.51168/sjhrafrica.v7i3.2074

26. Nieuwenhuijze, M., De Jonge, A., Korstjens, I., & Lagro-Janssen, T. (2012). Factors influencing the fulfilment of women's preferences for birthing positions during the second stage of labour. Journal of Psychosomatic Obstetrics & Gynecology, 33(1), 25-31. https://doi.org/10.3109/0167482x.2011.642428

27. Okonta, P. (2012). Birthing positions: Awareness and preferences of pregnant women in a developing country. Internet Journal of Gynecology and Obstetrics, 16(1).

28. Robertson, E. (2014). “To be taken seriously”: Women's reflections on how migration and resettlement experiences influence their healthcare needs during childbearing in Sweden. Sexual & Reproductive Healthcare, 6(2), 59-65. https://doi.org/10.1016/j.srhc.2014.09.002

29. Tinker, R., Catling, C., Pigott, K., De Vroome, M., Rogers, K., & Elliott, R. (2026). Upright positions during the second stage of labour and birth outcomes: A prospective observational study. Women and Birth, 39(2), 102184. https://doi.org/10.1016/j.wombi.2026.102184

30. Townsend, B., Fenwick, J., Thompson, V., & Foureur, M. (2016). The birth bed: A qualitative study on the views of midwives regarding the use of the bed in the birth space. https://doi.org/10.1016/j.wombi.2015.08.009

31. Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., et al. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467-473. https://doi.org/10.7326/M18-0850

32. United Nations. (n.d.). Goal 3: Ensure healthy lives and promote well-being for all at all ages. Retrieved February 13, 2026, from https://sdgs.un.org/goals/goal3

33. Wagh, R., Bangal, V., & Jondhale, P. (2025). A comparative analysis of maternal and perinatal outcomes in supine versus upright birthing positions at a tertiary care teaching hospital in Maharashtra. International Journal of Advanced Research. https://doi.org/10.21474/IJAR01/20483

34. World Health Organization. (n.d.). Maternal health. Retrieved March 26, 2026, from https://www.who.int/health-topics/maternal-health#tab=tab_1

35. World Health Organization. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience. World Health Organization.

36. Yadav, A., Kamath, A., Mundle, S., Baghel, J., Sharma, C., & Prakash, A. (2021). Exploring the perspective of nursing staff or caregivers on birthing positions in Central India. Journal of Family Medicine and Primary Care, 10(3), 1149-1154. https://doi.org/10.4103/jfmpc.jfmpc_2066_20

37. Zileni, B. D., Glover, P., Jones, M., Teoh, K. K., Zileni, C. W., & Muller, A. (2017). Malawi women's knowledge and use of labour and birthing positions: A cross-sectional descriptive survey. Women and Birth, 30(1), e1-e8. https://doi.org/10.1016/j.wombi.2016.06.003

38. Zwelling, E. (2008). The emergence of high-tech birthing. Journal of Obstetric, Gynecologic & Neonatal Nursing, 37(1), 85-93. https://doi.org/10.1111/j.1552-6909.2007.00211.x