Egeh Perpetua Chinasa
Claretian University of Nigeria, Nigeria
Abstract Title: Implementation of Upright Birthing Positions in Health Facilities: Barriers, Facilitators, and Effects on Maternal and Neonatal Outcomes - A Scoping Review and Meta-Analysis
Biography:
Sr. Egeh Perpetua Chinasa is a Catholic nun, nurse, and midwife from Imo State, Nigeria. She received her early education in Imo State and completed her nursing and midwifery training in Sokoto State, Northern Nigeria. Following a brief period of clinical practice, she entered religious life and was missioned to serve in various settings across Nigeria, Kenya, and Tanzania.
She continued her religious formation in Nairobi, where she worked with people living with HIV/AIDS in underserved communities, and later practiced as a nurse/midwife at Makiungu Hospital, Tanzania. In 2001, she moved to Germany to join the congregation of the Poor Handmaids of Jesus Christ, where she obtained certification in the German language and midwifery (Hebamme), and gained extensive clinical experience at St. Marien Krankenhaus, Frankfurt.
In 2012, while serving in Meru County, Kenya, she introduced evidence-based upright birthing positions, significantly improving maternal and neonatal outcomes. This experience inspired her academic advancement, leading to a BSc in Midwifery (Ghana, 2017) and an MSc in Midwifery (University of Port Harcourt, 2021).
She is currently the Head of the Department of Nursing at Claretian University of Nigeria and a PhD candidate. Her research focuses on evidence-based maternal care, particularly the comparative outcomes of upright and supine birthing positions.
Research Interest:
Background: Upright birthing positions are associated with important physiological benefits during labour; however, their adoption in clinical settings remains inconsistent worldwide. This study synthesizes current evidence on maternal and neonatal outcomes, as well as the key barriers and facilitators influencing their implementation.
Methods: A scoping review and meta-analysis were conducted in line with PRISMA guidelines. Seven electronic databases were searched for studies published between January 2015 and December 2025. Out of 1,660 identified records, 16–18 intervention studies (involving 2,441–4,848 participants) were included in the meta-analysis, while 42 studies contributed to the qualitative synthesis. Pooled estimates were generated using random-effects models, and thematic analysis was applied to identify implementation factors.
Results: Upright birthing positions were associated with a significant reduction in the duration of the second stage of labour (mean difference: −21.1 minutes; 95% CI: −30.4 to −11.8) and a lower rate of cesarean section among women without epidural analgesia (RR: 0.63; 95% CI: 0.42–0.94). Neonatal outcomes showed no significant differences. Despite these benefits, implementation remains limited, with only 22.6% of midwives routinely utilizing upright positions. Key barriers include insufficient training, inadequate infrastructure, and entrenched institutional preferences for supine positioning. Participation in training emerged as the most significant predictor of successful implementation.
Conclusion: Upright birthing positions provide clear maternal benefits without compromising neonatal outcomes. To enhance their routine use, there is a need to address systemic barriers through targeted training, enabling policies, and improved facility support, thereby promoting evidence-based, woman-centered maternity care.