Maternal and newborn outcomes of upright versus supine birthing position in Sub-Saharan Africa: A systematic review

Background: Maternal positioning during the second stage of labour, such as the supine (including lithotomy) or upright (like sitting) positions, plays a significant role in influencing both maternal and fetal outcomes during delivery. Aim: The aim of this systematic review is to compare maternal and neonatal outcomes between upright and supine birthing positions during labour. Methods: A search was done across various research databases but only three research databases (PubMed, Scopus and Google Scholar) yield articles carried out in sub-Saharan Africa. The Search was done to identify related studies carried out within Sub-Saharan Africa, for the past twenty-year period (2004-2024), in English language or translated to English. In addition, manual searches were conducted on the reference lists of the identified studies. Out of all searched literature, five studies retrieved (1quantitative comparative study1 prospective study, 1 quasi-experimental, 1 three-arm, open-label, randomized controlled trial. Results: Five studies involving 3,376 laboring women from diverse Sub- Saharan African countries, including Tanzania, Ethiopia, Benin, Nigeria, and South Africa, met the inclusion criteria. The literature review highlighted five key themes: duration of the second stage of labor, mode of delivery, maternal labor pain, fetal outcomes, and the most prevalent theme—perineal tears and the performance of episiotomies.