Vertical birth: scoping review on obstacles to its implementation

Introduction: The adoption of upright positions during labor and delivery is recommended by the World Health Organization, due to its recognized benefits, but it is not a common reality in Portuguese maternity hospitals. Objective: To map the knowledge on the obstacles to implementing upright birth in a hospital setting. Methods: A scoping review was carried out using the JBI methodology. The search was carried out in 2022, in B-on, CINAHL Complete, PubMed, and MEDLINE Complete. Study selection, data extraction and synthesis were carried out by two independent researchers, and 5 studies were included. Results: The obstacles inherent in the adoption of upright positions in labour and delivery were identified, including organizational, professional, parturient and childbirth interventions. The analysis of the studies reveals a lack of training and experience in vertical childbirth among health professionals, a lack of empowerment among women, a lack of organizational interest in promoting vertical childbirth and an epidural analgesia technique that limits mobility. Conclusions: Given the obstacles identified, it is up to the Maternal and Obstetric Health Nurse Specialist to be creative in finding solutions to overcome the obstacles identified and to promote change so that vertical positions become normal in Portuguese maternity wards.