Effects of Ambulation during the First Stage of Labor on Maternal and Neonatal Outcomes: A Randomized Controlled Trial

Background: In Jordan, practices in maternity wards are not based on the best evidence. Women are still largely confined to bed during the first stage of labor. Objective: This study examined the effect of ambulation during the first stage of labor on maternal and neonatal outcomes. Methods: A blinded randomized controlled trial was conducted in a labor ward of one large hospital in Southern Jordan. Primiparous women (n = 290) were randomly assigned to an intervention group (n = 140) and a control group (n = 150). The intervention group was encouraged to ambulate, and the control group received the usual care. Descriptive statistics, independent t-tests, and analysis of variance were used for data analysis. Results: Compared to the control group, women in the intervention group experienced a shorter duration of the first stage of labor (P < 0.001), reported less intensity of labor pain (P < 0.001), and used less analgesics (P < 0.001). They experienced less augmentation of labor (P = 0.030), were more likely to give birth by normal vaginal birth (P = 0.015) and were more satisfied with the birth experience (P = 0.001). No statistically significant differences were found between groups concerning perineal status, postpartum complications, and neonatal outcomes. Conclusion: Although the intervention has had a positive impact on maternal outcomes, no negative effects on neonatal outcomes were found. Encouraging women to ambulate and assume the upright position during the first stage of labor, is likely to produce better physical, social and economic outcomes in maternity services.