Comparative analysis of utilization of birthing position among parturient women in western Kenya

Abstract

Maternal and neonatal outcomes during the second stage of labor depend heavily on the positions women choose to adopt. Despite global and regional evidence supporting the benefits of alternative birthing positions: In Kenyan healthcare facilities the lithotomy position continues to be the main birthing position despite research supporting alternative positions like squatting, kneeling, and side-lying. The persistence of certain birthing positions is primarily caused by a lack of awareness among mothers about alternatives and healthcare systems that fail to endorse non-standard positions. The status of birthing position utilization plays a key role in advancing evidence-based maternal care practices. The research seeks to evaluate differences in birthing position utilization during the second stage of labor across two Kenyan regions, Kakamega and Bungoma. Methodology: A cross-sectional study design was employed. The research study enrolled 481 pregnant women from antenatal clinics located in the two referral hospitals of Kakamega and Bungoma. Researchers used systematic sampling to choose participants and gathered data through structured questionnaires and observational checklists. Data analysis was conducted through descriptive statistics and chi-square tests while maintaining a significance threshold at p < 0.05. Bandura’s Social Cognitive Theory provided the framework for this study because it emphasizes how observational learning and self-efficacy combined with environmental factors shape health behavior. Results: The majority of women who gave birth in the Bungoma district did so in the lithotomy position at a rate of 94.6%, compared to 93.3% in Kakamega district. Fifth point three percent of Bungoma participants and six-point seven percent of Kakamega participants had used alternative birthing positions. The chi-square test results indicated no statistically significant difference between the two study areas (χ² = 0.19, p = 0.663), confirming that they were comparable before the intervention. Conclusion: Research results indicate that the lithotomy position remains the predominant choice for women during the second stage of labor in Western Kenya. The research reveals significant gaps in maternal understanding and shows how healthcare system limitations prevent the usage of alternative birthing methods. Recommendation: Healthcare authorities need to update national maternal health resources and personal birth plans to provide information about birthing posture options. Healthcare providers require training while health facilities need proper equipment to accommodate multiple birthing positions.