Gupta et al.’s (2004 ) review also examines the effects and experiences of using a birth
stool with the supine position, the lateral and supine positions; use of a birth cushion with
supine or lithotomy positions and birth chair compared with supine or lithotomy position.
Use of a birth stool results in fewer episiotomies, more second degree tears, a higher
incidence of blood loss estimated to be over 500 mls; fewer reports of severe pain at birth
and (in the only trial that reported it) fewer fetal heart rate abnormalities than the supine
posture. Comparison of the lateral and supine positions found no differences in length
of second stage, number of episiotomies and assisted births although numbers were small.
Use of the birth cushion resulted in shorter second stages of labour, less assisted births,
no difference in number of episiotomies and blood loss estimated to be over 500ml and
less second degree tears when compared with the second stage spent in supine or
lithotomy positions. Comparisons of the birth chair with the supine or lithotomy position
found no difference in length of second stage, fewer episiotomies, more second degree
tears and more women experiencing blood loss estimated at greater than 500ml.