News Release

Walking Or Bed Rest OK For First Stage Of Labor, UT Southwestern Research Shows

Peer-Reviewed Publication

UT Southwestern Medical Center

DALLAS -- July 9, 1998 -- In the largest study of its kind, UT Southwestern Medical Center at Dallas obstetrics and gynecology researchers have concluded that walking during the first stage of labor is neither harmful nor beneficial to the mother or baby.

Dr. Steven Bloom, assistant professor of obstetrics and gynecology and lead author of the study published in today's New England Journal of Medicine, said women should be allowed to either walk or remain in bed during the first stage of labor, whichever is most comfortable to them. Current obstetrics practice dictates that a woman lie down during labor, but, as many doctors know, patients sometimes want to walk around, hoping to find comfort in motion.

Bloom and his colleagues assigned 1,067 women at Parkland Memorial Hospital in Dallas in spontaneous labor with uncomplicated pregnancies between 36 and 41 weeks' gestation to either a walking group or a bed-rest group. Seventy-eight percent of those assigned to the walking group actually walked; the rest had quicker labors, which may have precluded them from walking. Those in the bed-rest group were allowed to sit up. The researchers compared such factors as duration of the first stage of labor, the need for labor augmentation with medication, the use of analgesia for pain and the percentages of forceps deliveries and Caesarean sections.

"Labor and delivery outcomes were unrelated to walking, and infants' outcomes were also similar in the two study groups," Bloom concluded. "Walking neither enhanced nor impaired active labor and was not harmful to the mothers or their infants. Most of those who did walk indicated that they would do so again in a future labor. Since our results provide no objective evidence for or against walking during labor, it seems reasonable to let women elect either alternative."

This study brings the debate of walking or bed rest full circle since the first of the century. Bloom explained that J. Whitridge Williams, in the first edition of his obstetrics textbook in 1903, stated, "During the first stage of labor the patient usually prefers to move about her room, and frequently is more comfortable when occupying a sitting position. During this period, therefore, she should not be compelled to take to her bed unless she feels so inclined."

Other UT Southwestern researchers who participated in the study were Dr. Donald McIntire, assistant professor of obstetrics and gynecology; Mary Ann Kelly, obstetrics and gynecology research nurse; Marcy Garcia, certified nurse midwife in obstetrics and gynecology; Rebecca Burpo, faculty associate in obstetrics and gynecology and Parkland Nurse Midwifery School faculty member; and Dr. Kenneth Leveno, professor of obstetrics and gynecology. Heidi Beimer, Parland labor and delivery nurse, also participated.

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