Left Lateral Position vs Supine Position to Reduce Active Labor Duration

Globally, maternal positioning during labor is a key component of humanized childbirth. While the World Health Organization recommends allowing women to adopt comfortable positions, the supine position remains prevalent in many clinical settings for practitioner convenience. This study in Honduras seeks to generate local evidence on the impact of maternal position on labor progression. Nulliparous women at term (≥37 weeks) with a singleton pregnancy in cephalic presentation and in the active phase of labor (≥6 cm dilation) will be recruited from the labor and delivery unit of the Hospital Materno Infantil. After providing informed consent, participants will be randomized. The primary efficacy endpoint is the time from the onset of the active phase (or intervention start, if later) until delivery. The study hypothesizes that the left lateral position will significantly reduce active labor duration compared to the supine position, potentially reducing unnecessary surgical interventions and improving the childbirth experience.

Inclusion criteria

• Signed and dated informed consent form.
• Nulliparous woman.
• Singleton pregnancy at ≥37 weeks of gestation.
• Intact amniotic membranes.
• Cephalic presentation.
• In the active phase of labor (cervical dilation ≥6 cm).
• Age ≥18 years.
• No contraindication for vaginal delivery.
• Possession of a mobile phone (for potential follow-up contact).

Exclusion criteria

• Previous uterine surgery.
• Maternal condition preventing vaginal delivery.
• Fetal anomaly.
• Premature rupture of membranes.
• Multiple pregnancy.
• Fetal demise.
• Uterine myomas.
• Maternal comorbidities (e.g., chronic hypertension, diabetes mellitus type -1/2/gestational, hypothyroidism).
• Anemia.
• Age <18 years.
• Preterm gestation (<37 weeks).