Positioning.

Clinician preferences and the patient’s cultural background influence the

positioning women choose when laboring. Encourage the woman to assume any position
she finds comfortable (other than the supine) and change positions frequently (Fig. 15.5).
Movement and frequent position changes in labor decrease pain, improve maternalfetal
circulation, improve the strength and effectiveness of contractions, decrease the length of
labor, facilitate fetal descent, and decrease perineal trauma and episiotomies (Association of
Women’s Health, Obstetric and Neonatal Nurses [AWHONN], 2008; Zwelling, 2010). Zwelling
(2010) recommended that nurses follow six physiologic principles related to maternal
positioning in labor proposed by Fenwick and Simkin (1987): promote spinal flexion,
promote an