title: A randomized trial of birthing with and without stirrups.
abstract: OBJECTIVE
  The objective of the study was to determine whether bed delivery without stirrups reduces the incidence of perineal lacerations compared with delivery in stirrups.
  
  
  METHODS
  In this randomized trial, we compared bed delivery without stirrups with delivery in stirrups in nulliparous women. The primary outcome was any perineal laceration (first through fourth degree).
  
  
  RESULTS
  One hundred eight women were randomized to delivery without stirrups and 106 to stirrups. A total of 82 women randomized to no stirrups (76%) sustained perineal lacerations compared with 83 in women allocated to stirrups (78%) (P = .8). There was no significant difference in the severity of lacerations or in obstetric outcomes such as prolonged second stage of labor, forceps delivery, or cesarean birth. Similarly, infant outcomes were unaffected.
  
  
  CONCLUSIONS
  Our results do not incriminate stirrups as a cause of perineal lacerations. Alternatively, our findings of no difference in perineal lacerations suggest that delivering in bed without stirrups confers no advantages or disadvantages.
authors: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, USA.
authors: Marlene M
authors: MM
authors: Corton
authors: Janice C
authors: JC
authors: Lankford
authors: Rebecca
authors: R
authors: Ames
authors: Donald D
authors: DD
authors: McIntire
authors: James M
authors: JM
authors: Alexander
authors: Kenneth J
authors: KJ
authors: Leveno
mesh_terms: D000328:Adult; D001513:Beds; D036861:Delivery, Obstetric / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D022125:Lacerations / Q000453:epidemiology*; D016015:Logistic Models; D010298:Parity; D036801:Parturition; D010502:Perineum / Q000293:injuries*; D011187:Posture; D011247:Pregnancy; D055815:Young Adult