Left Lateral Position vs Supine Position to Reduce Active Labor Duration (DLI-SP)

Left Lateral Position Versus Supine Position in Reducing the Duration of the Active Phase of Labor: A Randomized, Single-Blind Clinical Trial

This randomized clinical trial aims to compare the effect of the left lateral decubitus position versus the supine position on the duration of the active phase of labor in nulliparous women. A total of 188 participants will be randomly assigned to one of two groups. The intervention group will be placed in the left lateral decubitus position, while the control group will remain in the supine position. Both positions will be maintained for 30-minute intervals with 5-minute rest periods, continuing until delivery. The primary outcome is the duration of the active phase of labor. Secondary outcomes include rates of cesarean section, use of oxytocin and analgesics, and maternal and neonatal complications.

Study Overview

• Status: Recruiting
• Conditions: Labor Pain
• Intervention / Treatment: Other: Left Lateral Decubitus Group; Other: Supine Position Group

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Estimated): 188
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ricardo A. Gutierrez Ramirez, MD, MSc; Phone Number: +50497546940; Email: ricardo.gutierrez@unah.edu.hn

Study Locations

• Honduras
  • Francisco Morazán Department
    • Tegucigalpa, Francisco Morazán Department, Honduras, 11101
      • Recruiting
      • Hospital Escuela
      • Contact: Ricardo A Gutierrez Ramirez, MD, MSc.; Phone Number: 50497546940; Email: ricardo.gutierrez@unah.edu.hn
      • Principal Investigator: Adriana P Mendoza Batres, MD
      • Principal Investigator: Kevin O Ponce Rodriguez, MD
      • Sub-Investigator: Juan J Galeas Reyes, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

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).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Left Lateral Decubitus Position; Participants will be placed in the left lateral decubitus position for periods of 30 minutes, interspersed with 5-minute rest periods. This cycle will continue throughout the active phase of labor until delivery.	Other: Left Lateral Decubitus Group; Participants will be placed in the left lateral decubitus position for periods of 30 minutes, interspersed with 5-minute rest periods. This cycle will continue throughout the active phase of labor until delivery.
Active Comparator: Supine Position Group; Participants will remain in the supine position for periods of 30 minutes, interspersed with 5-minute rest periods. This cycle will continue throughout the active phase of labor until delivery.	Other: Supine Position Group; Participants will remain in the supine position for periods of 30 minutes, interspersed with 5-minute rest periods. This cycle will continue throughout the active phase of labor until delivery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Duration of the active phase of labor.	The primary objective is to measure and compare the time taken to progress from the active phase to delivery between the two positioning groups.	Time (in minutes) from the diagnosis of the active phase of labor (cervical dilation ≥6 cm) to delivery of the newborn. Within the first 24 hours after diagnosis of active phase.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of Cesarean Delivery	The proportion of participants in each group who undergo a cesarean section.	From randomization until delivery (anticipated within 48 hours per participant).
Use of Oxytocin for labor augmentation/conduction.	The proportion of participants in each group who receive oxytocin infusion.	From randomization until delivery.
Incidence of maternal complications (e.g., perineal tears, hemorrhage, hypotension).	Composite of adverse maternal outcomes recorded during labor and the immediate postpartum period.	From randomization until hospital discharge (approximately 24-48 hours postpartum).
Neonatal status as measured by Apgar score.	The Apgar score (0-10) will be recorded and compared between groups.	At 1 minute and 5 minutes after birth.

Collaborators and Investigators

• Sponsor: Universidad Nacional Autonoma de Honduras

Publications and helpful links

General Publications

• Gupta JK, Hofmeyr GJ, Shehmar M. Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database Syst Rev. 2012 May 16;(5):CD002006. doi: 10.1002/14651858.CD002006.pub3.

Study record dates

Study Major Dates

• Study Start (Estimated): February 15, 2026
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): September 30, 2026

Study Registration Dates

• First Submitted: February 4, 2026
• First Submitted That Met QC Criteria: February 10, 2026
• First Posted (Actual): February 13, 2026

Study Record Updates

• Last Update Posted (Actual): February 13, 2026
• Last Update Submitted That Met QC Criteria: February 10, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Randomized Controlled Trial; Maternal Position; Left Lateral Position; Active Phase of Labor
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Labor Pain
• Other Study ID Numbers: PGO-UNAH-49-1-2026

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: The research team acknowledges the importance of data sharing but has not yet established the necessary infrastructure, resources, and legal/ethical agreements required for the secure preparation, anonymization, and controlled sharing of individual participant data (IPD). Decisions regarding future sharing will depend on internal review, compliance with Honduran data protection regulations, and securing appropriate funding and technical support for long-term data stewardship.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No