Midwives’ Knowledge, Attitudes, and Practices of Liberal Birthing Position Management During the Second Stage of Labor: A Cross-Sectional Study

Objective: To investigate the knowledge, attitudes, and practices of Chinese midwives regarding liberal birthing position management during the second stage of labor and explore the factors related to their practices.

Background: Midwives play a critical role in managing the second stage of labor, during which appropriate delivery posture is essential for promoting normal birth and improving childbirth experiences.

Methods: A cross-sectional study was conducted in Guangdong Province, China, from April to May 2023. Three hundred and sixty midwives completed the questionnaire on knowledge, attitude, and practice of liberal birthing position management during the second stage of labor. SPSS 29.0 was used to analyze the data. Descriptive statistics, independent sample t-test, one-way ANOVA, Pearson correlation analysis, and multiple linear regression analysis were performed. p < 0.05 was considered statistically significant.

Results: The midwives’ mean knowledge total score was high, with an 83.1% rate of correct answers. The midwives had a lower moderate level of attitude with a mean total score of 43.06 ± 9.08 out of 76 and a low level of the Worry dimension of attitude (19.86 ± 7.92 out of 48). The midwives had a moderate level of practice with a mean total score of 3.03 ± 1.85 out of 6. The scores of knowledge, attitude, and practice were pairwise positively correlated (p < 0.001). The multiple linear regression analysis showed that knowledge, attitude, having participated in training on maternal birthing positions, having experiences in clinical teaching, hospital grade, and hospital category were the predictors of midwives’ practice of liberal birthing position management during the second stage of labor (p < 0.05).

Conclusion: Midwives’ attitudes and practices of liberal birthing position management during the second stage of labor need to be improved, and participating in training and undertaking clinical teaching tasks are crucial for them to improve their practices in this area.

Implications: Midwifery managers need to pay more attention to the professional education and training of midwives and should establish organizations that are specifically designed to support midwives’ continuous learning and professional development. These organizations can offer targeted training programs, create collaborative learning environments, and facilitate the sharing of best practices among midwives. Nursing educators should be familiar with and in line with international standards, emphasizing upgrading midwifery teaching materials and establishing a standardized on-the-job training system.