{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T02:55:50Z","timestamp":1778640950121,"version":"3.51.4"},"reference-count":49,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,1,4]],"date-time":"2007-01-04T00:00:00Z","timestamp":1167868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:p><jats:bold>Objective\u2002<\/jats:bold> To assess whether the risk of severe blood loss is increased in semi\u2010sitting and sitting position, and if so, to which extent blood loss from perineal damage is responsible for this finding.<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Secondary analysis of data from a large trial.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> Primary care midwifery practices in the Netherlands.<\/jats:p><jats:p><jats:bold>Population\u2002<\/jats:bold> About 1646 low\u2010risk women who had a spontaneous vaginal delivery.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Blood loss was measured using a weighing scale and measuring jug. Logistic regression analysis was used to examine the net effects of birthing position and perineal damage on blood loss greater than 500 ml.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2002<\/jats:bold> Mean total blood loss and incidence of blood loss greater than 500 ml and 1000 ml.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Mean total blood loss and the incidence of blood loss greater than 500 ml and 1000 ml were increased in semi\u2010sitting and sitting position. In logistic regression analysis, the interaction between birthing position and perineal damage was almost significantly associated with an increased risk of blood loss greater than 500 ml. Semi\u2010sitting and sitting position were only significant risk factors among women with perineal damage (OR 1.30, 95% CI 1.00\u20131.69 and OR 2.25, 95% CI 1.37\u20133.71, respectively). Among women with intact perineum, no association was found.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Semi\u2010sitting and sitting birthing positions only lead to increased blood loss among women with perineal damage.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2006.01210.x","type":"journal-article","created":{"date-parts":[[2007,1,4]],"date-time":"2007-01-04T22:32:38Z","timestamp":1167949958000},"page":"349-355","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Increased blood loss in upright birthing positions originates from perineal damage"],"prefix":"10.1111","volume":"114","author":[{"given":"A","family":"De Jonge","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MTh","family":"Van Diem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PLH","family":"Scheepers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KM","family":"Van Der Pal\u2010de Bruin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ALM","family":"Lagro\u2010Janssen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,1,4]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"1","article-title":"Parturitional posture and related birth behavior","volume":"57","author":"Atwood RJ","year":"1976","journal-title":"Acta Obstet Gynecol Scand Suppl"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.12968\/bjom.2001.9.10.12694"},{"key":"e_1_2_6_4_2","first-page":"443","article-title":"Maternal position during parturition in normal labor","volume":"68","author":"Carlson JM","year":"1986","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-2182(98)00033-0"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/01674820410001737423"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004415"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1997.tb11534.x"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1515\/jpme.1983.11.6.286"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.1991.tb00045.x"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/01674820410001737432"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(83)92412-1"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1991.tb13453.x"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1989.tb03226.x"},{"key":"e_1_2_6_15_2","volume-title":"The Birthing Chair Trial. 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