The objectives of this study were to determine whether there was an association between clinical nursing knowledge of four birthing positions and current evidence-based research of those same positions and also to identify possible areas where nursing knowledge of those birthing positions was inadequate. This pilot study used convenience sampling to survey registered nurses (RNs) and licensed practical nurses (LPNs) on labor and delivery units. The survey was distributed to three hospitals in the southeastern United States, and twenty-four RNs and LPNs participated. Participants’ knowledge did not reflect current clinical evidence in two key areas, (1) the best position to minimize blood loss and (2) the best position to decrease the likelihood anal sphincter tears. Respectively, only 13% and 27.3% of participants selected the correct position. Continuing education for maternity nurses regarding current evidence-based practice concerning various birthing positions remains a need, and incorporating this could include more frequent opportunities for education classes and unit inservices. Results from this study should not be generalized, and more research is needed in this area to validate these findings.

Lorsque l'on s'intéresse aux positions d'accouchement, les avis sont très partagés. D'après la littérature, les positions dites verticales parmi lesquelles figure la position accroupie semblent aboutir à des issues materno-fœtales plus favorables que les positions horizontales qui comprennent la position gynécologique. Seulement, l'origine de ces bénéfices notamment du point de vue de la mécanique obstétricale reste incertaine. Il apparait que ce manque de clarté provient avant tout d'un manque de définition des postures segmentaires retrouvées lors de ces positions d'accouchement. L'objectif premier de ce travail était donc de définir les postures segmentaires au cours de différentes positions d'accouchement et de préciser en particulier le rôle de la posture des cuisses sur des éléments jugés importants en mécanique obstétricale à savoir l'orientation du plan du détroit supérieur et la courbure lombaire. En premier lieu, une enquête épidémiologique régionale a été effectuée afin d'attester les positions d'accouchement les plus fréquemment adoptées et d'identifier les facteurs associés à leur adoption. Par une méthode dérivée entre autres des méthodes d'analyse du mouvement par système optoélectronique, l'influence de la posture des cuisses (flexion et abduction) sur la posture du plan du détroit supérieur et du rachis lombaire a été analysée tout d'abord en position gynécologique puis en position accroupie. Enfin, l'importance de la posture initiale des cuisses sur les mouvements segmentaires a été évaluée au cours d'une manœuvre obstétricale (Mac Roberts), manœuvre couramment utilisée en cas de dystocie des épaules.Ce travail a permis de mettre en évidence l'importance de la caractérisation des postures segmentaires pour la compréhension des bénéfices d'une position d'accouchement sur une autre. / When looking at birthing positions, opinions are strongly divided. According to the literature, the so-called vertical positions, which include the squatting position, seem to lead to more favorable maternal-fetal outcomes than the horizontal positions which include the gynecological position. In fact, the origin of these benefits, particularly from the point of view of obstetric mechanics, remains uncertain. It appears that this lack of clarity comes primarily from a lack of definition of segmental postures found in these delivery positions.The primary objective of this work was therefore to define the segmental postures during different birthing positions and to specify in particular the role of the thigh posture on elements considered as important in obstetric mechanics namely, the orientation of the pelvic inlet and the lumbar curvature.Firstly, a regional epidemiological survey was carried out to document the most frequently adopted childbirth positions and to identify the factors associated with their adoption.Using a method derived inter alia from movement analysis methods based on optoelectronic system, the influence of thigh posture (flexion and abduction) on the posture of the pelvic inlet and the lumbar spine was analyzed firstly during gynecological position and then during squatting position. Finally, the importance of initial thigh posture on segmental movements was evaluated during an obstetric maneuver (Mac Roberts), a maneuver commonly used in cases of shoulder dystocia.This work has highlighted the importance of the characterization of segmental postures for understanding the benefits of one delivery position on another.