Upright and Squatting Positions During Labor: Effects on Birth Outcomes, Maternal Satisfaction, and Birth Trauma Perception in Multiparous Women

Background Maternal position during labor is a key non-pharmacological strategy that supports physiological birth and women’s active participation in the childbirth process. Although upright positions have been associated with favorable labor outcomes compared with supine positions, evidence directly comparing different upright positions—particularly in relation to maternal birth experience and perceived traumatic birth—remains limited. Objective This study aimed to compare the effects of standing and squatting positions during the first stage of labor on the birth process, birth comfort, pain intensity, and perceived traumatic birth experience among multiparous women. Methods This study was conducted using a comparative interventional design. A total of 82 multiparous women were included and allocated to either the standing group (n = 41) or the squatting group (n = 41) during labor. Data were collected using a personal information form, the Visual Analog Scale (VAS) for pain, the Labor Comfort Scale, and the Traumatic Birth Perception Scale. Outcomes were assessed during labor and within the first two hours postpartum. Statistical analyses included comparative and correlation analyses. Results No statistically significant differences were found between the standing and squatting groups in terms of labor duration, pain intensity, frequency of position preference, time spent in the position, birth comfort scores, or perceived traumatic birth levels (p > 0.05). However, in the squatting group, perceived traumatic birth was strongly and negatively correlated with overall birth comfort and all comfort subdimensions (p < 0.01), whereas no significant correlation was observed in the standing group. Conclusion Standing and squatting positions during the first stage of labor yield comparable physiological and clinical outcomes among multiparous women. Nevertheless, the strong association between birth comfort and perceived traumatic birth in the squatting group suggests that qualitative aspects of the birth experience may be influenced by the type of upright position adopted. These findings highlight the importance of offering women freedom of movement and individualized position choices during labor to support a positive childbirth experience. Trial registration: Retrospectively registered (NCT07383181)