PURPOSE:
This was a quality improvement project implemented through Midwize, a Karolinska Institutet supported project. MIDWIZE is a midwife-led, evidence-based quality improvement initiative focused on reducing preventable maternal and neonatal complications through simple, yet impactful, interventions. The purpose of the project was to introduce dynamic birth positions in a level four facility in Mombasa, Kenya.

DISCUSSION:
Evidence indicates that the use of dynamic birth positions during labour and birth allows women to have flexibility and control over their labour and birth process. While the traditional supine positions have been associated with increased risk of episiotomies, instrumental births, and caesarean sections, dynamic birth positions have been found to be beneficial to both the mother and the baby. With the dynamic positions, the duration of labour is shortened since gravity promotes descent of the presenting part.

EVIDENCE WHERE RELEVANT:
Forty women attending antenatal clinic (ANC) were recruited into the project. The nurses, midwives, and obstetricians were sensitized on dynamic birth positions, as were the women and their partners as they came for ANC. Data was collected at baseline to assess existing practices, at midterm to evaluate practice uptake, and at the endline to assess the impact of the intervention. At baseline, all women gave birth while lying on their backs. At midline, nine mothers adopted a lateral position, and some used a birthing stool. At the end line, which was five months after the inception of the project, the use of dynamic birth positions was at 62.5%, which was a significant uptake.

KEY MESSAGE:
Dynamic birth positions are adaptable even in resource-limited settings, and they are linked to good health outcomes. The health care providers need to support women and their partners in adopting the dynamic positions during birth. Spanish - respectful care (including three-minute presentation competition)