الفهرس 
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Abstract
Labor is a special time, both emotionally and physically, for each woman. It is a time of intense physical activity, stress, and pain, and it may prove to be a time of overt or hidden danger. Giving birth represents a major transition in a woman’s life- not only is she becoming a mother, she will also be growing and learning throughout the process (7).
Position affects the woman’s anatomic and physiologic adaptations to labor. There is no unanimity in medical approaches about how childbirth should be assisted in human beings. The position that the woman should adopt in the moment of the birth is still reason for great controversy. For pregnant women without risk, in the great majority of the maternities the gynecological position is mandatory for the moment of the birth. This guideline has been generalized historically and, according to its supporters, produces good results in births. On the other hand, there are evidences that, for women without any pregnancy risk, when they adopt a vertical or a squatting position in the moment of birth, the mechanisms of childbirth are respected, allowing more physiological births, with fewer maternal-fetus-neonatal complications (22, 37).
Addressed upright positions as squatting position in labor and delivery documented decreases in pain and length of labor, and in maternal and fetal morbidity. Radiologic studies show that squatting increases the diameter of the pelvic outlet by as much as 0.5 to 2.0 cm. In addition, squatting has been advocated to prevent supine hypotensive syndrome, enlist the forces of gravity, increase the bearing-down urge, and bring about the proper alignment of the fetus in the birth canal to facilitate delivery. Researchers also noted increased maternal involvement and pleasure in the birth process in the upright positions. Standing, kneeling, and squatting positions for delivery are associated with maintaining an intact perineum and reducing lacerations and episiotomies, because of even and direct application of the fetal head to the introitus rather than a concentration of pressure on the perineum (22,44).
Squatting position during labor has many benefits. It may facilitates progress of labor by stimulating more effective contractions, increases pressure of the presenting part against the cervix to facilitate effacement and dilatation, and promotes fetal rotation and descent. Squatting position also may helps to reduce the total time of second stage of labor, because it keeps the pelvis wide help the baby find the best way through. Squatting position is a self-regulated, low technology care measure that does not engender any additional health care costs. It may have an important place in helping labor remain physiologic. Despite of these, the effect of maternal position on progress of labor remains unclear, and many women continue to deliver in the traditional recumbent position (75-76).
Aim of the present study was:
The aim of this study was to determine the effect of squatting position during second stage of labor on nature and progress of labor among primiparae, to fulfill such aim:
To fulfill such aim
A quasi-experimental research design was used and the study was conducted in the year 2010 from the end of January till the beginning of July in the obstetrics and gynecological department at the National Medical Institute in Damanhur, Albehera Governorate.