Maternal Position During Childbirth and Perineal Injury: A Scope Review Protocol

Background: Maternal positions adopted during labor and the second stage of vaginal birth may directly influence perineal outcomes, including the occurrence and severity of perineal lacerations and the need for episiotomy. Although international guidelines encourage maternal mobility and freedom of position during childbirth, the literature presents heterogeneous findings regarding the specific effects of different birth positions on perineal integrity. In the context of strengthening evidence-based practice and woman-centered care, systematically mapping the available scientific evidence on this topic is essential. Objective: To map the scientific evidence regarding the relationship between maternal positions during vaginal birth and the occurrence and severity of perineal trauma. Methods: This scoping review protocol was developed in accordance with the methodological guidance of the Joanna Briggs Institute and will be reported following the PRISMA-ScR extension. The protocol is registered in the Open Science Framework. The research question was structured using the PCC framework (Population, Concept, Context): Population – women undergoing vaginal birth (primiparous and multiparous); Concept – maternal positions adopted during the second stage of labor, including upright and non-upright positions; Context – vaginal birth care. Searches will be conducted in PubMed, LILACS, SciELO, CINAHL, Scopus, and Web of Science, without initial restrictions regarding language or publication period. Eligible studies will include clinical trials, observational studies, and systematic reviews addressing outcomes such as perineal lacerations, episiotomy, and perineal integrity. Study selection will be performed by two independent reviewers, with standardized data extraction. Results will be presented through a PRISMA-ScR flow diagram, descriptive tables, and narrative synthesis. Expected Results: The review is expected to identify patterns of association between maternal positions and perineal outcomes, highlight research gaps, and support the development of clinical protocols aimed at perineal protection and the promotion of woman-centered childbirth care.