What do we actually know about the biomechanics of pregnancy and labour? A systematic scoping review

by Anastasia Topalidou, Lauren Haworth, Raeesa Jassat, Morgan Hawcroft-Hurst

Pregnancy and childbirth involve profound biomechanical transformations, adaptations, and functional demands on the maternal body. Although biomechanical complications have been identified as a major contributor to maternal morbidity and mortality, this remains one of the most under-researched areas in perinatal health. This systematic scoping review aimed to map and synthesise existing literature on the biomechanics of pregnancy and labour. Following Arksey and O’Malley’s framework and PRISMA-ScR guidance, comprehensive searches of MEDLINE, EMBASE, and MIDIRS were conducted up to May 2025. Eligible sources were peer-reviewed empirical studies assessing musculoskeletal, kinematic, kinetic, postural, or dynamic parameters in pregnant or labouring women. Titles, abstracts, and full texts were screened against predefined eligibility criteria. Data were charted using a structured extraction form and synthesised narratively across key biomechanical themes. Eighty-seven studies were included, all of which focused on pregnancy. No studies conducted during labour were identified. Most were observational with small sample sizes and limited diversity. Ethnicity was reported in only one study. Four key themes emerged: (1) Posture and spinal curvature, (2) Gait and locomotor analysis, (3) Functional tasks and interventions, and (4) Balance and stability. Findings showed high individual variability and no consistent biomechanical pattern across pregnancy. Real-world, neuromuscular, and labour-related biomechanics remain largely unexplored. This review underscores a critical gap in perinatal research: while biomechanical adaptations during pregnancy have been increasingly studied, labour remains entirely unexamined from a biomechanical perspective. Current evidence is fragmented, methodologically narrow, and lacks diversity, offering limited clinical relevance. We are effectively operating in a biomechanical vacuum, without empirical data to guide safer, more efficient, and personalised birth practices. Existing clinical approaches rely heavily on tradition, anecdotal experience, and untested theoretical assumptions. Addressing this evidence void, particularly in labour biomechanics and ethnic representation, is essential to improve perinatal outcomes and support equity in maternal care.

Breaking the cycle: Systematic review of perinatal interventions for parents at risk of child removal

by Esther Ariyo, Victoria Awortwe, Ebenezer Cudjoe

This systematic review examined the effectiveness of perinatal interventions aimed at preventing infant removals, with attention to service features, implementation barriers, and enablers. We searched six electronic databases and 15 relevant websites for peer reviewed studies published between 2014 and 2024. Eligible studies evaluated interventions targeting pregnant parents at risk of having another child removed and reported on infant removal outcomes. Independent reviewers screened studies using Covidence. A total of 256 records were obtained, of which six peer reviewed studies covering eight interventions, involving 3,254 pregnant women and 20 professionals met the inclusion criteria. Three studies included comparison groups, including only one randomized controlled trial. Five studies assessed program-level interventions, and one study evaluated a policy change. Risk of bias was assessed using the Mixed Methods Appraisal Tool (MMAT). Two of the three comparative studies indicated that targeted interventions may help reduce infant removals. Four of the six studies highlighted that trauma-informed, relationship-based, and multidisciplinary approaches delivered during pregnancy were associated with reductions in infant removals and improvements in maternal wellbeing, housing stability, substance use, and service engagement. Facilitators of successful implementation included continuity of care, culturally safe and non-judgmental support, and flexible services tailored to family needs. Common barriers were late referrals, limited intervention timelines, mistrust of services particularly among families with prior removals and insecure funding that constrained scale and sustainability. Despite generally positive outcomes, the evidence base remains weak due to small samples, limited diversity, lack of comparison groups, and short follow-up periods. This first systematic review of perinatal interventions for preventing infant removals highlights the need for long term, inclusive, comparative research. It underscores the importance of embedding early, holistic support in routine services and offers valuable insights for policy and practice on supporting parents with complex needs within the child protection system.