Karraz 2003.

Methods	Randomised trial.
Participants	221 women, Evry, France 144 study participants: 97 primigravidae, 47 multigravida 77 control participants: 47 primigravidae, 30 multigravida Inclusion Criteria: Parity: mixed, Pluralty: singleton, Gestation: between 36 and 42 weeks, Onset of labour: spontaneous or scheduled for induced labour, Other: uncomplicated pregnancies. Exclusion criteria ‐ women with pre‐eclampsia or previous caesarean.
Interventions	Study group: 144 women were assigned to the ambulatory group Women could walk, sit in a chair or reclined in a semi‐supine position (n = 141), as long as they demonstrated: acceptable analgesia; acceptable systolic blood pressure and ability to stand on one leg. 3 women in this group were excluded because they had a fast birth. Control group: 77 women were allocated to the non‐ambulatory group Women were not allowed to sit, walk or go to the toilet, they had to remain in the supine position or to lie in a semi‐supine or lateral position (n = 74). 2 women in this group were excluded because they had a fast birth, and another 1 woman was excluded because of inadvertent dural puncture. All women: ‐ Study conducted in daytime only (as women in labour at night are less inclined to walk). ‐ Received intermittent epidural injection of 0.1% ropivacaine with 0.6 µg/mL sufentanil. ‐ Repeat injections were given when the women requested additional pain relief.
Outcomes	Maternal Outcomes: Mode of birth. Maternal pain. Analgesia amount. Augmentation using oxytocin. Neonatal Outcomes: Nil
Notes	Duration was recorded as the time between epidural insertion (highly variable) and birth (end of second stage). It was therefore not used as a comparable duration of first stage of labour.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	'Randomly divided' in a 2:1 ratio.
Allocation concealment (selection bias)	Unclear risk	Not stated.
Blinding (performance bias and detection bias) Women	High risk	Not feasible.
Blinding (performance bias and detection bias) Clinical staff	High risk	Not feasible.
Blinding (performance bias and detection bias) Outcome assessor	Unclear risk	Not stated.
Incomplete outcome data (attrition bias) All outcomes	High risk	6 women were excluded after randomisation.
Selective reporting (reporting bias)	Unclear risk	Unclear.