MacLennan 1994.

Methods	Randomised trial.
Participants	196 women, Adelaide, Australia. 96 study participants: 49 primigravidae, 47 multigravida 100 control participants: 43 primigravidae, 57 multigravida Inclusion Criteria: Parity: mixed, Pluralty: singleton, Gestation: between 37 and 42 weeks, Onset of labour: spontaneous, Other: cephalic presentation; in established labour (presence of regular contractions less than 10 mins apart and cervical dilatation of 3 cm or more); able to ambulate in labour. Exclusion criteria: women undergoing intravenous therapy, with hypertension (> 90 mmHg diastolic blood pressure), epidural or narcotic analgesia at or before entry to trial, evidence of possible fetal distress, previous prostaglandin treatment, induced labour and a physical inability to ambulate.
Interventions	Study group: 96 women were randomised to ambulate with fetal heart radiotelemetry Women were encouraged to ambulate but were also given the option of sitting or lying down when they wished. Only 37 women actually chose to ambulate for half an hour or more. The mean time they spent upright was 1.8 hrs, and the mean time they spent recumbent was 4.5 hrs. Control group: 100 women were randomised to recumbence with conventional fixed electronic fetal heart rate monitoring. Most women chose a semi‐recumbent posture with the head end of the bed at 45 degrees but they could also be on their side with lower elevation of the head. All women: After entry to the trial, all women had an artificial rupture of the membranes if they had not already spontaneously ruptured.
Outcomes	Maternal Outcomes: Mode of birth. Analgesia type. Augmentation of labour using oxytocin. Neonatal Outcomes: Apgar scores. Admission to NICU. Perinatal mortality.
Notes	Duration was recorded as the time between entry (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)	Low risk	Described as 'Balanced variable blocks with stratification by parity'.
Allocation concealment (selection bias)	Low risk	Opaque, sealed envelopes.
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	Low risk	No stated losses to follow‐up.
Selective reporting (reporting bias)	Unclear risk	Unclear.