Rethinking deliveries

By HSC Staff Writer • Published: March 23rd, 2006
Category: Health in a Heartbeat

Many of us entered the world through the modern-day tradition of “pushing” during labor.

But new research in the American Journal of Obstetrics and Gynecology shows “coached” pushing only shortens labor by about thirteen minutes. And it may actually do minor pelvic damage in a small number of cases.

Coaches are common in delivery rooms, urging the moms-to-be to take a deep breath, hold it, and push forcefully with each contraction.

But doctors at the University of Texas Southwestern Medical Center say “coached pushing” is a modern-day activity, relatively unknown before the 1950s.

Researchers looked at the recent birth experiences of more than three-hundred women who were having their first child and who were coached by certified midwives.

Half the women were instructed to bear down for ten seconds at the peak of a contraction. The other half were told to do whatever felt best.

On average, the women who were told to push did indeed have shorter deliveries, reducing the second stage of labor by thirteen minutes.

But the tradeoff was an increased risk of incontinence.

Coached pushing had no bearing on a woman’s need for Cesarean section, episiotomy [i-“pi-zE-‘ä’tah-mE] or forceps delivery.

Researchers say obstetricians should keep in mind that withholding coached pushing is O-K… there are times when it pays not to be pushy.

It may mean some coaches will have to drop the time-honored cheer of “Push, Push!”

But there are still plenty of opportunities for them to provide comfort and reassurance in the delivery room.