[ozmidwifery] coached pushing

[Mary Murphy]

Apologies if this has been posted before. MM   Coached pushing offers little immediate benefit Source: American Journal of Obstetrics and Gynecology 2006; 194: 10-3 Comparing obstetric outcomes with and without coached pushing during the second stage of labor. Coached pushing during the second stage of labor offers no immediate benefits, apart from slightly speeding up the process, US researchers have found. The benefits of routine coached pushing during the second stage of labor are being increasingly debated. Indeed, results of a previous randomized controlled trial by the research team found it to be associated with evidence of pelvic floor dysfunction 3 months after delivery. To investigate the impact of such pushing on delivery and infant outcomes, Steven Bloom and colleagues (University of Texas Southwestern Medical Center, Dallas, USA) randomly assigned nulliparous women with straightforward labors and without epidural analgesia to perform coached (n = 163) or uncoached (n = 157) pushing during the second stage. The duration of this stage of labor was shortened by approximately 13 minutes with coaching when compared to without it—a significant change—but no other clinically significant immediate maternal or neonatal outcomes were significantly affected, the team reports. Summarizing their findings, the researchers write: "Although associated with a slightly shorter second stage, coached maternal pushing confers no other advantages and withholding such coaching is not harmful." Indeed, "the short-term outcome findings that coached pushing confers neither benefit nor harm might be preempted if it is confirmed that coaching has deleterious long-term effects," they warn. Posted: 11 January 2006