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Am J Obstet Gynecol. 2006 Jan;194(1):10-3.

A randomized trial of coached versus uncoached maternal pushing during the second stage of labor.

Author information

1
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Abstract

OBJECTIVE:

The objective of this study was to compare obstetrical outcomes associated with coached versus uncoached pushing during the second stage of labor.

STUDY DESIGN:

Upon reaching the second stage, previously consented nulliparous women with uncomplicated labors and without epidural analgesia were randomly assigned to coached (n = 163) versus uncoached (n = 157) pushing. Women allocated to coaching received standardized closed glottis pushing instructions by certified nurse-midwives with proper ventilation encouraged between contractions. These midwives also attended those women assigned to no coaching to ensure that any expulsive efforts were involuntary.

RESULTS:

The second stage of labor was abbreviated by approximately 13 minutes in coached women (P = .01). There were no other clinically significant immediate maternal or neonatal outcomes between the 2 groups.

CONCLUSION:

Although associated with a slightly shorter second stage, coached maternal pushing confers no other advantages and withholding such coaching is not harmful.

PMID:
16389004
DOI:
10.1016/j.ajog.2005.06.022
[Indexed for MEDLINE]

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