Format

Send to

Choose Destination
See comment in PubMed Commons below
J Midwifery Womens Health. 2007 May-Jun;52(3):238-45.

Best practices in second stage labor care: maternal bearing down and positioning.

Author information

1
Nursing Midwifery Program, The University of Michigan, Ann Arbor, MI, USA. joycecnm@umich.edu

Abstract

Despite evidence of adverse fetal and maternal outcomes from the use of sustained Valsalva bearing down efforts, current second-stage care practices are still characterized by uniform directions to "push" forcefully upon complete dilatation of the cervix while the woman is in a supine position. Directed pushing might slightly shorten the duration of second stage labor, but can also contribute to deoxygenation of the fetus; cause damage to urinary, pelvic, and perineal structures; and challenge a woman's confidence in her body. Research on the second stage of labor care is reviewed, with a focus on recent literature on maternal bearing down efforts, the "laboring down" approach to care, second-stage duration, and maternal position. Clinicians can apply the scientific evidence regarding the detrimental effects of sustained Valsalva bearing down efforts and supine positioning by individualizing second stage labor care and supporting women's involuntary bearing down sensations that can serve to guide her behaviors.

PMID:
17467590
DOI:
10.1016/j.jmwh.2006.12.011
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Support Center