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Randomized Controlled Trial
. 2006 Jan;194(1):10-3.
doi: 10.1016/j.ajog.2005.06.022.

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

Steven L Bloom  1 , Brian M Casey, Joseph I Schaffer, Donald D McIntire, Kenneth J Leveno
Affiliations
Randomized Controlled Trial

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

Steven L Bloom et al. Am J Obstet Gynecol. 2006 Jan.

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.

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