Women should push when they feel the urge

Article

Allowing the fetus to passively descend the birth canal instead of instructing women to push immediately has clear advantages for healthy women. . .

Allowing the fetus to passively descend the birth canal (i.e., passive descent) instead of instructing women to push immediately upon full dilation has clear advantages for healthy nulliparous women in the second stage of an uncomplicated labor who are using epidural analgesia. This according to a recent meta-analysis of randomized controlled trials.

The analysis, which includes seven studies involving almost 3,000 women, reveals that passive descent, compared with early pushing, increases a woman's chance of having a spontaneous vaginal birth by about 8% (RR, 1.08; 95% CI, 1.01–1.15; P=.025), decreases the need for an instrument-assisted delivery by almost 25% (RR, 0.77; 95% CI, 0.77-0.85; P≤.0001), and decreases pushing time by a mean difference of –0.19 hours (95% CI, –0.27 to –0.12; P≤.0001).

Researchers found no significant differences in rates of cesarean delivery (RR, 0.80; 95% CI, 0.57–1.12; P=.19), lacerations (RR, 0.88; 95% CI, 0.72–1.07; P=.20), or episiotomies (RR, 0.97; 95% CI, 0.88–1.06; P=.45).

Newsletter

Get the latest clinical updates, case studies, and expert commentary in obstetric and gynecologic care. Sign up now to stay informed.

Recent Videos
Zachary Wagner, PhD, discusses the harms of bias in reproductive care | Image Credit: ornsife.usc.edu.
Ciera Kirkpatrick, PhD, shows how TikTok is transforming cervical cancer awareness | Image Credit: linkedin.com.
Maria Gallo, PhD, discusses high attendance at crisis pregnancy centers | Image Credit: © x.com.
Eran Bornstein, MD, highlights early signs of preeclampsia clinicians need to know | Image Credit: northwell.edu.
Eran Bornstein, MD explains the need for first trimester preeclampsia screening | Image Credit: northwell.edu.
Veerle Bergink, MD, PhD, highlights familial links of postpartum psychosis | Image Credit: profiles.mountsinai.org.
Related Content
© 2025 MJH Life Sciences

All rights reserved.