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Think You Can't Push When You Want to During Labor? Think Again

Photograph by Twenty20

Childbirth is a marathon. Sometimes, just when you think you've reached the finish line, you might be told to hold off pushing even though you feel ready. The common belief at many U.S hospitals has been that waiting could make the delivery safer and easier, and may lessen the need for a C-section, but a new study is challenging this theory in a big way.

“The theory behind delayed pushing is that while [women] delay, the uterus continues to contract and perhaps do some of the work to deliver the baby," says Dr. Alison Cahill, lead researcher and chief of maternal-fetal medicine at Washington University School of Medicine in St. Louis. She also points out that not all hospitals ask moms-to-be to wait to push: “Both approaches are commonly used, and neither is considered the gold standard.”

To test the different approaches, the study followed 2,400 first-time moms who all had epidurals and were randomly assigned to either delay pushing or to push when they felt like it once they had reached 10-centimeter dilation. The results, which were published this month in the Journal of the American Medical Association, showed that early pushing did not, in fact, increase the need for a C-section and actually had some benefits.

In both groups, about 85 percent of the babies were born without surgery. According to Cahill, the pregnant women who pushed early were 40 percent less likely to have significant bleeding than women who started pushing later. They were also 30 percent less likely to develop an infection.

There was another benefit to pushing early as well—a shortened labor. What mom wouldn’t want that?

"The second stage of labor for women who pushed immediately was a little more than a half an hour faster," says Cahill, "and that shorter second stage of labor is healthier for both moms and babies."

Dr. Christopher Zahn, vice president of practice activities at the American College of Obstetricians and Gynecologists, tells NPR that the takeaway message from the study is that there are no significant benefits to delayed pushing, and delaying actually increases the risk of adverse events—particularly for the mother. Dr. Zahn describes the study as “a very well-done study with a large number of patients.”

Bottom line: Women know their own bodies and should be allowed to push when they feel ready.

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