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Home › Articles › Dads-to-Be › The Big Push

The Big Push

Does Coaching Help Labor Progress?

By Alexandria Powell

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We've all seen it in the movies: The man in blue hospital scrubs holding his wife's hand in the delivery room telling her to push. But does this really help labor along or just give the nervous dad-to-be something to do?

In a study published in the January 2006 edition of the American Journal of Obstetrics and Gynecology, researchers found that women who were told to "push" during contractions didn't birth much faster than women who just did what their bodies told them.

Babies in the group that was coached to push made their appearances on average only 13 minutes earlier than babies in the uncoached group, and no other differences or benefits were noted in the coached group. Could "push, push, push" soon be a passe phrase in the labor and delivery room?

Is Coaching Necessary?
Researchers at the University of Texas Southwestern Medical Center in Dallas looked at 320 women who were giving birth for the first time. None had complicated pregnancies, none received an epidural and they were randomly assigned. The 163 women in the "coached" group were told to push for 10 seconds during a contraction, while the 157 women in the "uncoached" group were told to "do what comes naturally."

"Aside from a 13-minute shorter second stage of labor, we found no other benefits in the coached group, including no difference in route of delivery (C-section, forceps, vaginal) or episiotomy/lacerations," says Dr. Steven Bloom, professor and chairman of obstetrics and gynecology at University of Texas Southwestern Medical Center. There were no differences in outcome for the newborns of the two groups either.

In addition, an earlier study of this same group of women showed that three months postpartum, women in the coached group had smaller bladder capacity and a decreased "first urge to void" (the point at which they wanted to pass urine). Of course, this was only one study, and bladder function can return to normal over time. It's far too early to tell if coached pushing is associated with clinically significant injury to the pelvic floor, Dr. Bloom says.


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