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The Big Push

Does Coaching Help Labor Progress?

By Alexandria Powell

Coached pushing is something that many moms, especially in the United States, are familiar with and have come to expect, says Deborah Lindemann, a registered nurse and professor of obstetrics and pediatrics at Life Chiropractic College West in California. But coaching during the second stage of labor – the point at which the cervix is fully dilated and the baby is ready to start moving through the birth canal – is a relatively recent concept.

"This was not a factor, say, in the Middle Ages," Lindemann says. "But back then, [humans] were so much more in tune with our bodies – we were out there working and walking."

Even as recently as the 1940s and early 1950s, coached pushing wasn't common, Lindemann says. In fact, women were often completely unconscious during the entire birth due to pain relief methods used at the time.

Lindemann feels coached pushing came into its own around the early 1970s. "Epidurals were just becoming more common then, and with that type of anesthesia, you often have to do the coached pushing," she says. Use of an epidural can make it hard for a woman to respond to her body's urge to push.

Women who are told to simply respond to the needs of their body during birth push differently that women who are coached, Lindemann says. The pushes tend to be more controlled and shorter. In coached pushing deliveries she has seen, women were told to push as many as four times during a contraction, to start pushing before the contraction had reached its peak and to keep pushing even though the contraction was mostly over.

Want to see more?

• Coach, Cheerleader or Spectator? Dad's Role in the Delivery Room
• Powerful Pushing: New Method Promises Safer, More Efficient Delivery
• Push Presents: An Extra Thank You from Dad
• Check out our Article Library.
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