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Database - Alliance francophone pour l'accouchement respecté (AFAR)

Record ID : 1370
Created on : 4/01/2006
Modified on : 1/12/2007

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URL of this record : http://afar.info/id=1370

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Author(s) :

Steven L. Bloom MD, Brian M. Casey MD, Joseph I. Schaffer MD, Donald D. McIntire PhD and Kenneth J. Leveno MD

Year of publication :


Bibliographical entry (without author) :

A randomized trial of coached versus uncoached maternal pushing during the second stage of labor. American Journal of Obstetrics and Gynecology
Volume 194, Issue 1, January, Pages 10-13

Résumé (français) :

Abstract (English):

(Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX)


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.


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.


Although associated with a slightly shorter second stage, coached maternal pushing confers no other advantages and withholding such coaching is not harmful.

Key words: Coached pushing; Uncoached pushing; Second-stage labor management

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Comments :

Argument (français) :

Argument (English):

Argumento (português):

Keywords :

incontinence/prolapsus ; incontinence/prolapsus ; active management of labor ; duration of labour

Author of this record :

Bernard Bel

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