• Erica Gillesby, Suzan Burns, Amy Dempsey, Shirley Kirby, Kami Mogensen, Kelly Naylor, Joann Petrella, Rebecca Vanicelli, and Breon Whelan.
• Labor & Delivery, Exempla Lutheran Medical Center, Wheat Ridge, CO 80033, USA. gillesbye@exempla.org
• J Obstet Gynecol Neonatal Nurs. 2010 Nov 1;39(6):635-44.

ObjectiveTo determine if the use of delayed pushing after the onset of the second stage of labor decreases the time of active pushing and decreases maternal fatigue.DesignRandomized clinical trial.SettingLabor and delivery unit of a not-for-profit community hospital.Patients/ParticipantsConvenience sample of nulliparous laboring women with epidural anesthesia.InterventionsImmediate or delayed pushing (2 hours) during the second stage of labor at the time of complete cervical dilatation.Main Outcome MeasuresThe length of pushing, total length of the second stage, and maternal fatigue.ResultsA total of 77 women were studied (immediate pushing group=39; delayed pushing=38). The immediate pushing group averaged 94 (± 57) minutes in active pushing, while the delayed pushing group averaged 68 (± 46) minutes, a statistically significant difference (p=.04). No significant differences were found in fatigue scores between the immediate and delayed pushing groups (p>.05).ConclusionsWe found that by delaying the onset of active pushing for 2 hours after the beginning of the second stage of labor, the time that nulliparous women with epidural anesthesia spent in active pushing was significantly decreased by 27%. Although the delayed pushing group rested for up to 2 hours, the total time in the second stage of labor averaged only 59 minutes longer than the immediate pushing group.© 2010 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

25 keywords...

hide…