Early pushing vs. Delayed pushing Among Nulliparous Women: M
Delayed pushing, or the practice of resting in the second stage before initiating active bearing down, has become an increasingly common labor management practice. Also known as “laboring down” or “passive descent,” this practice has been proposed to reduce maternal exhaustion and prevent maternal morbidity such as cesarean delivery and severe perineal lacerations. Although the American College of Obstetricians and Gynecologists has no explicit position statement on delayed pushing, midwifery and some obstetric literature recommend consideration of delayed pushing for 1–2 hours, or until the woman experiences the urge to push, for appropriate patients.

In this large birth cohort, delayed pushing was associated with longer second stage duration, increased odds of cesarean delivery, and increased odds of postpartum hemorrhage, but was not associated with neonatal morbidity.

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