Delayed Pushing does not Affect Spontaneous Delivery: Study

A common practice for laboring mothers at many U.S. hospitals, delayed pushing during the second stage of labor—when the cervix is fully dilated—had been thought to reduce the risk of deliveries in which forceps were used to deliver the baby. Now, a new study published in the Journal of the American Medical Association suggests that delayed pushing has no effect on whether pregnant women deliver without intervention (i.e. cesarean section or via forceps or vacuum).  Conducted by doctors at six different institutions, the study randomly assigned more than 2,400 first-time mothers at 37 weeks pregnant or later to two different groups: the first group was asked to begin pushing immediately after the second stage of labor began, while the second group was asked to delay pushing for 60 minutes. The researchers found that among the two groups, the rate of spontaneous delivery did not largely differ, as the” immediate group” experienced a spontaneous delivery rate of 85.9% and the “delayed group,” 86.5%.

Also noted in the study, however, was the rate of chorioamnionitis, or inflammation (infection) of the sac surrounding the baby in the uterus, as well as the rate of postpartum hemorrhages. The immediate group experienced lower infection rates and lower hemorrhage rates compared to the delayed group.  The study was therefore stopped after 75% of the births were analyzed due to postpartum hemorrhage and chorioamnionitis concerns that the delayed pushing group may have had, and that results were unlikely to differ substantially if the full study was carried out.

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