Pushing in the second stage of labour: part 1.

The second stage of labour has traditionally been managed by the midwife, directing women how and when to push. This usually involves women being instructed to use the Valsalva manoeuvre within prescribed time limits in supine or lithotomy positions. The rationale is that the duration of second stag...

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Publicado en:British Journal of Midwifery Vol. 12; no. 8; pp. 502 - 509
Autor principal: Chalk A
Formato: pictorial Journal Article
Publicado: Mark Allen Holdings Limited Aug2004
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Pushing in the second stage of labour: part 1.
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        au: Chalk A
        affil: Resuscitation Officer and Midwife, Victoria Hospital, Blackpool, Fylde and Wyre Hospitals NHS Trust
      sug:
        subj:
          Labor Stage, Second
          Pushing (Childbirth)
          Birthing Positions
          Female
          Fetus
          Midwifery
          Pregnancy
          Pushing (Childbirth) Methods
          Fetus, conception to birth
          Female
      ab: The second stage of labour has traditionally been managed by the midwife, directing women how and when to push. This usually involves women being instructed to use the Valsalva manoeuvre within prescribed time limits in supine or lithotomy positions. The rationale is that the duration of second stage of labour is reduced and therefore the risks of adverse effects to mother and fetus minimised. However, there is accumulating evidence that directed pushing within arbitrary time limits in supine positions is disadvantageous to the woman and fetus and is actually unjustified. Spontaneous pushing, which allows the woman to follow her own instincts and push in the second stage of labour, does not put the women or the fetus at risk of adverse effects. On the contrary, it offers clear benefits to both. Furthermore, the woman should be allowed to adopt positions that are most comfortable for her, yet encourage fetal rotation and descent through the maternal pelvis. The positions adopted can be variable, as long as labour is progressing, although upright positions are advocated during the second stage of labour compared to supine positions, which are not recommended.
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        Journal Article
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    language: English
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