No-Push Childbirth

A new study says that taking a break from pushing during childbirth can take some of the "labor" out of labor, and is perfectly safe for both mom and baby.

The study, published in next month's issue of the American College of Obstetricians and Gynecologists' journal Obstetrics and Gynecology, examined the labor of 252 women, all of whom were given an epidural to ease the pain. Some women were told to rest while others followed the more traditional method of pushing throughout their labor.

Laborious Labor

Pushing usually comes during what is known as the second stage of labor — the cervix is completely dilated, and the mom begins to have the natural urge to push her baby down the birth canal and, eventually, out. Women who are not given an epidural experience a natural and very strong urge to push as the baby's head descends into the vagina.

Doctors have traditionally encouraged women to push even if they have been given an epidural and don't feel the urge to push. There have not been any studies proving the need for pushing throughout labor.

"There is nothing written in stone that says once a woman is completely dilated she needs to start pushing or the baby's in trouble," explains Dr. John Gianopoulos, professor and chair of obstetrics and gynecology at Loyola University Medical Center in Chicago. "Unencumbered by data, people said, 'Well, there's a natural urge to push so we should have them start pushing.' It has always been dogma to have them push right away."

Sit Back, Relax

However, according to the new data, if the mom sits back and rests during this stage, the baby will naturally descend the birth canal closer to the vagina's opening. Starting to push when the baby is already to close to the vagina's opening means less work and exhaustion.

The method has been used for years in expectant moms with medical conditions, but now it has been expanded to include healthy moms, too. "There are certain patients who you do not tell to push in the second stage of labor — people with cardiac disease, people with neurological disease — you don't want them to bear down because there is a concern that it would make the disease process worse," says Gianopoulos.

Don't Want to Wait

The more laid back approach has one drawback for the mom eager to hold her newborn: the average labor is increased from roughly one-half to 1 1/2 hours up to nearly five hours.

"A lot of women look forward to having the baby and thinking it is going to take another three hours would not be very appealing, at least to many of my patients," says Dr. W. Benson Harer Jr., former president of the American College of Obstetricians and Gynecologists and chief of staff at Riverside County Regional Medical Center. "When given the option of having the baby sooner, I'm sure most women would prefer to do that."