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Updated: Jun 15, 2026
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Measuring Delay Discounting in Humans Using an Adjusting Amount Task
Published on: January 9, 2016
Delayed versus immediate pushing in second stage of labor
Mary Kelly1, Eileen Johnson, Vickie Lee
1Rex Healthcare, Raleigh, NC, USA. Mary.Kelly2@rexhealth.com
MCN. the American Journal of Maternal Child Nursing
|March 11, 2010
Summary
Delaying pushing in labor by 90 minutes significantly reduces pushing time for mothers. This method shortens labor duration without increasing overall second stage of labor time or adverse outcomes.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Medicine
Background:
- The second stage of labor involves pushing, a critical phase that can be prolonged.
- Current practices often involve immediate pushing upon complete cervical dilation.
- Understanding optimal pushing strategies is essential for improving maternal and fetal outcomes.
Purpose of the Study:
- To compare the effectiveness of immediate pushing versus delayed pushing (90 minutes after complete dilation) in the second stage of labor.
- To assess the impact of delayed pushing on pushing duration, maternal fatigue, perineal injuries, and fetal well-being.
Main Methods:
- A randomized clinical trial involving 44 nulliparous mothers receiving continuous epidural anesthesia.
- Participants were assigned to either immediate or delayed pushing groups.
- Primary outcome was pushing duration; secondary outcomes included length of the second stage, maternal fatigue, perineal trauma, and fetal heart rate decelerations.
Main Results:
- The delayed pushing group experienced significantly shorter pushing times (38.9 minutes) compared to the immediate pushing group (78.7 minutes).
- No significant differences were observed in maternal fatigue, perineal injuries, or fetal heart rate decelerations between the groups.
- The overall length of the second stage of labor was not significantly increased by delaying pushing.
Conclusions:
- Delaying pushing for up to 90 minutes effectively reduces the time spent actively pushing during labor.
- This strategy offers a significant reduction in pushing effort without compromising maternal or fetal safety.
- Clinical practice can be informed by these findings to potentially optimize labor management and reduce interventions.
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