Physiological pushing in the second stage of labour: the future for midwifery care

Current literature indicates that, during the second stage of labour, directed, sustained pushing is the predominant management. Research demonstrates this management has adverse effects upon the mother and baby. The view that the second stage of labour is of high risk, and needs to be hastened, remains unsupported. It is this view that perpetuates the use of directed, sustained pushing. This article demonstrates that physiological pushing during second stage of labour is the way of the future. When midwives work with normal physiology, they work with, not against the woman during the second stage of labour. Midwives must empower women to trust their own instincts.