Identifying the Best Way to Manage Labor.

The second stage of labor, defined as the interval from complete cervical dilation through delivery of the fetus, is the most physiologically demanding period of labor for both the mother and the fetus. Additionally, prolongation of this stage can lead to operative deliveries, which are associated with increased risks of adverse neonatal and maternal outcomes. However, the optimal technique for managing maternal pushing during this stage, immediate or delayed pushing, is unknown. Washington University School of Medicine is addressing this question by conducting a large, multi-site, randomized controlled trial that will assess both maternal and neonatal outcomes. Completion is expected by 2018.