Pushing techniques in the second stage of labour.

It is routine to require women to 'take a deep breath in, hold it and push' in the second stage of labour, but there is no scientific evidence to support this practice. In a randomized controlled trial of spontaneous (n = 15) versus directed (n = 17) pushing in the second stage, no adverse effects of spontaneous pushing on the woman or baby were found. There was a negative correlation between the length of the second stage and the venous cord blood pH at delivery in the directed pushing group, suggesting that a long second stage was disadvantageous to the fetus when the woman was using a directed pushing technique. No such association was found in the spontaneous pushing group, despite the fact that the women in this group had a significantly longer mean second stage.