Effect of Directed Versus Spontaneous Pushing During the Second Stage of Labor on Birth Outcome among Primiparas | ||||
Zagazig Nursing Journal | ||||
Article 9, Volume 10, Issue 2 - Serial Number 2014, 2014, Page 133-149 PDF (238.05 K) | ||||
Document Type: Original Article | ||||
DOI: 10.12816/0029154 | ||||
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Authors | ||||
Amany Abdo Hussien1; Sanaa Ali Nour2; Hend Salah El-Din3; Amany Hamed Gad4 | ||||
1Demonstrator in Obstetrics and Gynecological Nursing- Faculty of Nursing- Zagazig University | ||||
2Professor of Obstetrics and Gynecological nursing- Faculty of Nursing- Zagazig University.( | ||||
3Assist. Prof. of Obstetrics and Gynecological nursing- Faculty of Nursing- Zagazig University | ||||
4Lecturer of Obstetrics and Gynecological nursing- Faculty of Nursing- Zagazig University | ||||
Abstract | ||||
Background: Although spontaneous and directed pushing techniques adopted during labor have been studied during the past several decades, controversy still surrounds the results regarding obstetric variables. Aim: The aim of this study was to compare the effect of directed pushing versus spontaneous pushing during the second stage of labor on birth outcome. Setting & Subject: The study was conducted in Maternity and Childhood Hospital at Zagazig University Hospitals. It comprised a purposive sample of 200 parturient women in their second stage of labor. The study subjects were divided into equal groups of 100 "spontaneous and directed pushing groups". Tools: three tools were used for data collection (a structured interview sheet, physical assessment sheet, visual analogue scale, modified fatigue symptom checklist and birth outcome sheet). Results: revealed that spontaneous pushing had a better and positive effect on maternal vital signs. The duration of pushing was lower in the spontaneous pushing group than directed pushing. Most of the women in the spontaneous pushing group had significantly a lower pain index after 1 hour from full cervical dilatation and perceived less fatigue within 1-4 hours of childbirth (p=0.000). They also had significantly lower rates of episiotomy, perineal lacerations, postpartum hemorrhage and cesarean section. Their newborn had the highest Apgar score at the first and fifth minutes and none of them had fetal complications. Conclusion: It can be concluded that improved fetal status, neonatal and maternal outcomes have been identified when women were allowed to bear-down in response to their own natural urges rather than in response to commands for repeated, sustained pushes using Valsalva maneuver. Recommendations: It is recommended that; the utilization of the spontaneous pushing technique must be encouraged, with randomized clinical trial to provide further confirmation of the study findings. | ||||
Keywords | ||||
Pushing method; Second stage of labor; Valsalva; Fatigue | ||||
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