What is Guided Pushing?
Guided pushing, also known as directed pushing, is a technique used during the second stage of
labor. It involves healthcare providers giving specific instructions to the birthing person on how and when to push. This method is often used to help the individual effectively use their energy and strength for a more efficient delivery.
Why is Guided Pushing Used?
Guided pushing is typically implemented to help manage and expedite the labor process. It can be particularly useful when the labor is prolonged, there are
complications, or when the birthing person has received an
epidural and may not feel the urge to push naturally. The technique aims to reduce the risk of maternal or fetal distress by facilitating a smoother delivery.
How is Guided Pushing Performed?
During guided pushing, the healthcare provider instructs the birthing person to take a deep breath, hold it, and push for a count of 10 seconds during a contraction. This process is repeated three to four times per contraction. The provider may use verbal cues, hand signals, or even physical support to assist in the pushing process.
Potential to shorten the second stage of labor.
Improved coordination and effectiveness of pushing efforts.
Reduced risk of maternal and fetal complications.
Increased confidence for the birthing person, especially if they are unsure of when or how to push.
Increased maternal fatigue due to prolonged breath-holding and intense pushing.
Higher likelihood of perineal trauma or
tearing.
Possible negative impact on fetal oxygenation if pushing is too forceful or prolonged.
Alternatives to Guided Pushing
There are alternatives to guided pushing, such as
spontaneous pushing or physiological pushing. This method allows the birthing person to push when they feel the natural urge to do so, typically leading to a more gradual and less forceful pushing process. Spontaneous pushing can be more comfortable and less exhausting for some individuals.
The birthing person has received pain relief that diminishes the urge to push.
There is a need to expedite the delivery due to maternal or fetal
distress.
The birthing person is inexperienced or anxious and needs reassurance and guidance.
Conclusion
Guided pushing is a valuable technique in the field of
gynecology, providing structured support during labor. While it offers numerous benefits, it is essential to consider the individual needs and circumstances of the birthing person. Healthcare providers should balance the use of guided pushing with other methods to ensure the safest and most effective delivery experience.
