Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial Analgesia: A Randomized Clinical Trial | Pregnancy | JAMA | JAMA Network

Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial Analgesia: A Randomized Clinical Trial | Pregnancy | JAMA | JAMA Network

Delayed pushing doesn't seem to change the chance of spontaneous delivery

A large new study suggests that delaying pushing during labor doesn't affect the chances women will have a spontaneous vaginal birth, rather than a C-section or with another intervention. Researchers ran a trial at six centers with more than 2,400 women, half of whom started pushing immediately when the cervix was fully dilated and half of whom waited an hour. Excessive bleeding and a certain infection were more common among the delayed pushing group, while perineal lacerations were more common among women who started pushing immediately. The finding calls into question the practice of delayed pushing, which is common in U.S. hospitals. 

Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial AnalgesiaA Randomized Clinical Trial

Alison G. Cahill, MD, MSCI¹; Sindhu K. Srinivas, MD, MSCE²; Alan T. N. Tita, MD, PhD^3,4; et alAaron B. Caughey, MD, PhD⁵; Holly E. Richter, PhD, MD^3,4; W. Thomas Gregory, MD⁵; Jingxia Liu, PhD⁶; Candice Woolfolk, PhD¹; David L. Weinstein, MD¹; Amit M. Mathur, MD⁷; George A. Macones, MD, MSCE¹; Methodius G. Tuuli, MD, MPH¹

Author Affiliations

JAMA. 2018;320(14):1444-1454. doi:10.1001/jama.2018.13986