title: "I gotta push. Please let me push!" Social interactions during the change from first to second stage labor.
abstract: BACKGROUND
  Forms of social interaction may occur among the participants in medicalized births, in which a woman in labor is experiencing strong involuntary urges to push but has not yet been found to have a completely dilated cervix. This article examines the social events and communications that occur at the change between first and second stages of labor.
  
  
  METHODS
  Three cases are described from videotapes of women in the second stage of labor and their caregivers.
  
  
  RESULTS
  Several social and interactive features occurred, in which (1) the caregiver, usually a nurse, by invoking the "no pushing rule," insisted that the woman suppress her involuntary urges to push; (2) both the caregiver and the parturient displayed an orientation toward the future and the eventual certification of full cervical dilation by a designated authority, usually a physician, regardless of the actual state of the woman's cervix or her involuntary urges to push; and (3) the certification process marked a ritual transition to "official" second stage labor, in which the woman's involuntary urges were considered appropriate and actively encouraged.
  
  
  CONCLUSIONS
  A discrepancy between a laboring woman's sensations and caregivers' ideas about how labor should be conducted has implications for clinical care of women, wherein the goal should be to facilitate the woman's accomplishment rather than to direct the "delivery."
authors.affiliation: East Carolina University, Greenville, North Carolina 27858, USA.
authors.forename: L
authors.initials: L
authors.lastname: Bergstrom
authors.forename: J
authors.initials: J
authors.lastname: Seidel
authors.forename: L
authors.initials: L
authors.lastname: Skillman-Hull
authors.forename: J
authors.initials: J
authors.lastname: Roberts
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007747:Labor Stage, First / Q000502:physiology*; D007748:Labor Stage, Second / Q000502:physiology*; D009723:Nurse-Patient Relations; D009773:Obstetric Nursing; D009774:Obstetrics / Q000193:education; D011247:Pregnancy; D013337:Students, Medical