title: Management of second stage labour with an epidural--a problem in isolation?
abstract: This paper examines practices in second stage labour of a woman with an epidural. Common practices are compared with the current literature. Recommendations from this comparison are that practices such as directed pushing should be discouraged and pushing should be delayed until the presenting part has descended to a vaginal station greater than +1. Implications for practice are discussed and recommendations made to implement changes.
authors.affiliation: Flinders University of South Australia, 13 Willong St, Tallangatta 3700, Victoria.
authors.forename: D
authors.initials: D
authors.lastname: Birrell
mesh_terms: D015360:Analgesia, Epidural / Q000451:nursing* / Q000592:standards; D016362:Analgesia, Obstetrical / Q000451:nursing* / Q000592:standards; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007748:Labor Stage, Second / Q000502:physiology*; D008880:Midwifery / Q000379:methods* / Q000639:trends; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic / Q000379:methods; D010808:Physical Examination / Q000451:nursing; D011247:Pregnancy; D013995:Time; D014636:Valsalva Maneuver / Q000502:physiology