title: Provider support of spontaneous pushing during the second stage of labor.
abstract: OBJECTIVE
  To describe the association between provider communication and actual maternal pushing behavior in second-stage labor and to test differences in length of second stage and total maternal pushing time by maternal pushing behavior.
  
  
  METHODS
  Descriptive.
  
  
  METHODS
  Midwest hospital birth unit.
  
  
  METHODS
  Twenty primigravidas who gave birth vaginally.
  
  
  METHODS
  Type of provider communication (supportive of spontaneous or directed pushing).
  
  
  METHODS
  Maternal pushing behavior (spontaneous or directed) documented by videotape review.
  
  
  RESULTS
  The percentage of provider communication supporting spontaneous pushing versus directed pushing and the percentage of actual spontaneous versus directed maternal pushing behavior were associated (Pearson r = .80, p = .001, for spontaneous and r = .89, p = .001, for directed). Neither duration of second stage (t = .06, p = .95) nor time spent pushing (t = .15, p = .89) differed by spontaneous versus directed pushing style.
  
  
  CONCLUSIONS
  The proportion of spontaneous pushing by the birthing woman was positively and significantly associated with the proportion of caregiver communication supporting and encouraging spontaneous pushing. Importantly, spontaneous pushing did not significantly lengthen the duration of second-stage labor or total time spent pushing.
authors.affiliation: University of Michigan School of Nursing, 400 N. Ingalls, Room 4236, Ann Arbor, MI 48109-0482, USA. csampsll@umich.edu
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Sampselle
authors.forename: Janis M
authors.initials: JM
authors.lastname: Miller
authors.forename: Yuwadee
authors.initials: Y
authors.lastname: Luecha
authors.forename: Kathryn
authors.initials: K
authors.lastname: Fischer
authors.forename: Lisabeth
authors.initials: L
authors.lastname: Rosten
mesh_terms: D000328:Adult; D015400:Clinical Nursing Research; D003142:Communication; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006771:Hospitals, Maternity; D006801:Humans; D007748:Labor Stage, Second; D008423:Maternal Age; D008880:Midwifery; D009321:Natural Childbirth / Q000379:methods*; D017283:Neonatal Nursing / Q000379:methods; D009723:Nurse-Patient Relations; D015588:Observer Variation; D010298:Parity; D010817:Physician-Patient Relations; D011247:Pregnancy; D011256:Pregnancy Outcome; D011312:Pressure; D012307:Risk Factors; D014590:Uterine Contraction / Q000502:physiology*; D014741:Video Recording