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Friday, 30 December 2005 13:20
BNN: British Nursing News Online · www.bnn-online.co.uk
Coaching by midwives could do more harm than good
US researchers have found that women who are “coached” through labour by a midwife may be doing themselves more harm than good - doing little to shorten the labour and increasing the risk of bladder problems after birth.

For generations, women have relied on the midwife to tell them when to start pushing, but the University of Texas scientists said that women should follow their own instincts and do what comes naturally.

During coaching, the midwife or the woman’s partner will judge when the last part of labour should begin and will tell the mother to push and hold her breath for a full 10 seconds through the contraction.

Researchers looked at 320 women with uncomplicated pregnancies who were about to give birth. Half were coached by a midwife to push for 10 seconds during a contraction, while the other half were told to do what came naturally.

The American Journal of Obstetrics and Gynaecology study found that coached women did have a slightly shorter second-stage labour, but only from 59 to 46 minutes which was not deemed significant.

It also appeared that coached labour could increase the risk of bladder problems. Some 128 women returned three months after giving birth for a bladder control check up, with the coached women showing smaller bladder capacity.

The researchers concluded that "coached pushing could potentially increase the amount of pressure on the pelvic floor with subsequent deleterious effects", but said that more research was needed to establish whether the effects on the bladder are permanent.


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