Pregnant women coached through their first
delivery do not fare much better than those who just do
what feels natural, according to a recent study released.
Researchers at the University of Texas Southwestern found
that women who were told to push 10 minutes for every
contraction gave birth 13 minutes faster than those who
were not given specific instructions.
But they said the difference has little impact on the
overall birth, which experts say can take up to 14 hours
on average.
"There were no other findings to show that coaching or
not coaching was advantageous or harmful," said lead author
Dr. Steven Bloom, the interim head of obstetrics and gynecology
at the Dallas-based university.
"Oftentimes, it's best for the patient to do what's more
comfortable for her," he added.
Bloom and his team studied 320 first-time mothers who
had simple pregnancies and did not receive epidural anesthesia.
About half were given specific instructions by certified
nurse-midwives during the second stage of labor, when
they were fully dilated. The rest were told to "do what
comes naturally."
On average, coached mothers trimmed the final stage to
46 minutes compared to 59 minutes, according to the study
sponsored by the National Institute of Child Health and
Human Development at the National
Institutes of Health.
Women in both groups experienced about the same number
of forceps use, Caesarean deliveries and skin tears, among
other complications.
The results were published in the January issue of the
American Journal of Obstetrics and Gynecology.
Less clear was whether extra pushing encouraged by a
coach could lead to bladder trouble.
In an earlier study, the researchers tested bladder function
in 128 of the mothers three months later.
While such problems usually resolve on their own over
time, women who had been coached had a smaller bladder
capacity and felt the urge to urinate more often, they
previously found.
Senior author Dr. Kenneth Leveno, a professor of obstetrics
and gynecology at the school, said it was still not clear
if the bladder problems could lead to long-term complications
and more studies are needed.
"We don't want to alarm patients about this," he said.
Friday's finding that coaching "confers neither benefit
nor harm might be pre-empted if it is confirmed that coaching
has deleterious long-term effects," the study concluded.
