Effect of Different Pushing Methods in the Second Stage of Labor on Perineal Injury

Document Type : Original Article


1 M.Sc. of Midwifery, Faculty of Nursing & Midwifery, North Kkhorasan University of Medical Sciences, Bojnord, Iran

2 M.Sc. of Midwifery, Faculty of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

3 M.Sc. in Midwifery, Faculty of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

4 Associate Professor of Public Health & Epidemiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


Introduction: Despite the questions about the effectiveness of active pushing method in the second phase of delivery, this method is still being used in many centers. Researchers have shown that spontaneous pushing method decreases the perineal injuries. However such studies have not yet been done on Iranian women. We studied the effect of pushing method in the second stage of labor on perineal injury in a group of Iranian primiparous women.
Methods and Material: Randomized clinical trial of 108 primiparous women with uncomplicated labor a base fliess table randomly assigned to spontaneous and active groups. In spontaneous group used her own urge to push and active groups encouraged to take a deep breath, hold it and push for ten numbers. After delivery evaluation of perineal condition
Results: Episiotomy incidence lower in the spontaneous group (p< 0/021). Length and deep of pisiotomy lower in the spontaneous pushing versus active pushing (length p < 0/01 & deep p< 0/001). Perineal lacerations were no significant between groups.
Conclusion: Spontaneous pushing leads to lower rate of episiotomy. It is also an effective method that is accompanied by lower maternal complications after delivery.


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