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Re: open glottis pushingFrom: MS GAIL M HART (YTDP43A@prodigy.com)Fri Oct 27 21:05:49 1995
-- [ From: Gail Hart * EMC.Ver #2.10P ] -- RE<<<I know of no studies supporting the practice of either "coached" or "natural" pushing, but teleologically, until something is shown to be better, wouldn't it seem reasonable to allow nature to take its course?<<<<< A discussion in Guide to Effective a Care (etc) of open glotis vers "coached" or sustained pushing in second stage says<quote> "In all the published controlled trials comparing different approaches to bearing down in which cord umbilical arterial ph assesents were available, mean cord umbilical arterial Ph was lower in the group im which sustained or early bearing down had been ecouraged. Sustained bearing down efforts also appear to predispose to abnormalities of the fetal heart rate and depressed Apgarr score" <pg 228> I'll admit to a bias twords doing things a bit more naturally<G> and an opinion that this 'uncoached" pushing contributes to the very low incidence of low apgar babies we encounter. I also admit that IT IS MUCH LOUDER, and hearing this style of pushing might make folks uncomfortable -- we try to warn them in advance<G>. GAil Hart, LDEM Oregon
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