Which of the following would be most appropriate for the nurse to suggest about pushing to a woman in the second stage of labor?

Question

A) "Lying flat with your head elevated on two pillows makes pushing easier.".
B) "Choose whatever method you feel most comfortable with for pushing.".
C) " Let me help you decide when it is time to start pushing.".
D) "Bear down like you're having a bowel movement with every contraction.".

Answer 1

B
Feedback:
The role of the nurse should be to support the woman in her choice of pushing method and to encourage confidence in her maternal instinct of when and how to push. In the absence of any complications, nurses should not be controlling this stage of labor, but empowering women to achieve a satisfying experience. Common practice in many labor units is still to coach women to use closed glottis pushing with every contraction, starting at 10 cm of dilation, a practice that is not supported by research. Research suggests that directed pushing during the second stage may be accompanied by a significant decline in fetal pH and may cause maternal muscle and nerve damage if done too early. Effective pushing can be achieved by assisting the woman to assume a more upright or squatting position. Supporting spontaneous pushing and encouraging women to choose their own method of pushing should be accepted as best clinical practice.