During the second stage of labor, a nurse encourages effective pushing by the woman. What directions from the nurse best achieve this?
A.
"Hold your breath and push as hard as you can."
B.
"Now that you are fully dilated, start pushing."
C.
"Push when you feel the urge and breathe between attempts."
D.
"When you feel a contraction, push with your mouth closed."
ANS: C
Open-glottis pushing is the recommended technique of pushing during contractions. When the woman feels the urge to push, she is instructed to bear down while continuing to breathe between contractions. She is encouraged to only hold her breath for 5 to 6 seconds at a time so that air escapes during the pushing. This process facilitates maternal-fetal circulation and gradual fetal descent. The other instructions are not consistent with this method.
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