21/01/2026
๐๐ข๐๐ซ๐จ-๐๐๐๐ซ๐ง๐ข๐ง๐ ๐ฌ ๐ฐ๐ข๐ญ๐ก ๐๐๐๐๐ ๐๐ข๐ซ๐ญ๐ก
๐๐๐ฅ๐๐ฒ๐๐ ๐๐ฎ๐ฌ๐ก๐ข๐ง๐ : ๐๐ก๐๐ญ ๐ญ๐ก๐ ๐๐ฏ๐ข๐๐๐ง๐๐ ๐๐ก๐จ๐ฐ๐ฌ
A recent large French study of 10,565 spontaneous vaginal births offers important insight into how the ๐ฌ๐๐๐จ๐ง๐ ๐ฌ๐ญ๐๐ ๐ ๐จ๐ ๐ฅ๐๐๐จ๐ซ can be supported more physiologically โ and more safely โ for many women.
๐๐๐ฒ ๐๐ข๐ง๐๐ข๐ง๐ ๐ฌ:
โข Average active pushing time: ๐.๐ ๐ฆ๐ข๐ง๐ฎ๐ญ๐๐ฌ
โข First-time mothers: ~๐๐ ๐ฆ๐ข๐ง๐ฎ๐ญ๐๐ฌ
โข Multiparous mothers: ~๐ ๐ฆ๐ข๐ง๐ฎ๐ญ๐๐ฌ
โข ๐๐.๐% ๐ก๐๐๐ฅ๐ญ๐ก๐ฒ ๐ง๐๐จ๐ง๐๐ญ๐๐ฅ ๐จ๐ฎ๐ญ๐๐จ๐ฆ๐๐ฌ
โข ๐.๐% ๐ซ๐๐ญ๐ ๐จ๐ ๐ฌ๐๐ฏ๐๐ซ๐ ๐ฉ๐๐ซ๐ข๐ง๐๐๐ฅ ๐ญ๐ซ๐๐ฎ๐ฆ๐
โข Low rates of postpartum hemorrhage
๐๐ก๐๐ญ ๐ฐ๐๐ฌ ๐ญ๐ก๐ ๐๐๐ซ๐ ๐๐ฉ๐ฉ๐ซ๐จ๐๐๐ก?
In France, it is standard midwifery practice to allow a period of ๐ซ๐๐ฌ๐ญ ๐๐ญ ๐๐ฎ๐ฅ๐ฅ ๐๐ข๐ฅ๐๐ญ๐ข๐จ๐ง (often up to 3 hours) before active pushing begins. This phase โ sometimes called ๐๐๐ฅ๐๐ฒ๐๐ ๐ฉ๐ฎ๐ฌ๐ก๐ข๐ง๐ or ๐ฉ๐๐ฌ๐ฌ๐ข๐ฏ๐ ๐๐๐ฌ๐๐๐ง๐ญ โ allows:
* the uterus to continue working
* the baby to descend gradually
* the pelvic floor to adapt over time
* the spontaneous urge to push to emerge
๐๐ก๐ฒ ๐ญ๐ก๐ข๐ฌ ๐ฆ๐๐ญ๐ญ๐๐ซ๐ฌ ๐๐จ๐ซ ๐ฆ๐๐ญ๐๐ซ๐ง๐๐ฅ ๐จ๐ฎ๐ญ๐๐จ๐ฆ๐๐ฌ?
Research increasingly suggests that many complications historically attributed to a โprolonged second stageโ โ including ๐ฉ๐๐ซ๐ข๐ง๐๐๐ฅ ๐ญ๐ซ๐๐ฎ๐ฆ๐, ๐ฉ๐๐ฅ๐ฏ๐ข๐ ๐๐ฅ๐จ๐จ๐ซ ๐ฌ๐ญ๐ซ๐๐ข๐ง, and ๐ฆ๐๐ญ๐๐ซ๐ง๐๐ฅ ๐๐ฑ๐ก๐๐ฎ๐ฌ๐ญ๐ข๐จ๐ง โ are more closely related to the ๐๐ฎ๐ซ๐๐ญ๐ข๐จ๐ง ๐๐ง๐ ๐ข๐ง๐ญ๐๐ง๐ฌ๐ข๐ญ๐ฒ ๐จ๐ ๐๐๐ญ๐ข๐ฏ๐, ๐๐ข๐ซ๐๐๐ญ๐๐ ๐ฉ๐ฎ๐ฌ๐ก๐ข๐ง๐ , rather than the total length of time at full dilation.
In this study, pushing was typically:
โข ๐ฌ๐ก๐จ๐ซ๐ญ
โข ๐ข๐ง๐ฌ๐ญ๐ข๐ง๐๐ญ๐ข๐ฏ๐
โข ๐ ๐๐ซ๐ข๐๐ ๐ฉ๐ฎ๐ฌ๐ก๐๐ฌ ๐ฉ๐๐ซ ๐๐จ๐ง๐ญ๐ซ๐๐๐ญ๐ข๐จ๐ง
rather than prolonged breath-holding or coached pushing.
These findings are consistent with the core principle taught at ๐๐๐๐๐ ๐๐ข๐ซ๐ญ๐ก. Rather than teaching a single โright wayโ to push, ๐๐๐๐๐ ๐๐ข๐ซ๐ญ๐ก emphasizes:
* understanding birth physiology
* recognizing internal cues and urges, and
* building confidence to pause, wait, and listen to one's body
To reiterate, for many women, allowing time at full dilation before pushing:
โ๏ธ reduces the amount of active pushing needed
โ๏ธ supports fetal descent and rotation
โ๏ธ may lower the risk of interventions and trauma
โ๏ธ does not compromise baby's wellbeing
As always, delayed pushing is not appropriate in every situation, but it is a valuable, evidence-based option that deserves to be a part of the shared decision making process between the mother and her care provider.
Reference:
Montfort, Elรฉa et al. Active second-stage duration under 15 minutes in spontaneous vaginal deliveries with delayed pushing.
American Journal of Obstetrics & Gynecology.
Composed By:
Sumreen W, AMANI Birth Academy Mentor & Affiliate Support
