By Susan Heavey
WASHINGTON (Reuters) – Pregnant women coached through their
first delivery do not fare much better than those who just do
what feels natural, according to a study released on Friday.
Researchers at the University of Texas Southwestern found
that women who were told to push 10 minutes for every
contraction gave birth 13 minutes faster than those who were
not given specific instructions.
But they said the difference has little impact on the
overall birth, which experts say can take up to 14 hours on
average.
“There were no other findings to show that coaching or not
coaching was advantageous or harmful,” said lead author Dr.
Steven Bloom, the interim head of obstetrics and gynecology at
the Dallas-based university.
“Oftentimes, it’s best for the patient to do what’s more
comfortable for her,” he added.
Bloom and his team studied 320 first-time mothers who had
simple pregnancies and did not receive epidural anesthesia.
About half were given specific instructions by certified
nurse-midwives during the second stage of labor, when they were
fully dilated. The rest were told to “do what comes naturally.”
On average, coached mothers trimmed the final stage to 46
minutes compared to 59 minutes, according to the study
sponsored by the National Institute of Child Health and Human
Development at the National Institutes of Health.
Women in both groups experienced about the same number of
forceps use, Caesarean deliveries and skin tears, among other
complications.
The results were published in the January issue of the
American Journal of Obstetrics and Gynecology.
Less clear was whether extra pushing encouraged by a coach
could lead to bladder trouble.
In an earlier study, the researchers tested bladder
function in 128 of the mothers three months later.
While such problems usually resolve on their own over time,
women who had been coached had a smaller bladder capacity and
felt the urge to urinate more often, they previously found.
Senior author Dr. Kenneth Leveno, a professor of obstetrics
and gynecology at the school, said it was still not clear if
the bladder problems could lead to long-term complications and
more studies are needed.
“We don’t want to alarm patients about this,” he said.
Friday’s finding that coaching “confers neither benefit nor
harm might be pre-empted if it is confirmed that coaching has
deleterious long-term effects,” the study concluded.
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