Directed pushing can unnecessarily distress women. When left to their own devices in second stage, instinct guides a spontaneous urge to push. Yet, many midwives feel compelled to impose strict instructions on how to breathe and bear down (Yeates and Roberts, 1984). The question is, does this drill sergeant approach expedite or impede delivery and what effects does it have upon maternal wellbeing?
Rossi and Lindell (1986) observed spontaneous posi- tions adopted and breathing techniques used by women in second stage (n=50 low risk women 28–40 weeks gestation). In a non-prescriptive environment, women were found to spontaneously adopt open-glottis pushing. Behaviours exhibited differed considerably from when the closed glottis/valsalva regime was implemented. It was concluded that women instinctively know how to labour and do not require forceful direction in order to have suc- cessful outcomes.