Although the second stage of labor was shorter by an average of 13 minutes among women coached to push, there was nothing else to suggest that coaching or not coaching was advantageous or harmful, according to a recent study.

For the most part, it doesn’t matter whether the mother is coached or not, the UT Southwestern Medical Center researchers found, and further study would be needed to determine if any bladder problems might be permanent.

"Oftentimes, it's best for the patient to do what's more comfortable for her," says Dr. Steven Bloom, lead author of the paper and interim chair of obstetrics and gynecology at UT Southwestern.

Let Nature Do It

The latest research -- which follows an earlier study that found increased pelvic-floor problems among coached women -- focused on second-stage labor, when the cervix is fully dilated and the baby begins to descend.

The study group was comprised of 320 women who were giving birth for the first time, had uncomplicated pregnancies and did not receive epidural anesthesia. They were randomly assigned to two groups: 163 were coached to push for 10 seconds during a contraction, and 157 were told to "do what comes naturally." Nurse-midwives attended both groups.

The second stage of labor was 13 minutes shorter -- averaging 46 minutes compared to 59 minutes -- among the mothers coached to push.

"There were no other findings to show that coaching or not coaching was advantageous or harmful," says Dr. Bloom.

Change in Bladder Function

The earlier report, which appears in the May issue of Obstetrics and Gynecology, involved the same group of women. In that analysis, researchers considered whether coaching causes long-term problems to the mother's pelvic region.

Of the 320 women in the study, 128 returned for testing three months later. The coached women were found to have a smaller bladder capacity and a decreased "first urge to void" -- the volume at which a woman wanted to pass urine. However, over time, the bladder function can return to normal, according to the researchers.

"Whether or not these functional changes have long-term consequences, I’m not ready to say," comments Dr. Kenneth Leveno, professor of obstetrics and gynecology and senior author of both studies. "We don’t want to alarm patients about this."