London:

Pregnant women should follow their own instinct and do what comes naturally while giving birth instead of being coached by a midwife about when to push, says a study.

For generations, women giving birth have relied on the midwife to tell them when to start pushing. But, according to British experts, this coached pushing during delivery could do more harm than good, doing little to shorten the labour and increasing the risk of bladder problems after birth, reported the online edition of Daily Mail.

Researchers from the University of Texas’ Southwestern Medical Centre took 320 women with uncomplicated pregnancies who arrived to give birth. Half were coached by midwives to push for 10 seconds during a contraction and the rest were told to “do what comes naturally”. The research, published in the American Journal of Obstetrics and Gynaecology, found that women being coached did have a slightly shorter second-stage labour. But the reduction was only from 59 to 46 minutes, which in the scheme of a normal labour does not amount to a significant advantage. And it appeared that coached labour could increase the risk of bladder problems.

The researchers went back to the women three months after their labour to see if there had been any impact on their bladder control. Of the 128 women who took part in this stage of the research, the coached women had smaller bladder capacity and felt the urge to go to the lavatory sooner than those in the uncoached group.

The researchers concluded that “coached pushing could potentially increase the amount of pressure on the pelvic floor with subsequent deleterious effects”.

However, the study said more research is needed to work out if these effects on the bladder were permanent. But they said it might be wise to recommend that coached pushing is used only in specific circumstances, such as if a woman has prolonged second stage labour or the baby’s heart rate suggests it is in distress.

According to Steven Bloom, lead researcher, “Often it is best for the patient to do what is more comfortable for her.”