AABC will hold a How to Start a Birth Center Workshop on July 7-8 in St. Paul, MN. Check out all the links to find detailed information about the workshop. This is a Student Only workshop.
May 23, 2017 by
In reviewing the evidence on the length of pushing times, several trends become clear:
- The amount of research on this topic has grown significantly in the past few years!
- Laboring people who have epidurals have significantly longer pushing times compared to those without epidurals.
- Not all researchers have taken into account the time of delayed pushing in their studies. This makes it difficult to apply some of the research to people with epidurals who have reached 10 centimeters but waited for some time before pushing.
- The only randomized trial on this topic found that extending the length of pushing by one hour (in line with the new guidelines) decreased the Cesarean rate from 43% to 20%. This study was too small to determine differences in complications for birthing people or newborns.
- Observational research has shown that for mothers, longer pushing times are related to higher rates of postpartum hemorrhage, infection, and 3rd and 4th degree tears. Severe tears are more common with longer pushing phases even after adjusting for instrumental birth and episiotomy. Unfortunately, no study has measured what impact “hands-on” intervention to speed up the birth (the care provider using their hands to facilitate a prolonged second stage through perineal massage, etc.) might have on tears.
- Most people with prolonged pushing times will end up with a vaginal birth. However, longer pushing times are still associated with a higher chance of Cesarean and vacuum or forceps assisted birth.
- For babies, longer pushing times have been associated with higher rates of low Apgar scores, NICU admissions, birth trauma and other newborn health problems. In one study, researchers found the overall combined rate of newborn complications is around 2.5% for first-time mothers who push 3 or more hours.
- Some of the health problems associated with longer pushing phases might be related to an underlying reason for the prolonged pushing phase, rather than the length of pushing time alone.
- All of the researchers who mention the new ACOG/SMFM consensus guidelines state that their data support the new guidelines—that laboring people should have additional time to push, given that rates of vaginal birth are high and overall rates of complications are low.
- Deciding whether or not to continue pushing at a certain time point is an individualized decision, based on weighing the risks and benefits in that particular individual’s situation.
Read entire article here
Senator Figures now serves as Chairwoman of the Children First Trust Fund Board Joint Legislative Oversight Committee, and on the following Senate Standing Committees: Finance and Taxation, Education; Rules; Judiciary; Education; Governmental Affairs; Children, Youth Affairs and Human Resources; and Local Legislation #3. She was elected by the Senate to serve on the Sunset Committee and the Legislative Council. Senator Figures has been appointed to serve on the Permanent Legislative Committee on Reapportionment, Permanent Joint Legislative Committee on Medicaid Policy, Mental Health Capital Outlay Oversight Committee, the Children’s Policy Council, the Alzheimer’s Task Force (co-chair), Energy Council, the Alabama Women’s Commission, and the Alabama Prison Reform Task Force.
Senator Figures is very passionate about protecting, caring for, and protecting our children. She led the effort in helping to author legislation and securing funding for the school personnel background checks for both public and private schools to make children safer. She also, authored, and sponsored the Amiyah White Act and the Hiawayi Robinson Emergency Missing Child Alert System Act.
If you are interested in supporting the Tatia Oden French Memorial Foundation’s mission to end the use of Cytotec in labor induction, we encourage you to submit a comment to the Citizen Petition submitted by the Foundation to the FDA on April 26, 2017. Your comment may help impact FDA’s decision to conduct a Sentinel study on Cytotec, which will allow them to gain a better understanding of the adverse events associated with the use of the drug for labor induction. Submitting a comment is very simple, this document walks you through the process step by step.
Prior to submitting a comment:
- 1. Note the unique identification number of our petition: FDA-2017-P-2563-0001.
- 2. Gather any articles or supporting materials you’d like to submit with your comment; make sure the materials are relevant and provide a translated copy if it’s in a different language.
- 3. Ensure that any medical information you plan on submitting protects the privacy of patients by deleting names or identifying information.
How to submit the comment:
- 1. Go to https://www.regulations.gov/document?D=FDA-2017-P-2563-0001
- 2. Click on the ‘Comment Now!’ box located to the right of the title of the petition: “Citizen Petition from The Tatia Oden French Memorial Foundation”
- 3. Type in your comment and submit, along with any supporting articles and materials.
We thank you for supporting our Citizen Petition by submitting your comments. With your help, we can save the lives of those giving life to others. For more information about the Foundation and the Petition, visit: http://www.tatia.org or email firstname.lastname@example.org.