Women in their first pregnancy should push early in the delivery, as soon as the cervix is fully dilated, in order to minimise risks to themselves and the baby, according to a study of 2,000 American mothers.
Several previous studies have had mixed or contradictory findings on the two most common techniques used in American maternity wards: pushing immediately or waiting about an hour in order to encourage spontaneous birth, which some doctors believe reduces the need for cesareans or forceps.
From May 2014 to December 2017, six American hospitals participated in a study to determine which method is the safest for mother and child.
Hospital staff advised half the women to push immediately after being fully dilated while recommending the others to wait an hour longer.
The 2,400 women who participated were randomly placed in either group. All had received an epidural or other pain relief.
In the study published Tuesday in the JAMA journal, the researchers concluded that pushing immediately reduced the risk of complications such as infections and hemorrhage for the mother, even if there was a greater risk of significant perineal tearing.