Aim: This study aimed to compare the effect of spontaneous versus directed pushing during second stage of labor on birth outcomes and early maternal postpartum fatigue.
Method: Quasi-experimental design was utilized. A purposive sample of 112 primiparae was randomly allocated to spontaneous and directed pushing groups. The study was conducted at labor room and postpartum unit, Benha University Hospital. Data were collected through five main tools: structured interviewing questionnaire, delivery and maternal assessment sheet, neonatal assessment sheet, Modified Fatigue Symptom Checklist and Visual Analogue Scale for maternal satisfaction about pushing technique during labor.
Results: Mean duration of the second stage of labor in spontaneous pushing group was significantly shorter than the directed pushing group (p≤0.001). There was statistically significant difference between the spontaneous and directed pushing groups regarding Apgar score in 1st and 5th minutes (p≤ 0.001 and p≤ 0.05 ) respectively. A highly statistically significant difference between both groups regarding the postpartum fatigue score at 60 minutes and 24 hours after delivery (p≤ 0.001). Spontaneous group experienced higher satisfaction level about pushing technique than directed group.
Conclusion and recommendations: Spontaneous pushing technique shortened the second stage of labor, decreased postpartum fatigue, enhanced maternal satisfaction, and improved newborn outcome compared to a directed pushing technique. The study recommended that preparing simplified guidelines about effective pushing technique during labor and distributing it to pregnant women at antenatal clinic and labor wards.
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