Pushing Techniques During Labor: Issues and Controversies


  • Linda Petersen RNC, BSN,

    Corresponding author
    1. Linda Petersen is a clinical nurse specialist in the Children's and Women's Services Department of Nursing at the University of Iowa Hospitals and Clinics in Iowa City, IA.
    Search for more papers by this author
  • Patti Besuner RN, BSN, MN

    1. Patti Besuner is a perinatal clinical nurse specialist in Perinatal Services at TriHealth (A Community Partnership of Bethesda and Good Samaritan Hospitals) in Cincinnati, OH.
    Search for more papers by this author

Address for cowespondence: Linda Petersen, RNC, BSN, Children's and Women's Services, Department of Nursing, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242.


The lack of support for spontaneous bearing down versus directed pushing efforts, varying opinions on the determination of readiness for pushing, and the prevailing use of prolonged breath holding associated with pushing during labor are aspects of second-stage labor management that continue to be areas of contention among physicians and nurses. A discussion of current practice outcomes surrounding these controversies from the AWHONN Second Stage Labor Research Utilization Project conducted in 1994–1995 is presented in view of the available research literature. In addition, recommendations for future nursing research are identified.