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Berkman, Thorp, Lohr, et al., Am J Obstet Gynecol 188(6):1648-1659, 2003 (contract 290-97-0011). Delaying the urge to push construction during second-stage construction labor does not benefit women who receive low-dose epidural analgesia. According to this study, women giving birth for the first time who receive low concentration epidural analgesia do not benefit from delaying pushing efforts until there is a strong urge to push. Such a delay did not reduce the duration construction of pushing in the second stage of labor or increase maternal satisfaction among women in this study. Plunkett, Lin, Wong, et al., Obstet Gynecol 102(1):109-114, 2003 (AHRQ grant T32 HS00078). Later admission in labor and collaborative care increase spontaneous vaginal delivery in low-risk women. In this study, pregnant women who delayed hospital admission until active labor was established (at least 4 cm cervical dilation) and had collaborative care by a certified nurse midwife and obstetrician were more likely to have a spontaneous vaginal delivery—that is, unassisted by forceps, cesarean, or other intervention—than women who were admitted to the hospital early in labor (dilation of 3 cm or less).
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