# Effect of mother’s active pushing at cesarean delivery: a randomized controlled trial

## TL;DR

This study found that allowing mothers to push during a cesarean delivery reduced their perceived pressure and increased their sense of control and participation, without causing harm.

## Contribution

The study introduces maternal active pushing during cesarean delivery as a novel method to improve the intraoperative experience.

## Key findings

- Active pushing reduced perceived fundal pressure intensity during cesarean delivery.
- Women who pushed reported greater participation and control during the procedure.
- No adverse maternal or neonatal outcomes were observed with active pushing.

## Abstract

This study aimed to evaluate the effect of maternal active pushing during cesarean section (CS) on postoperative pain, intraoperative discomfort, and the mother’s sense of control and participation.

A prospective, randomized controlled study.

Patients were randomly assigned into two groups. In the Conventional group (n = 45), the CS was performed traditionally without maternal pushing. In the Assisted group (n = 55), patients were instructed to push during delivery. Outcomes measures included patients’ perceived pressure, pain, and sense of participation. Breastfeeding and postnatal depression were assessed using validated scales, along with maternal and neonatal outcomes, surgeon satisfaction, and operation duration.

Patients in the Assisted group reported significantly lower fundal pressure intensity (VAS score 3 vs. 5, P < 0.01) compared to the Conventional group. There was no significant difference in postoperative pain. However, women in the Assisted group reported a greater sense of participation (6 vs. 0, P < 0.01) and control (4 vs. 0, P < 0.05) than those in the Conventional group. No significant maternal or neonatal complications were observed.

Maternal active pushing during CS positively impacted intraoperative experience by reducing perceived pressure and enhancing the sense of control and participation, without adverse effects on maternal or neonatal outcomes. These findings support further research with larger, multi-center studies to validate the potential benefits of this approach.

NCT05520580 (https://clinicaltrials.gov/ct2/show/NCT05520580).