A meta-analysis of passive descent versus immediate pushing in nulliparous women with epidural analgesia in the second stage of labor.

Objective: To determine which method of pushing-passive descent or early pushing-most benefits women with epidurals during second-stage labor.

Data Sources: MEDLINE, CINAHL, and Cochrane Database.

Study Selection: Studies limited to randomized controlled trials in English, comparing passive descent to early pushing in women with effective epidural analgesia.