05/29/2026
“Coaching pushing has also been found to potentially increase the amount of pressure on the pelvic floor with subsequent negative consequences such as decreased bladder capacity, less urge to empty the bladder, an overactive bladder muscle, and stress incontinence (leakage of urine). Coaching pushing also involves “breath-holding” (so-called “purple pushing”) which can be very tiring, reduces oxygen levels in the mother and baby and increases the risk of tearing. An uncoached or a spontaneous second stage of labour allows you to work with the uterine contractions and the foetal expulsion reflex and allows the baby to descend without damage as you gently push/breath the baby out.” – Stacey Rosenberg
The body is designed to coordinate labor through reflexive, involuntary patterns rather than forceful effort. Research suggests that coached or breath-holding pushing does not improve outcomes for mother or baby in most cases and can increase strain on the pelvic floor as well as reduce oxygen efficiency during labor.
This added mechanical and physiological stress may contribute to fatigue, tissue strain, and longer-term pelvic floor dysfunction.
In contrast, allowing the nervous system to guide a more spontaneous, reflex-driven second stage of labor supports coordinated uterine function and a more efficient descent of the baby through the pelvis.