Obstetrical, perinatal and maternal implications of spontaneous pushing and directed pushing Section: Featured Articles How to quote Muros Naranjo MC et ál. Implicaciones obstétricas, perinatales y maternas de los pujos espontáneos frente a los dirigidos. Metas de Enferm jun 2011; 14(5): 8-11 Authors1Mª Carmen Muros Naranjo, 2Esther Conde Puertas, 3Eva Luque López Position 1Matrona. Servicio Andaluz de Salud. Centro de Salud Martos, Jaén.2Matrona. Servicio Murciano de Salud. Hospital La Inmaculada.3Matrona. Servicio Andaluz de Salud. Complejo Hospitalario de Jaén. Contact address Mª Carmen Muros Naranjo. C/ Turuñuelo, 35. 41470 Peñaflor (Sevilla). Contact email: mcmuros@hotmail.com Abstract There are two ways of directing the second stage of labour: spontaneous pushing and directed pushing. Spontaneous pushing represent a natural way of managing the second stage of labour; however, lately, and as a result of epidural analgesia, healthcare professionals frequently resort to directed pushing without taking into account the negative repercussions it has on the patient.The aim of this work was to perform a comparative analysis of the available evidence on the obstetrical, perinatal and maternal effects of spontaneous vs directed pushing. Methodology: bibliographic review of the Pubmed, CINAHL and Cochrane databases, between the years 1995 and 2008, under the following tag words: “pushing”, “second stage labour”, “delayed pushing”, “passive foetal descent”. Data were collected on the duration of the expulsion stage, pushing time, instrumental deliveries, alterations of the foetal cardiac pattern, disaturations, PO2, PCO2 and pH foetal values, Apgar score, perineal outcome, fatigue and tiredness and maternal satisfaction with both types of pushing. Results: according to research, spontaneous pushing permits the passive descend of the foetus and results in fewer maternal and foetal adverse effects. Spontaneous pushing is a safe method for mother and baby in the management of the expulsion stage. Even though, an increase in the duration of the second stage of labour is observed, the pushing time is reduced, this being the parameter that really entails negative repercussions. Keywords: delayed pushing; directed pushing; expulsion stage; foetal passive descend; labourObstetrics Versión en Español Título: Implicaciones obstétricas, perinatales y maternas de los pujos espontáneos frente a los dirigidos