Delayed versus early pushing in women with epidural analgesia: a systematic review and meta-analysis.

Specific interventions included in the review To be included, the trials had to use delayed pushing. The duration of delay varied between the studies. In some studies it was between one and three hours (or earlier if there was an involuntary desire to push), in others women were delayed until the head became visible at introitus or rotation and descent ceased. Comparators, although not prespecified, were immediate or early pushing.