“Wait Until You Feel Something”: The Myth That Prolongs Labor and Increases Risk
She was 10 centimeters. Fully dilated. Ready. Her epidural had kept her comfortable through eight hours of labor.
“Don’t push yet,” the midwife said. “Let’s turn down your epidural so you can feel the urge. Just wait until you feel something.”
The patient looked at me, confused. She had chosen an epidural specifically so she wouldn’t “feel something.” Now she was being asked to let her pain relief wear off so she could push “naturally.”
This moment plays out in labor rooms every day. It sounds reasonable. It sounds physiologic. It sounds like patient-centered care.
It’s also unsupported by evidence.
The Persistence of “Laboring Down”
The practice of delayed pushing goes by several names: “laboring down,” “passive descent,” “rest and descend.” The theory is straightforward: if a woman with an epidural waits to push until the baby descends lower on its own, she’ll push for less time and have better outcomes.
For decades, this made intuitive sense. Epidurals blunt the urge to push. Why not let gravity and uterine contractions do some work first?
Then researchers actually tested it.
What the Evidence Shows
