Part six: Limits on pushing and time in the second stage

Traditional approaches to pushing and time limits in the second stage of labour are based on a narrow, one-dimensional understanding of its physiology. Paradoxically, good quantitative and qualitative evidence that exposes these limitations has existed for some time but changes in practice have been slow to catch up. Some of the most robust and woman-centred recommendations for practice described so far in this series can be generated from the evidence, making the continuation of some conventional practices difficult to justify.