Coached pushing become common practice at the same time epidural anesthesia was widely introduced in hospitals. Women who have opted to have an epidural, sometimes become unable to feel any sensations in the lower half of their bodies. Epidurals did improve some since that time, and nowadays most women can feel when they have the urge to push, and just have pain relief. If you don't have any feeling in that part of your body at all, coached pushing makes sense. If not, whether you have received an epidural or not, coached pushing is not necessary. What are the disadvantages?Research into maternal and fetal outcomes for coached and natural pushing groups shows that there were no differences in fetal outcomes, and the number of vaginal tears encountered were the same for both groups. There is a higher risk of pelvic floor damaged for women who are coached to push. The baby's oxygen supply can be reduced during vigorous pushing efforts. Coached pushing can be stressful and unpleasant. Who wants a whole team of people shouting at them while they are about to have a baby?
If you are having an unmedicated birth, or even if you are hoping for an epidural, but you do not want to be coached on how to push, you may want to discuss this with your doctor or midwife in advance. You can include your wishes on a birth plan too. It is possible you will have a cervical check to confirm you have reached 10 centimeters, and then be allowed to push with the urge.