When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include when possible:

Telling the woman to start pushing as soon as her cervix is fully dilated.

Coaching the woman to use sustained, 10- to 15-second, closed-glottis bearing-down efforts with each contraction.

Starting an epidural so that pain is reduced and the woman can relax.

Encouraging the woman to try various upright positions, including squatting and pushing with the head of the bed up. —