Pregnant women in the throes of labor might want to tell others in the delivery room to stop being so pushy.

Women traditionally have been coached to push during contractions by everyone from doctors and midwives to helpful husbands. A study being published in the January issue of the American Journal of Obstetrics and Gynecology adds to the growing body of evidence that prodding to push doesn't do much good, and it might even increase women's risk of bladder problems.

"Oftentimes it's best for the patient to do what's more comfortable for her," said Dr. Steven Bloom, the study's lead author and interim chairman of obstetrics and gynecology at University of Texas Southwestern Medical Center in Dallas.

UT Southwestern researchers divided 320 women into two groups: 163 moms-to-be were coached by midwives to push for 10 seconds during a contraction, while 157 were told to "do what comes naturally."

'We're inching down that path'

Coaching made no difference when it came to the need for Caesarean section, forceps delivery or episiotomy. It also had no effect on the health of the baby or the likelihood of tearing in the vaginal area. The only variation between the two groups was that coached women spent 13 fewer minutes in labor.

"If you were talking to my wife, who's had two babies, she would say she'd do anything to shave 13 minutes off her labor," Bloom said. "But other women might say, 'What are the tradeoffs?' "

A couple of potential tradeoffs surfaced during follow-ups with 128 of the women three months after they gave birth. Those who were coached had slightly less bladder capacity and more overactive bladder muscles -- factors that could contribute to incontinence.

So does coaching do more harm than good?

"We're inching down that path," Bloom said. "But to make a sweeping statement that there's no need for coaching anymore wouldn't be accurate. Especially for women with an epidural [anesthetic], it may be appropriate."

Dr. Xavier Pombar, a high-risk obstetrician at Rush University Medical Center in Chicago, said he has noticed a trend toward letting women "labor down," or giving them more control over the pace of the delivery.

"I used to tell them to start pushing," Pombar said. "Now I've gotten into the habit of letting them labor down."