Generally we are taught to look for signs of 2nd stage such as involuntary pushing, anal dilatation ,purple line, grunting, going into her self, PP visable, heavy show. We dont necessarily need to do a VE unless it is clinically indicated.

Most women are in tune with their bodies and do what the feel is right for them. I do not agre with the Amercian way of holding your breath with chin to chest and count to 10, I think it does more harm than good. We try to get 3 pushes out of one good contraction.

I have seen a odematous cx however as with others it was OP with fetal tachy.

__________________