Use of fundal pressure during the second stage of labour

The objective of these guidelines is to evaluate the benefits and the risks of using fundal pressure and to issue guidelines on its use.
The application of fundal pressure refers to the application of pressure to the fundus of the uterus with the intention of shortening the duration of the second stage of labour. The second stage of labour is the period from complete dilatation of the cervix until natural birth. It has three successive phases: (i) engagement of the presenting part, (ii) descent and rotation, (iii) release.
The following indications and specific technical procedures were excluded:

• suprapubic pressure and McRoberts’ position to alleviate shoulder dystocia

• fundal pressure applied during entrapment of the aftercoming head in the event of a breech presentation

• fundal pressure during a caesarean section

• suprapubic pressure and uterine massage during placenta expulsion.