Great article!
I gave birth a little over three weeks ago, so the experience is still fresh in my mind.
My OB nurse wandered off into the corner to fiddle with some blankets while I was in hard labor, so my husband and mother-in-law were the ones "coaching" me. After telling me when to push once or twice, they just sorta sat back and did what I told them to... much less annoying than leaning over me and doing that heavy breathing in my face.
I pretty much ran the show when my girl-girl was born nigh on 18 years ago. but I had a full cast & crew (heart issues on my end) and sure wouldn't have wanted it any other way. I did it with IV painkiller alone, having sworn all involved to agree not to provide me with anything more, even if, in laborious throes, I pleaded with them otherwise.
I was glad to read that the study posed a question that had lingered for me, lo these many years. that being how an epidural-ized woman could possibly push? she can't feel anything so how then could direct her muscles?
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When I had my son, it took 36 hours (thank God they won't let women go that long any more). Half of that was transition labor, and I was literally begging for death. When they finally took me into delivery, my coach was crying and the delivery nurse was literally holding my face with hers a few inches away telling me to PUSH PUSH. If I'd had the strength, I'd have knocked her halfway across the room.
As it was I just sent my coach out of the room and did the rest myself.
I had my tubes tied less than six months later.
Having babies ain't for p*ssies, and when it comes to pain, that's what i am. 
PUSH PUSH does not help. Anyone who's had a child knows that, no freaking study needed. I wish somebody would do a study on how long it takes a man to squeeze a whole cantelope through the entire length of his colon. :-|
Peacebug, one surprising thing I learned was that there is no directing of muscles needed. My body took over at the end -- I couldn't have STOPPED my body from pushing/bearing down had I tried with all my might.
It's amazing how long it can take information to get mainstreamed. This is the same thing that Sheila Kitzinger has been saying since forever (Episiotomy and the Second Stage of Labor was published in 1984).
I've often told women that the difference between coached pushing and natural pushing is like the difference between moving your bowels when you're constipated (grunt and strain until you're veins are popping out) and moving your bowels when you're NOT constipated (your body knows what to do, just go with it).
I'm with reecie, if I had to put up with someone telling me what to do while in labor I would have been tempted to give them a smack.
Thank goodness somebody else finds the notion of giving people 'jobs' so they feel useful to be annoying! It took so much fucking serenity to fight the endless battle with 'routine".
They push drugs, episiotomies, pushing this and doing that, when honestly they should be responsive to the different needs of different women. If something is needed, by all means suggest... but just the way things are done routinely pisses me off. With my first kid, they refused to let me hold her right away and I was young and didn't know what to do. I wanted to breastfeed, and they kept trying to talk me out of it. They even gave the babies bottles behind our backs and scoffed at me about it. It took the angelic patience of La Leche League to set me straight and since I have been throwing "The Womanly Art of Breastfeeding" at every expectant mother I can. It saved my mothering back then, and it saved me from giving up and listening to everyone but ME and BABY.
They've fortunately gotten better and are encouraging breastfeeding and natural birth methods, which is a step in the right direction. Thanks for this post!
reecie - you're so right. most times the muscles kick in on their own and at just the right moment. so the admonishment to push is - well - redundant.
and just try to stop pushing! which I had to do for a bit because girl-girl's heart rate did a nosedive at one point and the docs wanted to get me into a surgical room, just in case. that is not easy.
all ended well of course with no medical intervention needed.
I continue in awe at the magical aspects of our fine bodies.
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Ah, thank you for answering one of life's persistent questions for me. I've never had a baby, so I have always wondered what telling a woman to push during labor was all about. It did seem sort of redundant.
I love your analogy of having someone walk around behind us reminding us to chew and breathe. And what about that breathing thing with the short breaths and the funny faces? Does that really help? More to the point, does that really help the laboring mother?
Just curious.
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