First off --- Epidurals --- Do they truly prolong pushing, versus no epidural? Short answer: yes, sometimes, but not usually by too much. There is no clear cut answer to this question, to tell you the truth. Are you looking at first time mothers, or women who have given birth before? Epidural or no epidural? Amount of sensation she has with her epidural? Amount of "urge to push" without the epidural, or with the epidural? Position of the baby? Pitocin in use or not? Effective pusher or not effective pusher? There are so many variables.
To break it down, let's limit some of the variables. First time mother only. Average size baby. Normal, spontaneous labor (no pitocin). Baby in proper position for birth. Epidural with moderate coverage, giving mom the ability to feel pressure and where to push, versus mother with no epidural and the ability to have full sensation to push. Will the epiduralized mother take longer to push? Sometimes, not always. There is no crystal ball to predict.
A compilation of studies of epidural vs no epidural for length of 2nd stage labor can be foundhere.
If you go down to "Analysis 01.08" you can see the specific numbers (in minutes) of length of 2nd stage. Mean ranges are:
Epidural: 36.54 to 115.00 minutes of pushing (2nd stage) Non-Epidural ("control"): 29.50 to 62.00 minutes of pushing (2nd stage)
So, to summarize, not having an epidural can possibly lead to shortened pushing in labor, but not always.
Personally speaking, I have seen the higher end (2+ hours) of pushing in first time mothers with an epidural, more often than the shorter length of pushing in first time mothers with an epidural. As for women without epidurals, I have seen first time mothers push for just several minutes, all the way up to 3 1/2 hrs of pushing. There is no easy answer to give, to be honest, about whether an epidural will prolong YOUR pushing stage or not.
Use of hypnosis/prepared childbirth/other methods. I have seen this used successfully over the years. However, the woman is usually very well educated and has excellent support with her to help promote whatever method of relief/natural childbirth she is using. These women truly put their minds to natural childbirth, and focus within themselves to control their pain. I have seen women who use this for both short labors and long labors. It works well, like I said, if she has really prepared herself mentally for labor, and she has good coping mechanisms to help her achieve her goals.
This is where the "psyche" part of the 4 P's of labor come in to play. The woman believes in herself, in her body, and trusts that she will cope well with labor. She has planned out how she will handle her contractions, and avoids all negativity. She surrounds herself with like-minded people to help support her method of birthing. She is flexible and open to suggestions and changes as needed. She remains an active participant in her labor, and does not let the contractions take over. She maintains a positive attitude about her birth. She is not afraid, and listens to what her body is telling her during her labor and birth.
These births, I find, are the most amazing of all births. It shows how empowering birth can be for women. This is also NOT for every woman. Not every woman has the ability to focus on the positivity, and may not have the coping mechanisms and skills to be able to "go with the flow" of her labor and birth. This does not mean that she is a "failure", it just means she knows her limitations.
On a personal note, I found that self hypnosis worked best for me, with my last birth. I used a lot of visualization and focal points in my mind to help me relax and go with each contraction. I also practiced this before labor started, so that I would be better prepared when the contractions started. It worked well for me, and I would do it again if I were to have another baby.
**** Every woman is different. Every woman has different needs, expectations, and experience when it comes to birth. Every woman has a right to birth the way she chooses. ****