Kristeller maneuver: when they “push you” or “climb on you during childbirth” 2026

How many people know what the Kristeller maneuver consists of? What do you know about the benefits or risks of the Kristeller maneuver? And most importantly, how many women consented to this procedure being performed?

The obstetric technique we are talking about, called the Kristeller maneuver, consists of applying pressure with the elbow or hands on the bottom of the uterus in the direction of the vagina to "push the baby" to come out. According to surveys by the Ministry of Health, it is used in 26% of births, that is, one in four women who give birth suffers from this technique during childbirth.

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We could assume that in a health system that boasts of being scientific, and with professionals who act based on the evidence of studies, a procedure that is performed during one in every four births must have proven benefits that leave no room for doubt.

However, the WHO (World Health Organization) and the SEGO (Spanish Society of Gynecology and Obstetrics) contraindicate this technique to shorten the second phase of labor since the studies carried out do not observe benefits, and on the other hand, there are possible risks due to its practice. Although the SEGO clarifies that “the pressure on the uterine fundus may be used only with the intention of helping the detachment of the head.”

According to scientific studies, no significant differences are found in the duration of the second phase of labor when performing this maneuver, nor is the delivery time shortened, nor are instrumented deliveries reduced after performing the Kristeller maneuver. That said, when a woman says "they pushed me to help the baby come out," it has no scientific support.

Risks of practicing the Kristeller maneuver

One would expect, then, that this maneuver at least does not pose a risk to the mother or the baby, since it is performed frequently and without apparent scientific benefits. The reality is very different.

The Kristeller maneuver puts pressure on the uterus and pelvic floor, considerably increasing the possibility of uterine rupture, increasing the chances of tearing in the mother, subsequent damage to her pelvic floor, and fetal morbidity. When the baby descends into the birth canal, it makes a series of movements, rotations and flexion-deflection of the head, and with the sudden acceleration with said maneuver, it does not facilitate correct fetal positioning. Although more studies are needed, its risks cannot be ruled out. Of course, to these risks we must add that it is an annoying and painful technique, and for a woman it is not pleasant for someone to exert pressure on the bottom of her uterus during the expulsion of labor.

Perhaps we think that if the technique we are talking about does not have scientifically proven benefits nor is it free of risks, all women who undergo this maneuver will be informed and consulted regarding performing the Kristeller maneuver.

Should they inform me when they are going to perform the Kristeller maneuver?

According to a report by Parto es Nuestro, a non-profit organization made up of health professionals and women who fight for more humanized and respected childbirth care, "approximately 96% of the women who underwent the Kristeller maneuver did not know what was going to be done to them, nor did they give their consent to perform said technique." In most cases, in fact there is no record of this after delivery, since it is not recorded in reports or in the medical history.

For midwife Alejandro Ojeda, this is the main problem. The fact is that the woman has the right to be informed at all times about the birth process, and about each of the actions that affect it. Her body remains hers within the hospital, as does her birth.

I am convinced that the majority of professionals who perform the Kristeller maneuver seek a benefit for the woman and her baby, even despite the scientific evidence.

Alternatives to the Kristeller maneuver

However, many things can be done beforehand to promote delivery without having to use this maneuver:

The problem is that currently births are excessively medicalized and intervened. The rush and rigid protocols of the system do not allow for the respected evolution of the process.

If, having exhausted resources, the woman, with her consent and with adequate information, decides to have the technique performed, I see this action as justified. I am one of those who thinks that women in childbirth have the right to be correctly informed and to choose accordingly.

The fact is that today it is a practice without scientific recommendation, and that it is used on too many occasions without the relevant consent. It is necessary to make known the reality of this and many other actions so that women can make informed decisions and feel like participants in a process that corresponds to them, their birth.