A nurse is coaching a woman during the second stage of labor. Which of the following should the nurse encourage the client to do at this time?

A. Holding her breath while pushing during contractions: Prolonged breath-holding increases intrathoracic pressure, reduces venous return, and can decrease uteroplacental perfusion. This may compromise fetal oxygenation and increase maternal fatigue, particularly during repeated pushing efforts. B. Begin pushing as soon as the cervix has dilated to 8 cm: Initiating pushing before full cervical dilation increases the risk of cervical edema and lacerations. Effective bearing down requires complete dilation to allow fetal descent without maternal or cervical trauma. C. Push with contractions and rest between them: Coordinating pushing with uterine contractions maximizes expulsive force while rest periods allow maternal recovery and fetal reoxygenation. This pattern supports efficient fetal descent and reduces exhaustion during the second stage of labor. D. Pant while pushing: Panting is used during the transition phase or when pushing should be delayed, such as with an urge to push before full dilation. During the active second stage, panting interferes with effective bearing-down efforts.