When should the nurse encourage a laboring client to begin pushing?

Encouraging a laboring client to begin pushing is appropriate when the cervix is completely dilated. Complete dilation, which is 10 centimeters, indicates that the cervix has fully opened to allow the fetus to move down the birth canal. At this stage, the uterus contracts effectively, and the baby's descent can proceed safely and efficiently.

The process of pushing is essential for the delivery of the baby, and it is most beneficial when the cervix is fully dilated. Pushing before this point can potentially lead to complications, such as cervical swelling or the baby being in a less optimal position, which could hinder progress or require interventions.

Other factors, such as the mother's urge to push or physical signs of being ready to deliver, can play a role as well, but the primary determinant for beginning the pushing phase is the complete dilation of the cervix.