Home Birth: Urge To Push Before Fully Dilated?

[lilianfox]

Hi

I am 27 weeks pregnant with my second DD. My first birth was at home and was a good experience. Birth was straight forward and I used the pool but got out at full dilation as contrations had slowed down etc Went to the loo and gave birth while sitting on the toilet! All was well though, baby healthy and well and no tears etc

However, before I was fully dilated I had a strong urge to push at the end of contractions. However, I believed and the midwife in attendance said I was not fully dilated so better wait to push etc I found not pushing very hard and painful which is why I resorted to using the gas and air in the pool. Most of the time I was in the pool I was trying to use my engery to resist pushing at the end of contractions as the midwife said I was not quite fully dilated.

My question with this coming labour planned again to be a home birth in water is it safe to push before I am fully dilated if I get the urge this time? Does anyone have any experience of this? If you didn't have an internal exam did you just push when you felt like it? This is the one aspect of labour which has really left me not feeling in control as I felt last time I was going against my body but I suppose it also did feel as if things were happening really fast. I think resisting pushing and having the gas and air slowed the labour down?

I was induced with my ds, and found that I had an awful urge to push before I was fully dilated, so much so that I begged for an epidural! I could hardly catch my breath during contractions because the need to push was so great. Luckily I refused the epidural when the anithetist finally turned up.
I dont know what would have happened if I'd pushed properly, although am sure I must have pushed a little as the need was so big.

If you push before you are fully dilated you can cause your cervix to swell, which can then take hours to go down.

Some people get a cervical lip, which means just a small part of the cervix is covering the head. So you feel the need to push but if you do you are in danger of the cervix swelling and prolonging everything.

My intention with ds2 (a home waterbirth) was to have a vaginal exam before I started to push as I was aware of the whole cervial lip thing, but as it happened the MW only got to us 15 minutes before ds arrived.

Maybe ask to look at your notes from your previous birth and see if a cervical lip is mentioned? Then speak to your current MW's and ask what they would do when you start getting the urge to push, and talk through what the options are. This may help you feel more in control.

Good luck

When I was in labour with my third baby I didn't wait to be told to push - in fact the midwives wouldn't believe I was ready to and got me a bedpan, saying I was needing the toilet!

DD was born after a few pushes & I couldn't have resisted if I'd tried.

Why don't you have a word with your midwife in advance? Giving birth on the loo sounds a bit alarming, but I'm glad to hear your baby was ok.

Personally, I think your body knows more than a midwife who had had an explore up your fanjo.

If you need to push, then you need to push, and I think you should just go with it.

Go with the flow of what your body tells you to do, I say.

Hi

Thanks for your replies! Yes I will speak with my midwife and see what her opinion is. I wanted to explore the topic abit to see what other people's experiences are before talking to her.

I think I read on a thread once you see that the issue of not pushing before fully dilated was only relevant if you were not pushing voluntarily and being 'told' to push when feeling no urge to.

I also refrained from pushing 'iliketomoveit' due the the cervical lip and believing the cervix may become inflamed/swollen etc. Is this the case with a natural home birth if you are feeling the urge to push though? 'Iliketomoveit' can I ask if you were hoping for an exam before to give go head as it were with pushing what did you do when midwife only arrived 15 mins before? Did you just go with your natural urge to push? or did you only push when m/w arrived? did she give you an internal then?

'PigTail' & 'Poolet' I really do want to go with my body and see what happens but am still slightly scared about if it is true that pushing before fully dilated will make cervix swollen etc does anyone have any literature on this?

Bensmum: thanks for sharing your experience. It is good to know that others have also have had this tremendous urge to push and actually how resisting it can be very painful!

A true anterior lip is quite rare and there is some evidence to suggest the if the baby is a little posterior your body may have an urge to push before full dilation as this helps turn the baby.

You should definitely trust your body and push when you feel the urge.

I had a home birth and had no internals at all and pushed when my body said, infact I wasn't aware I was pushing to begin with.

Ask away! I'll answer anything!

Yes I was hoping for a VE before I started to push. For some reason I had a bee in my bonnet about pushing before the cervix was totally dilated (this happened to a good friend of mine). So I spoke about it with my MW and she said if it made me feel better, then she'd do a VE. It wasn't about permission to push from the MW, it was about me feeling confidant to push (I was a VBAC and wanted things to go as well as they possibly could).

However, ds had other ideas. As soon as I stepped into the birthing pool I felt the urge to push and no bugger was going to stop me. By the time the MW arrived, laid her resuc. kit out and tried to listen with the doppler, ds's head came out with the next contraction, so I didn't actually have any VE during labour.

I had home water birth four months ago. When the midwife arrived and examined me I was 6cm, so I got in the pool as soon as it was ready. I didn't get examined again - baby arrived 45 minutes after midwife got to my house and about 30 minutes after I'd got into the pool. When the sensation of the baby coming started five or ten minutes after getting into the pool, I made an effort not to push as I thought I was only 6cm, but my baby came anyway. I didn't actually do any pushing. I just tried to relax and go floppy which seemed to work as my "pushing stage" was only 21 minutes according to my notes and I didn't tear. I think the contractions pushed my daughter out by themselves - I didn't do anything!

I got to 9cm at home and felt the urge to push. After several hours of pushing and nothing happening we transferred in where they said my cervix was swollen and now more like 7-8cm.

I had an epidural for a few hours to try and give it a chance to go down without me pushing against it but nothing changed and so I ended up with an emcs.

So there are risks. But that doesn't happen to everyone.

when i had ds2 i was labouring in the pool and had the urge to push, midwife told me to go with it, just based on the noises I was making!
they did no internals (aside frm one, when they first arrived) and allowed me to do things as I wanted to

all went very well

ds3 was also a homebirth and i pushed when I needed to again. he was born just fine (48 minute labour!)