To push or not to push?

[tonton]

Have read some conflicting messages about whether you should actively push or not during 2nd stage of labour. If you don't 'need' to push, does that mean it's no harder with an epidural, which I was planning to avoid because you can't push well? That sounded very confused. Hope you'll understand!

I couldn't have NOT pushed - the instinct was so strong.

I had the epidural with my second child and totally lost the sensation, they kept telling me when to push as I could not feel a thing, it was horrible and took a whole hour to get him out from the start of pushing.

With the first I just had gas and air but even though painful was wonderful experience.

Would never have the epidural again, not that I plan any more children

I had an epidural, which had completely worn off by the time I was told to start pushing so I was feeling things again, but I didn't feel anything instinctively and had to be told how to do it. I was pushing for three hours before they decided I needed a c-section, and I hadn't got a clue what I was doing the whole time.

It is supposed to be better if you allow the baby to make it's own way down the birthing canal, if you push too strongly you risk tearing. Little pushes are better than big ones, to ease the baby's head out gradually. So controlled pushing. It's very hard to do, but your midwife will help you. You can control the pushes, just like when you are asked to stop pushing once the baby's head is out to allow them to turn it and check for the cord, most women manage this.

i never felt the urge to push w/my second (my first i had forceps and full epidural), even w/no pain relief. in retrospect, i wish i'd have asked to remain on all four. that felt most 'comfortable' to me.

I had ideas of breathing the baby out to avoid tearing, but when that urge came I pushed for all I was worth and NOTHING was going to stop me.

I think your body will tell you what to do if you listen.

So if 'controlled pushes' are best - sounds very sensible, is it possible to do that with an epidura or am I kifding myself? I'm prepared to go withought but want to udnerstand the consequences as much as possible!

Maybe women who don't need to push are in an upright position and have such effective contractions that can do it all for them, and for some reason to push.
If you have an epidural won't you be lying down generally, and don't the midwives put a monitor on and then tell you when to push, so you have no choice to push or not to push? (I haven't had an epidural so I can't remember what I learnt about them at the antenatal clinics).

Maybe women who don't need to push are in an upright position and have such effective contractions that can do it all for them, and for some reason no need to push.

If you have an epidural won't you be lying down generally, and don't the midwives put a monitor on and then tell you when to push, so you have no choice to push or not to push? (I haven't had an epidural so I can't remember what I learnt about them at the antenatal clinics).

I pushed as and when needed.... no thought realy went into it, just instinct. One tear not needing stitchhing, but it was first baby and 8lb 5 so not unexpected!

I gave birth standing leaning over a bed both times and never "needed" to be told to push it was pretty instinctive, I had to be told when to breathe the head out though with no 1 baby, but second time around did it all myself.
Both labours drug free and have heard that as epidurals afect your lower body you are only able to lie down. My body told me quite firmly both times that being upright was the way to go.

I didn't know when to push at all. The only way I knew was when DP told me that monitor was going higher and I was contracting and then the midwife yelled at me to push.

It was so superficial, although I was not in pain the after effects were the worst.

I had no pain relief and often think I may have pushed too hard. (I tore every time).

Perhaps it's easier to slow things down at this stage if you have had pain relief. I don't know.

no tears either as in stitches tears - plenty of eye tears

I got terrible piles probably I was pushing very hard but just couldn't feel it so managed to push the piles out as well as the baby .

Was sore for about 2 weeks after with my first was only a few days.

I had an epidural with my first, you are lying down there is no choice there unless you have a mobile epidural and even then your positions are limited. You feel no urges to push, you are told when to push, which means that the risk of tearing is greater as you cannot listen to your body and lying down is not the best position to push in.

With my second I had a home birth, he came down the birth canal with no help from me, I felt him making his way down and although I felt the urge to push, my mw told me not to, she said he was making his own way down just fine (plus she was waiting for the second mw to arrive, it all happened a little quickly you see!). Then I gave a series of little pushes and out he came. I had a little tear with him, which was not surprising as he had a huge head and still does, but with dd who has a little head and was born tiny, I had a nasty internal and external tear and I'm convinced that is because of the epidural and the whole hospital procedure of getting the baby out quickly to free the room up for the next woman.

Both times I had no idea when to push - had to be told when by the midwife.With first labour ,contractions stopped. With second one, midwife could feel contractions coming by touching my abdomen and said push, but I only felt a slight 'urge'

Both children delivered without pain relief and in crouching position. I might as well had an epidural!

I had an epidural and the pain relief was fantastic, but it was weird losing the sensation of 'working' the contractions had given me. The contractions dwindled an hour or so after the epidural and I was put on a syntocin drip. At the pushing stage I was only feeling the contractions slightly, so had to be very focused and concentrated to follow them - there wasn't any 'urge'. In the end ds was born by ventouse, but the pushing helped to avoid a CS. If I have an easier labour next time round (this time it lasted over 2 days and I was so tensed up by the end that I actually dilated faster after the epidural than before) I'd like to try drug-free, as it really was disorientating to lose that 'working' sensation, and I think I would have experienced an urge to push.

There has been some information about this in the papers recently - they were talking about pushing as instructed by the midwive versus doing what comes naturally. Pushing comes naturally to most women but it is less intense than the type of pushing encouraged by some midwives (holding breath for count of ten, chin on chest etc etc). The recent research found that natural pushing made the 2nd stage take a little bit longer but had health benefits - can't remember what they were now. If you have an epidural then it is very likely that you will end up doing the midwive led type of pushing because you won't feel your own urge to push. Not pushing at all is unlikely to work in my opinion. I have seen second time mums (with epidurals which is why they hadn't been pushing before) just do about two or three pushes to get the baby out so they nearly made it without pushing but that last bit does need some effort I think.

here

sorry here