'push, come on, push' a OBEM question

[YuleingFanjo]

OK.

so every birth I see on OBEM there is some point where the labourig woman gets encoraged/told to push. Not always 'push, push, push!', maybe 'come on now, you can do it, well done, keep going' and so on.

is this normal?

is this what happens in labour?

it's just that when I gave birth I was transfered up to the CLU and did the 6-10 cm bit up there on my back. The baby's hearbeat was being monitored and they had to break my waters which had meconium in them. I clearly remember the doctor saying I was 10 cm dilated and I know I asked the midwife shortly after 'so should I push now?' to wich she answered yes. However I don't remember pushing as shortly afterwards I was prepped for a C-section 'as a precaution' and ended up having an episiotimy and forceps. I pushe 3 times (couldn't feel a thing) under instruction from the Doctor and my baby was born.

I just wonder why no one gave Me any encouragement to do the pushing bit?

*nb this is probably why I should never watch OBEM

Well, in my first birth there was a bit of that, but I had an epidural so needed to be coached for that.

The remaining 3 births were at home;

Dd - she was born with me kneeling by the side of the bed - I coughed her out - literally - the midwife said 'give a little cough now', and out she came! No pushing at all. (10lb!)

Ds2 - born with me standing up - gravity did most of the work, but I did have to work quite hard to get to the point of him being ready to come out - I was hulahooping and dancing!!!!! (without a hulahoop!) (10lb2)

Ds3 - no pushing until he got stuck (slight shoulder dystocia), and then it really was a case of PUSH as hard as you can, McRoberts, and then luckily he was born with no ill effects. (10lb12!!!!!)

Yes, I was told to push with each contraction, but only after transition when I felt the head drop down. It was definitely a case of "right, you've done the dilation bit, now it's the next phase where you need to do some work."

Also I remember clearly the bit when the head is delivered and they make you do "little pushes" so you don't tear (didn't work ).

ok

after reaching 10cm, how long can you push for - I mean what's an average amount of time or does it wildly differ?

I just feel like I got to 10cm and then they decided to wheel me into theatre. I went up to clu at around 10.30pm and was 6cm, baby was born at 1.21am. I was told afterwards that I was never in an emergency situation. I just wonder why the spinal and so on when presumably I could have spent some time pushing. Was it just the presence of meconium?

I was encouraged with DS but it was more of a "that's it, come on, keep going" as each contraction came and a "well done" afterwards. The MW had to remind me to breathe too as I was holding my breath while pushing so it became "push down, quick breath, that's it, good girl" and other pep-talk. I didn't get to do the little pushes for the head, after 3.5hrs of pushing the consultant decided he was doing a ventousse and I decided "fuck you". The second he left the room to get his kit I did a massive push bourne out of sheer stubborness and temper. DS shot out - head, shoulders, body - all in one go with the MW cheering me on :o

I didn't get the chance with DD, she was an EMCS during latent labour.

With ds they told me 'how' to push - down into your bottom but they didn't need to tell me to do it iyswim 'cause my body made me do it.

With dd they were still getting their gloves etc on so no encouragement given - one push and she was out (having been nowhere near delivery 2 minutes earlier!)

I was never told to give little pushes, both of them shot out 'like a cork out a bottle' as dh says but I think that might be because they had huge head iyswim??

X-post.

I pushed for 3.5hrs with DS. When I got to 9.5cm I finally agreed to let them break my waters and put a clip on his head to monitor his heart, I'd been in labour around 32hrs at the point and they weren't getting a good read on the doppler or the ECG. Because they had the clip and they could see he was happy in there they let me push for two hours. The consultant came and agreed to let me have another hour, I sneaked an hour and a half. Then the rest is in my earlier post.

I think it depends on how well the baby is doing and how well mum is doing. When they decided to ventousse I'd been going for 36hrs, I was almost exhausted - I was passing out between contractions - and they wanted DS out before he became distressed.

My MW was fantastic and talked and encouraged me through the whole pushing part. Due to a misaligned coccyx it took some doing to get her " round the corner" and they threatened vontous so I pushed even harder but couldn't have done it without MW telling me how well I was doing

By " her" I mean DD not the MW

I didn't push for long with DD2, about 15 minutes.

I don't think I pushed at all. I'm slightly about the whole pushing thing. I thought the uterus basically expelled the baby and would do it whether the woman was actively involved or not. That's certainly how it felt like to me - a titanic thing happening over which I had zero control.

ok, so if you are hoing to push you don't wait until 10cm, you do it before then? I just thought that you would wait until fully dilated? I was on gas and air and having a right laugh so lost track of what my body might have been doing naturally. Maybe I was pushing all that time but just didn't realise it? I don't remeber transition either.

"through the whole pushing part"

so when is the pushing part?

AFAIK pushing begins at or just after 10cm, it did for me anyway. I went through transition during which I decided I'd done enough for one day and was going home, and then I knew I had to push. It wasn't as clearcut as a little voice in my head or anything, it was more a compulsion but I knew I wanted to do it and had to do it.

DS was OP (back-to-back) and had his head tilted which made pushing more difficult and took longer, 3.5hrs is definitely not the norm!

I had an overwhelming urge to push when I was fully dilated.my body just doubled up and squeezed through the contraction! I reckon my body could've done it without me doing anything iyswim? Ds I pushed for about 30 mins after 5 hours contractions, dd was 2 pushes and out after 40 mins contractions!

You shouldn't actively push until fully dilated, as it does more harm than good.

Looking back I certainly remember transition - a loss of control, panicking, swearing etc. Then a huge urge to push.

That was the best part of labour - the pain almost went away because I felt I was actually progressing and doing something positive.

It must be weird having had an epidural and not actually feeling what is going on in your body. I had very clear signals all the way through.

I got lots of encouragement to push - midwife checked DS's heartbeat and spotted it dropping with the contractions just before they found out I was fully dilated.

The midwife kept on shouting "push! push! dr's going to get the forceps because baby needs to be born, lets see if we can get the baby out before the forceps are ready!"

And there wasn't any of that little pushes to stop tearing either. More "I know it's a bit stingy, but keep pushing!"

Luckily DS started screaming the minute he was born, had an Apgar score of 9, so he was thankfully fine.
Pushing stage took 22 minutes according to my notes. Not sure if that's normal, or if I'd maybe been pushing a bit before then - midwife said my breathing was "very expulsive" before she examined me and told me to start pushing.

IME the pushing part started when I could form a mental image of ds's head moving down inside me.

The idea of 'choosing to push' or 'waiting to push' is a bit alien to me - not with ds1, because of the epidural, but with the others, I could no more 'wait' to push than I could have danced an Irish Jig at that point - was completely involuntary, and my body was going to do it whatever.

maybe I was pushing all the time, before the spinal. strange that I would not know.

i had the opposite of involuntary pushing with ds - contractions had ended and i was pushing against nothing iykwim.it was v hard to do and ended up with tears and stitches.

i can't remember at all what happened with dd at this stage as she arrived 10 mins after i walked into delivery room (mean nurse made me walk) just as her dad rushed back into the hospital.don't remember pushing at all.

Yueling - it sounds to me as if they were prepping you for CS because of the meconium.

It also sounds as if you weren't encouraged to push your baby out yourself - perhaps they were too busy prepping you. If you were on your back, you may not have felt the urge to push. As others have said, gravity really can play a part. I laboured upright and moving until 10 cm, when I felt ready to start pushing - then the waters broke and I had meconium, was transferred to another hospital and in all the chaos (and stretchered on my back) I completely lost any desire to push. Like you, I ended up with an assisted delivery.

I have always felt that there was too much interference in my case. If I had been left alone, where I was, upright, I wouldn't have been able to help but push that baby out myself. But on your back with people rushing round panicking about meconium - not conducive to allowing your body to do what it was designed for.

Do you feel the midwife let you down Yueling?

I had asked in my birthplan (homebirth) to NOT be coached to push hard, but be encouraged to breathe the baby out a bit less violently. However I was definitely told to push - I think I was even told to be angry. It seemed to take forever to get the baby around the corner and I ended up with a 3rd degree tear then a big PPH because my uterus wouldn't contract.

I do wonder if the violent, long pushing contributed to both the tearing and the knackered uterus. It wasn't what I wanted to do, but by that stage I just wanted it over so I went with it.

Bushy - on the one hand my midwife was lovely - really nice to me and pleasant - on the other I do feel like she hardly gave me any instruction. She was on attachment from the CLU (I started off in the MLU) and so was more used to consultant led births. Over 3 days I saw several midwives and in hindsight I feel lke I was left to my own devices far too much up until I was taken up to the CLU. I hadn't been internally examined for hours so had no idea how dilated I was until I got upstairs and they checked then gave me gas and air and broke my waters.

I am grateful that my baby was ok but the doctor at the birth spoke to me afterwards and said it was never an emergency situation.

I thought most women were given 1-2 hrs to push?

Mine both 'popped out' with just the sheer force of the contractions, no effort from me, but I was vertical.