Very worried about pushing after 1st birth

[NeverGotMyPuppy]

Hi everyone
My son is a year old and we are planning number 2 quite soon. Nothing about pregnancy or labour scares me, I found labour quite exciting and feel I would be better prepared for less pleasant bits if they were to happen again (e.g. infected episiotomy). However - the pushing bit is worrying me.

With my first I was in a midwife led unit but had to be transferred due to failure to progress and meconium in my waters. I went from 7cm to 10cm in the ambulance but was then told to wait for an hour before pushing because baby was semi brow presentation. I pushed for an hour, then my contractions stopped, then I was given the drip then I pushed for another hour before I was given the episiotomy and ventouse. I've no complaints about any of it, I trusted that they would do what needed to be done.

However during pushing the midwife kept telling me that I wasn't trying hard enough, I needed to think of things that made me angry and I needed to put myself 2nd for my baby because I was a mother now. I really really tried - so much so I burst blood vessels in my eyes. I stayed calm throughout, I didnt make noise I concentrated on pushing but it just felt to fruitless- he wasnt coming out. The midwife said I needed to give 3 pushes per contraction and I just couldn't manage the 3rd. When he was weighed she said that I would never have got him out by myself.

In preparation for baby number 2 is there anything I can do to make myself better at pushing? I did quite a lot of birth prep but I always assumed pushing was just a case of going for it and clearly I didnt. The episiotomy really ruined my first couple of weeks of motherhood and it was clearly my fault so if I could avoid it 2nd time round that would be great.

Sorry for the essay and any advice would be great. I am aware, btw, that I'm not even pregnant yet and even if I do get to childbirth again I might need a c-sec etc, but this has been playing on my mind.

[KittyKel]

I’m so sorry you had an awful experience. I had the same, I was told I ‘wasn’t pushing right’. I pushed for almost 4 hours, I even started to fall asleep between contractions by the end, I was that exhausted! It turns out she had her arm stuck, there was no way I could have got her out naturally (the doctors had to yank so hard to get her out with the forceps they caused permanent nerve damage to her arm and shoulder so how could I have managed that with just my undercarriage?!) but I still feel I somehow ‘failed’ based on how I was spoken to that day.

You know your body, don’t let a bad experience undermine your confidence.

[Chocolatelover45]

Hmm I had similar, 3 people shouting at me to push, I felt an overwhelming urge NOT to push. Baby was back to back. I was on my back too. They told me baby was struggling, so had episiotomy, venture, 3Rd degree tear. Baby had apgar score of 10 so obviously not struggling that much.
Was left feeling as though should have pushed harder

[MrsCl19]

Ready your story op and others has already made me feel better!

I went in at 4, waters had gone fast contractions but only 4cm I went in the pool till 8:30 everything was so calm and got out to be checked only 5cm by this point I was knackered so had the pethidine and went from 5-10 in about an hour and half so when it came to pushing I was out of it tbf I was still sucking on gas and air and I didn't think I needed to push an hour later.... episiotomy and ventouse she arrived..

But like you the pushing bit scared me for #2 but putting it down to pethedine and aim for next time will be just gas and air

[Yummymummy2020]

Did you ever try that perinanal (totally butchered the spelling I’m sorry!) massage? Apparently it really reduces your risk of tearing and need for epistomies! Loads of places sell the oil stuff for it and I believe it works wonders!!! I’m so sorry you had such an awful experience it sounds like your midwife wasn’t very nice! I’m sure she just wanted what was best for you and baby but that’s very disheartening for you, I’m sure this labour will be lovely for you as you were so unfortunate last time with the experience!

[thesuninsagittarius]

Shocked to read some of these stories! My births are all 20+ years ago now but I do remember that the position of the baby is the important thing. It effects the urge (or not) to push, and sometimes, 'push harder' ain't going to do it and intervention is needed. DD1 was a classic posterior presentation, with the cord wrapped around her neck and arm, effectively tying her hand to her head. No one checked her position before I was induced and as a result I had a painful episiotomy and forceps which left me bruised and traumatised. Her brother was in the textbook position, head well-flexed and spine uppermost. The urge to push was overwhelming but I could FEEL him moving down as I pushed, something that just didn't happen the first time. I only pushed for 20 minutes and he was born easily. I do think there should be more checks done on the baby's position for mums today. Scan before inducing, check throughout early labour!
It's awful to read about young women like yourselves going through these things (with unsympathetic midwives) and then having to cope with physical injuries and mental trauma that could have been avoided.

[Thattwatoverthere]

I had forceps and an episiotomy with my DD after pushing very hard for a while. I struggled afterwards due to the horrific piles I got from pushing too hard and couldn't walk or sit comfortably for a good few weeks. I dont know if the epidural numbed the urge or if it just wasn't there to begin with. She was back to back with the cord around her neck so maybe as PP have said, my body knew it wasnt going to happen.
My DS was born very quickly at home and nothing on earth could stop me pushing. It was so involuntary even though I didn't know I was actually giving birth at that point. Similar sensation to being sick in a way. Very weird feeling but so much better than the first time. He was back to back also.
A debrief sounds like a good idea, mine was really helpful

[newgame989]

There’s no limit for a debrief - you can ask for a consultant review of your notes as relevant to decisions for second birth with any interval. We had an undetected cord wrap here and damage from pushing too hard, sympathies, it takes a bit of gearing up for, the second birth!

[OhTheRoses]

You are thinking about it because it is important to you. Therefore it is something you need to deal with. Get a debrief; get a plan in place op. It will be worth it. I promise you, without my dd, my life would be so much less than it is. Actually read 2nd child for dd. Remember it is the 21st Centiry and whilst childbirth will always be hard there should always be dignity.

PS dd is 21, ds is 24. His birth has never stopped being shit; hers put it into perspective and shifted the blame (for want of a better word) from me to them. The midwife was called Liz. Liz was crap, not me.

Biggest hug ever.

[NeverGotMyPuppy]

Thanks everyone. I'd like to try the midwife led unitn again anyway but could I actually request that I dont have her if I have to be transferred? I dont know why I'm thinking about this, I'm not even pregnant yet

[Sparkey47]

You’re allowed to ask for a different midwife if you feel yours isn’t going to be beneficial to your labour/birth, for whatever reason. It’s your birth after all, they’re catering to your needs!

[Vintagegoth]

Similar story with my first. Very slow second stage and pushing for over 2 hours. Had gas and air taken away as I was told I had had "too much" and was not pushing hard enough. For DD2 I did not push at all and "breathed" her out as I had torn badly with DD1 and was advised not to actively push. She came out in under 2 mins.

So much pressure is placed on labouring mothers to somehow labour "correctly". Untimately your body will do whatever it wants, you can only help it along the way.

[WhoArtinHeaven]

Oh bless you OP! The episiotomy was not your "fault", so please don't think that!

My first birth was a toned down version of yours by the sound of it. I pushed fruitlessly for around 1.5hrs and in the end needed a cut (at which point baby practically flew out). Narrowly avoided forceps. I had pushed so hard that I couldn't move without significant pain afterwards - I had strained muscles that I didn't know I had!

Consequently I was nervous for my next birth.

Honestly it could not have been more different and baby came out so easily in three or four contractions. I tore a little bit, but honestly didn't know it had happened until the midwife told me.

I panicked just before I started pushing and told midwife I wouldn't be able to do it "again" but now wrong I was!

DC2 was bigger than DC1 too.

I honestly think that everything was stretched out during first birth and so was much easier second time. DC1 was stuck in the birth canal and it was the last little bit that I couldn't quite manage. I couldn't believe how easy it was second time around, it still feels surreal now thinking about it!

I hope you have a similar experience.

[BlahBlahBlahh]

I know what you mean. I was pushing for 3 hours and I honestly didn't think I could carry on I was so exhausted

[Kittywampus]

I had my debrief when I was pregnant with dc2, the midwife said that was a common time to have one. That would have been about two and a half years later.

[NeverGotMyPuppy]

Thanks all, this has been really helpful.

I think I'm going to ask for a debrief and see if I can understand it a bit better. Does anybody know if there is a time limit? DS is just over a year old.

[GrumpiestCat]

Your midwife sounds horrendous! I reckon if your birth plan just specifies you don't want her and her pep talks anywhere near you you'll feel an awful lot more confident. You are forearmed with knowledge this time: if it's not happening you can't magically push harder. I'm sure you did nothing wrong and I think it sounds sensible to work on the things you can control and hypnobirthing was helpful for keeping calm so defo try that. Good luck OP. The first time is such a steep learning curve.

[Kittywampus]

@Magpiefeather if the midwife unit is closer to the hospital then that sounds like a good solution.

[Magpiefeather]

@Kittywampus in theory I would consider a home birth, but my big worry is we are now quite rural and 45mins to nearest hospital should it all go pear shaped....

That’s great to hear your experience. I do think the pressures of beds, numbers etc have a bearing in hospital. Which is inevitable really I suppose. I’m going to research the midwife led units/birthing centres nearby as maybe that would be a happy medium.

[Kittywampus]

@Magpiefeather would you consider a home birth this time around? I had one the second time and the midwife took a much more laid back 'watch and wait' approach, partly I suspect because there weren't the same pressures on time and beds as there would have been in the hospital.

[AnxiousFTM]

I don’t have any advice to offer you, just wanted to say that I was treated the same by my midwife telling me I wasn’t trying hard enough or doing it properly and asking why was I giving up, she was even telling me how long I had left to push before they would have to intervene. I literally couldn’t push any harder! Ended up with forceps and a bad tear (which 5 weeks later I’m still suffering with), but I can’t help feeling it’s my own fault for not pushing properly thanks to her comments! x

[OhTheRoses]

Just to reassure, dd's birth, and she was 1.5lb heavier than ds was an absolute dream. But I had insisted on consultant led care and if I wasn't to have an elcs an experienced midwife.

Can any midwives explain why the birth position cord are not more rigorously established. DS was posterior and had the cord wrapped round his neck - the midwife did not realise the position, nor did she take seriously that my baby was struggling three times. Three times his heartbeat disappeared and three times it was blamed on a faulty belt. After the third it was my husband who opened the door and belted "I want and dr in here right now". Midwife 1 arrived and hit the emergency button. The room filled. I was given one push while the surgeon prepared the forceps and hauled by two midwives onto a birthing stool. He was too far out to push back in and they had to cut the cord before he was born. Actually I did manage a super human effort and pushed him out at that point, breaking blod vessels. His apgar score was very low, he was blue and took time to resuscitate.

Neither dh nor I fully understood the extent of the trauma until dd's birth. It was not natural trauma. The midwife should have k own he was posterior, there could have been a qyick portable scan to check cord in early labour, their could have been a discussion about vaginal v caesarean in the circs, the midwife shoukd have acted on the fact the heartbeat was lost, if not the first time, certainly the second.

They weren't busy, it was Christmas day and there were more staff than women.

My advice: insist everything is checked by a doctor and be the squeaky wheel. There was no comparison between that labour and dd's.

And it is important from a resource perspective, I had to have prolapsed bladder repaired and now have a rectocele and a weak anal sphincter. Much of these later problems could be prevented by better obstetric care. If men gave birth these standards would never be tolerated.

[userabcname]

Hi OP, I don't think it was your fault at all! I had no urge to push whatsoever but was urged on by the midwife and doctor. Then they said I'd have to have intervention after 3 hours of unsuccessful pushing and I thought bugger it so pushed so hard I thought I was going to split it half (it was indescribably painful) and ended up with severe tearing that caused a pph. I don't think anyone was to blame - I think sometimes things just go wrong and thank heavens we have access to modern medicine and doctors when they do! If it's any consolation I've heard that first labours are much harder than subsequent ones as your body will know what to do next time around so hopefully it will all go much smoother for you.

[Magpiefeather]

I’m having similar fears OP.

My DD was born on a very very busy night at the hospital, so busy I later found out they closed the labour ward (after I was admitted).

They kept telling me I wasn’t dilated enough despite me using all my might to resist the urge to push. Then finally I just couldn’t help pushing, it was involuntary, them telling me not to push was like telling someone not to vomit when they’re in the throes of food poisoning or something.

Anyway they finally acknowledged that I was fully dilated and took me to delivery... as I say so busy they were still cleaning the blood off the floor from the previous birth when I was wheeled in. Finally “allowed” to push. I started trying to do what I thought my body wanted me to. After a while midwife is saying “you’re going to have to push harder than that.” “You’re hardly pushing at all”, and then “the heart beat is dropping, you’re going to have to push as hard as you can, you need to get this baby out.”

I was so desperate to avoid any further intervention that I think I took her at her word too literally and pushed with honestly all my might - dd popped out all in one go resulting in 3rd degree tear.

She was fine.

I healed well, but did have some bowel urgency issues and pain. Although this seems much better now (dd is 2.5).

We are kind-of trying for baby 2 now. And I am terrified that if I go for another vaginal birth I will do more damage and will make myself incontinent. On the other hand I have this feeling that maybe it would be different, I would feel less terrified of the physical feeling of giving birth, and I would feel more able to advocate for myself / properly listen to my body. And I feel it might be physiologically very healing if the birth went well. So I’m afraid I have no advice but I am comforted by PPs stories and experiences.

With my birth the cynic in me thinks the midwife made me push harder to get the baby out quicker so they could get the next lady in.

Midwives on the thread.... do ALL baby’s heart rates drop when they are moving down the birth canal? I’m sure I have read something to that effect somewhere.

[Kittywampus]

I had a pretty similar experience with my first baby, ending up with a forceps delivery. I thought the same as you, that my pushes weren't effective.

When I was pregnant with my second I had a birth debrief and the midwife there explained that my baby had not been correctly positioned, and the forceps had been used to turn her before pulling her out. No amount of pushing would have worked.

The second time around I felt a very clear urge to push, which I couldn't have resisted if I had wanted to. My second baby came out in a few pushes with no conscious effort involved. He was bigger than dc1 as well.

[NeverGotMyPuppy]

OhTheRoses I dodnt know you could do that - thank you