Why are you NOT supposed to start pushing when you want to?

[LuLuBaihasbeenagoodgirl]

I've (hopefully) got months before I have to put this into practice, but I was just thinking about jotting down some notes for my birth plan.

WIth DD I did push when I felt like I needed to (I just didn't tell anyone) but I know you aren't supposed to until they tell you to.

But surely you should just trust your body to do what it needs to?

What is the science behind the idea that you shouldn't push?

[jadey24]

When i had my dd ( first child) i expected clear instructions on when to push etc. I was my sister's birthing partner before i fell pregnant and they told her what to do throughout. When i went into labour i was told nothing. And when i started to push i didnt know thats what i was doing at first untill they said oh she is pushing nw lol and just left to me to my own devices & let me do as i pleased.

At first i pushed when i had the urge but after 3 hours of pushing i had enough and when i got the urge and it passed i would just force push a little more but couldnt too much. I did end up with a 2nd degree tear but i prob would anyway. I wouldnt advise it lol coz it hurts more too & yeh i think it can deffo increase risk of tearing.

[StarlightWonderStarlightBright]

No downbutnotout I was aiming for a homebirth initially , but when I realised that neither I or my dH had any confidence in the homebirth team, and when they starting to get heavy about what ws allowed or not, I phoned the Edgeware Birth Centre and talked through my birth plan. They implied that some things were a little unusual but not at all radical and agreed to support it, so I gave birth there.

The best bit was that I was so confident in where I was giving birth and not at all nervous about going in, it made the labour very relaxing before I even set off. So much so I was dozing between contractions to the lull of the car engine and gave birth jus after 90 mins of arriving.

The MW commented that I had a high pain threshold, but that is nonsense because I was begging for an epidural or a gun at just 2cm with my first.

When are you due?

[downbutnotout]

Oh, I dream of being able to do that, starlight. Was it a home birth?

[StarlightWonderStarlightBright]

The second by far! I felt in control, had personal space, no-one was talking to me, distracting me or moving me around. I was MUCH more comfortable, and I followed my body to find the best position to deliver in. I DID have a MW by the way, but she was just sitting on a stool in the corner watching.

[downbutnotout]

Hi starlight - which was better?

[StarlightWonderStarlightBright]

I was made to push with no urge, directed by the midwives. Contractions waned. It took 3 hours. I got 2nd degree tear.

I was left completely alone with no guidance or anyone touching me for DC2. Pushed when I felt like it. 20mins. I got a 2nd degree tear.

[gabygirl]

downbutnotout - I find it amazing that people like me who are just birth enthusiasts and trainee doulas are aware of the recommendation that a mum be left for a reasonable length of time before being encouraged to push, once full dilatation has been reached, but that there are midwives out there who aren't aware of it. I mean - do they not read the NICE guidelines, midwifery journals etc? Same with the issue of valsalva pushing (when the midwife directs the mother to hold her breath while pushing long and hard during a contraction in second stage). It's not recommended as standard practice, but there are a good number of midwives at our local hospital who are still doing it routinely . I can only assume they haven't bothered to read anything since completing their training 20 years ago, and some of them are such old dragons that I can't imagine a student questioning their practice.

[downbutnotout]

I had the opposite problem - my NHS midwives insisted that I push when I had absolutely no urge to do so. It had no effect, I got demoralised, my contractions started to fade and I ended up being transferred to hospital by ambulance where I delivered normally anyway. What a waste and what a shame I missed out on my home birth - won't be allowed one with current pg as the baby has an anomaly. But this time I will be fully prepared to tell the midwives what they can do with their suggestions if I'm not ready!!

[gabygirl]

My understanding is that this is one of those issues that well educated midwives the world over debate endlessly!

There's a school of thought that some of the difficulties caused by premature pushing (exhaustion, cervical oedema) are linked to women with malpositioned babies sitting on their arses and lying down during labour, so that the presenting part is pressing on the part of the vagina that triggers the pushing reflex. Some midwives feel that women who are allowed TRUE freedom of movement in labour and who are allowed to just go with what their bodies are telling them to do are unlikely to push on an undilated cervix in such a way as to cause cervical oedema, if they are pushing spontaneously, and that doing a VE to confirm dilatation can interfere in the normal physiological process by interrupting the hormonal 'dance' at a very crucial point in the labour.

Ketal - women died in childbirth over the centuries for all sorts of reasons: the main one being that they caught infections from people with unwashed hands inserting them into their vaginas during the birth process! Also from pre-existing illness, placenta praevia and from obstructed labour caused by rickets in childhood. I've had a look at a document which showed the records of births kept by a very busy 18th century midwife, and the maternal mortality rate was much lower than you'd think. Healthy women having a single baby rarely died in labour.

[ketal]

I was told to do what my body felt like doing. I felt like pushing, so I did (I had a waterbirth, on all fours, so doing all the right things...) but obviously my body told me to do the wrong things, as I ended up with a bad third degree tear (almost 4th) and am still having physio two years on.

I don't believe in "your body will get it right" - if that was true, people wouldn't tear and why have so many women died over the cernturies from childbirth?

[LuLuBaihasbeenagoodgirl]

Wow - thanks everyone. Very interesting info on that site LuLumama posted.

[StarlightWonderStarlightBright]

My midwife kept 6 ft away from me at all times (except for taking bloodpressure and one feel of my tummy).

She kept quite during the 2nd stage as requested, although she did once say 'in a minute it will sting like hell' which it never did

[littleboyblue]

I started pushing at 8cm, they told me I should wait until I was 10, but I figured by body knows what it needs to do, so when it told me to push, I pushed. Did have a 2nd degree tear though.

[pinkmalibu]

When i had my DS i went from 4cm to 10 in 3 hours and was only checked when i first got to the delivery room. I think your body does tell you when your ready to push, as it an urge you can't easily hold back. And i was told to push if i felt i needed to! I ended up having a vontouse delivery and didn't need stitches because i breathed through the whole thing! (ante-natal yoga def helped)

I think it's only a rough guess with the 10cm thing and it's more about how the cervix feels to the midwife. They can feel if one part hasn't fully dilated.

xx

[Andthentherewerethree]

the majority of tiem a m/w asks you not pusdh until full dilatation is confirmed is due to the possibility of their being an anterior lip and if you push this casue its to swell. so a change of position can be advised to try and alleviate the pressure to push, also sometimes labouring women get the urge to push if their baby is not in an ideal position such as posterior then they feel pressure and want to push but it is actually the baby casuign the pressure and not being fully dilated.

if fully dilated and you have the urge to push and do push the m/w can usually tell very quickly if your urges are correct, there are lots of external signs for them to watch out for and that you will show.

i think its mary cronk who really beleives in the purple line, i have seen it a few times but for soem women, easing apart their buttocks to look for a purple line feels more invasive than a ve! oh could be gaskill, actually not cronk.

The problem that occurs mostly now is midwives aren;t getting to spend enough time with their 'clients' in labour and don;t get to learn their ways of coping and watching how the womansd behaviour changes as it differs for each woman. This is a very sad but true fact.

i truly beleive m/w in the majority are thier to help and enjoy their work and are all for empowering women to trust thier instincts and being an advocate and providing women with information to make thier own decisions, but unfortunatley the press and many peoepls birth stories only highlight the neagtive side of midwifery.

I wish you a successful and pleasing birth experience though op.

[Lulumama]

you can learn an awful lot from an experienced midwife who looks at the labouring woman, and really sees/hears what is going on.

[thisisyesterday]

ooh that purple line sounds weird! I had one VE, which was when the first midwife came out to assess me. I was 8cm already, cue mad rush to get a second one.

so I guess they knew it wouldn't be long until I was 10cm anyway
they also mentioned the changing shape of bump as well, to indicate that delivery was imminent

[Lulumama]

www.gentlebirth.org/archives/birth.html#Dilation this is interesting, i saw the purple line described in my first client, and reckoned she was 5 cm, the MW examined her shortly after and she was 6, so i felt

the sounds you make too are a big sign, if you google it , there is lots of interesting info and stuff about VEs and the need/or not for them.

[thisisyesterday]

there are other visual and audible clues that a labouring woman is ready to push, not just a VE

what are these lulumama? I guess I must've been doing them? lol

I was really impressed with my midwives, I have to say. and afterwards when they were writing in my notes one of them was like "was she 10cm?" and the other one was just like, "well, we didn't check, so let's just put that she was" lol

[Lulumama]

if you are having an unmedicated labour and are very much following your body's cues, you can labour at your own pace and push when you get the urge.

sometimes, women can get the urge to push before the cervix is fully dilated and pushing on a not fully dilated cervix can lead to the cervix swelling . often it will just be a little bit of cervix, an anterior lip, and getting into the knee -chest postion can relieve pressure off the cervix and reduce the urge to push. certain breathing excercises can help you resist the urge to push if you are not quite dilated enough

that makes it very difficult for the baby to descend and for labour to carry on progressing

there are other visual and audible clues that a labouring woman is ready to push, not just a VE.

you should try to avoid pushing hard and uncontollably as the head is crowning to avoid tearing.

[TattyCatty]

I was told that even though I was fully dilated and had a huge urge to push that I still had quite a large rim of cervix and that trying to push would make it swollen and harder still to get baby out. DD was OP (back to back), so I had huge urges to push for about the last 2 or 3 hours of my labour but wasn't "allowed" to as I wasn't actually ready - it was the pressure of DD in my back that was actually giving me the urges.

[keels26]

Watched a birthing programme and am sure it said not too push until fully dialated because you can make the cervix swollen or something like that.

[thisisyesterday]

ahh yeah they prob thought you hadn't dilated enough then.

[thisisyesterday]

givethedog... did they say why?