Anyone else been advised/heard about NOT actively pushing?

[lechatnoir]

I've been chatting to a really interesting MW (not mine sadly ) who works at the local birthing centre and she was saying how they now don't encourage the usual forced extreme pushing that we all know or imagine during labour as the body is actually capable of naturally pushing the baby out with contractions. The stats in her clinic for the number of women with tears/rips was astonishingly low so if she's right, why do most MW still encourage women to push the baby out with such force?

Any thoughts or comments most welcome (as I'm 1 week off my DD so could come in handy )

LCN

my 4th baby i had NO urge to push - it just did not happen..

dreaded the same with number 5 and my body did push but not the same poo styled force of the earlier ones

6th time i did do a lot of pushing and the tear was worse

I read something about this when I was pregnant with DS3 - I'll see if I can find it.

have had a look on my favourites and things - can't find it but if you google "childbirth no pushing" or something like that, there are a few website about it.

Makes sense to me as well - with DS2, I started pushing without even realising what I was doing and he popped out after 3 pushes.

Sorry I can't find the thing I had - I probably deleted it after DS3 was born!

Was told not to push with ds2 as ds1's labour had been so so fast with me getting a hideous 3rd degree tear.
I didn't push at all,he just came out with the contractions, it was all very controlled ( the whole labour lasted 25 minutes)but I still got another 3rd degree tear.

Man, I was so pissed off.

Ihave to say that my two births were very different. With dd I had an epidural and she came out back to back, so I had two hours of being yelled at to push with no real urge to. The epidural wore off for the delivery of the placenta and I suddenly understood that urge It was overwhelming, and I was being told not to push, but just couldn't stop myself. I ended up with quite a big bleed.
WIth ds, I had a natural labour and didn't really have to be told to push, or make the effort to. My body just took over, which was overwhelming. I do think it makes a great difference. With dd I had a tear that had to be stitched, and I was uncomfortbale for weeks. With ds, I delivered standing up and had a tear that needed no stitches and I felt 'normal' immediately. It did help that I had a brilliant midwife. If anyone had tried to tell me to push I think I would have kicked them hard
I understand the need to be told to push with an epidural. I do however think that the epidural dosage should maybe lowered for the second stage. Beause I hadn't 'felt' the pushing or crowning with dd I was incredibly worried about it second time round, but I didn't even feel ds crowning. My tip is to stay as upright as possible and just do whta your body is telling you to do. I remember with ds the contraction that started out normally and ended with a massive urge to push. As soon as that happens, just go with it, you'll nearly be there

Not an expert on this, but I think it would be very hard not to push at all, if you feel you need to, IYSWIM.
At one point in 2nd birth, MW told me not too push, presumably as my babies arrive pretty fast, to avoid tearing, and it was hard to manage even for a few seconds.

if you look into hypnobirthing they also suggest 'breathing' rather than 'pushing' the baby out - similar reasons to those your MW gives, that by pushing you actually tense up your fanjo so much more likely to tear (they reckon). they teach you something called the 'j' breath where you concentrate on going with the natural contractions and keeping the birth canal open.

have to admit i didn't manage to do this despite taking the classes, as was just desperate to get the baby out! my contractions had completely stopped so did it all myself just like they tell you not to. but i only had a very small tear, no trouble at all - think the perineal massage did wonders for this, recommend it if you haven't already started.

did find the J breath very useful for doing a poo after the event when everything was bloody sore and swollen tho (not a great side effect of pushing)!!! worked a treat.

with my DS2, I was keen to avoid a third CSection and the MW was happy for me to let my body do the work. Although I was pushing with each contraction it was involuntary rather than forced iyswim. Unfortunately DS2 had a huuuuge head and got stuck, so we tried some active pushing. That didn't work as I was so tired by that time so I ended up with an instrumental delivery.

the whole thing up to that point was a very nice experience.

I agree Concordia, I didn't make a choice to push, I just couldn't help it!
I had to try not to once too as MW thought all going too fast- very difficult, I didn't really manage it.

omaoma is right it is discussed in hypnobirthing, I never got that far as I ended up with emcs but would thoroughly recommend doing Hynpobirthing.

There is quite a lot of evidence in the midwifery/medical literature about externally directed pushing not being a great idea. Unfortunately it seems to take a long while for practice to catch up.

Idea of breathing baby down is to allow the natural expulsive reflex (term coined by Mechel Odent water birth advocate) to do the work while you use the exhalation to facilitate it. Just like other musclular activity if the effort is on the exhalation it is easier. So with each long exhalation you help nudge the baby down by directing the energy down and out the vagina.

Having someone else tell you when to push would be like someone telling DH 'ejaculate now! with no idea what state of arousal he was in. Only you know the sensations in your body so you know what to do. Directed pushing with epidurals is obviously a whole other matter as then you probably won't know what it going on.

The evidence is there and the proof is in the many women who have done it successfully.

I didn't actively 'push' in the sense I was making an effort to push. My mw was encouraging to go slower and hold back a bit. I didn't need to push. My body was doing the work without my conscious effort.

I had read alot about this before having my babies and was very interested.

I had also been with one of my best friends as she 'breathed her baby out' and it was a lovely birth.

However both of mine were op, and I had to do a lot of directed pushing to get the buggers out.

I didn't push with DD2, but I was 'helped' by the third degree tear and 2nd degree tear I had had with my first two. I was quite scared of the pushing.

But I stood up for the whole birth, and used a hypnobirthing CD and though I felt the urge to push, it was really a matter of breathing the baby out. When I only had a graze I was absolutely delighted.

Not so delighted with the retained placenta that followed ...

I had only read about the breathing thing on MN about 24 hours before DD2 was born so it didn't involve any extra prep iyswim.

I'm studying hypnobirthing for my second birth and it makes absolute sense to me to let the body do the work.

with DC1 the urge to push was almost satisfying and deeply powerful, similar to the end of a bout of constipation IYSWIM . At crowning my MW asked me to blow out hard as if blowing out a big birthday cake. This was just to direct that powerful pushing energy somewhere else I think and DS emerged by himself it seemed. I have also used this technique on the loo since!

follow the urges of the body and you can't go far wrong IMO. No need for rushing or straining at all unless there is some special circumstance.

I didn't push with my third - the thought of reopening my 3rd degree tear helped!

I was on my side and my body pushed her out. It was all very calm and I only had a graze despite the fact that she was 9'5.