Panic about pushing baby out! Any sage advice?

[pinkmama]

Hi. 35 weeks with 3rd baby. I have large babies, and with rather unfortunate large heads (please let this one have my head and not dh's). Anyway, dd (1st baby) got her head stuck, was trying to come out ear first, ended up in emergency section. DS 1 managed to get out, after 2 hour first stage but 2 hours of pushing, and with the aid of ventouse (suppose he was technically my first vaginal birth). Hoping to have this one at home, mw supportive, all well so far. However I am obviously not that great at pushing! Everyone assures me that this time round, because I have done it once, it will be easier. I realise I will ahve to go to hospital if I get stuck, which I am prepared for, but would really, obviously, rather not! What, if anything, can I do to maximise my ability to push better?

i know whayt you need.
firstly, an epidural so that you can't feel a bloody thing.
then a midwife who keeps saying
"PUSH... No, not like that... INTO YOUR BOTTOM"

i found that really helpful. NOT.

i actually have no idea... i ended up with ventouse as i am also crap at pushing!

Pink I have large babies with big heads too. All I can say is that my first delivery was difficult (9lb 9oz, induced and monitored throughout, unable to move much and ventouse yanked him out - this was the last chance before section - I was on the table ready to be 'done').

Second baby was 9lb 13 and she was easy peasy - partly because she was the second - I think it's right that it's easier after one vaginal birth - and I stayed upright during the whole labour, moving around for a lot of it and gave birth on knees holding on to the head of the bed. So gravity is my top tip.

Good luck - I would try a home birth if I ever did it again.

I had to be continously monitored with 1st because waters went with muconium (?sp) in them, and it was awful, couldnt cope with the pain, ended up with epidural, which seemed to trigger a load of unfortunate events. They tried ventouse with her but she was quite distressed by then. She was 9 11lb. Ds though was 3 weeks earlier and much smaller at 8 9lb. I think it helped as you say puddle with staying upright, I found it easier to manage, and I had no time for any pain relief other than gas and air. However right towards the end they got me to lie down to examine me and I got stuck on my back which I guess didnt help the pushing. This time dh has got strict instructions to keep me upright at all costs.

ds1 was 9lb 13, had huge episiotomy as i had been pushing about 2 hours. ds2 was 8lb 7 tried not to push cos mw was gonna cut me, but contraction pushed him out and i tore. ds3 was 9lb 6, in the birth pool. i got a yoga video and they recommended relaxing when doing pelvic floor exercises rather than just tightening and then when you get to the pushing stage, just relax and as long as your muscles arent all tight the contraction will push the baby most of the way out. i had to do a bit of pushing, but most of the time i relaxed and concentrated on letting my muscles go as loose as possible. it helps not to scream at the same time (easier said than done!), just breathe quietly, let all your muscles relax and you do far less work and get far less tired. hope it goes well, third babies are lots easier anyway

Know all about pushing big babies (9 and a half pounder, DD2) and had to cancel home birth plans at the end of pushing for an hour as she was well and truly stuck. Therefore, can empathise with your concern. Still would go for home birth again though as it kept me more relaxed and in control.
I guess it is not just in the pushing but in the relaxing and allowing your body to "open up" IYKWIM. Discuss your concerns with your mw and work out a plan for which positions will help the baby drop down more naturally - ie all those squat ones and the sitting on the loo to open your pelvis up ones. Ask your mw what will happen if you do get stuck so that you know your worst case scenario has a plan of action. Will they offer ventouse at a home birth for you? (mine did but decided baby in wrong position and well and truly jammed in there!).
Also - worth remembering in the early stages to reserve as much energy as possible and sleep/rest etc. so that you are prepared for the hard work at the end? plenty of mars bars!!!

crossed posts with gigglingoblin - agree with her

Thats interesting about the relaxing at contractions, and must be hard, guess your bodys instinct is to tense up, but it does make sense.

Midwife is coming around in couple of weeks to go through the homebirth with me so will talk about concerns with her. I dont think they offer ventouse at home here.

I hope to add a little comfort -

ds1 was born after induction after a particularly long hard labour (8lb 7oz) on the bed with epidural which didn't work etc etc.

ds2 was born after a day of mild contractions but only bad for a few hours (was born after an hour in hopsital! (8lb 12oz)

ds3 was born after induction after an hour of mild contractions and an hour of not so nice contraction STANDING UP (RECOMMENDED) and he was 11lb 30z.

So, hopefully like me, it will be easier this time, your body will hopefully kick into gear and know what to do. All of mine were late but waiting for ds3 to come seemed a lifetime. A midwife told me that third babies often take their time coming but when they come they come quickly - well I'm proof that this is obviously sometimes the case!!!!!!!!

All the best and hopefully you have a smooth labour.

11lb 3oz!!!!!!!!! OMG, good job I am sitting down! I saw consultant on Wednesday who when asked about size of baby she said it was on track, dh said, yes, but on track for what? She has large babies, and she laughed and said yes she does, its on track! I was hoping not to go over 10lb. DD was late and ds was 2 weeks early, so hoping this one follows the earlier rather than later pattern. Cant beleive that leap in baby size. Did you tear if you dont mind me askign?

No - no tears!!!!!!!!! Mind you looking at the size of me I was expecting him to be smaller than the other two.

I know I said I hope to add comfort - it sounds a frightening size but he it honestly was an easy birth (again I reiterate the gravity of standing was just fab) and some gas and air to cling to for dear life of course. oh and a fab midwife who didn't hassle me to push or anything, told me to go with what my body was telling me!!!!!!!

It does sound frightening. I have never had a small baby to compare, but I have heard people say bigger babies are easier to push as you have more weight to push against. Highly impressive weight though!

LOL hes remained big (now 10m) and is on the top line for weight and height so all in proportion but in age 1 and a half to 2y clothes! He gorgeous but heavy LOL.

PINKMAMA - I do hope I have given you greater concern, that wasn't the aim, I was just telling you that even though some babies get bigger each time it doesn't naturally follow that the labour will be harder. Sorry if I have frightened you! or anyone else pregnant at this time.

Pink - notoriously hard for docs and midwives to predict size - you know that don't you? Lots of threads on here on this. When DD came out even midwife said, oh she's a slmall one, not like your first. None of us could believe it when they weighed her. My second was bigger and labour great - 5 hours start to finish on gas and air.

No Sax, you havent panicked me, dont worry! It was quite reasuring to know that even big babies can come out relatively easily so I took it positively.

I know puddle, with dd they told me she was big and she was, with ds had scan 2 days before he was born and was told he was 7lb, 2 days later he appeared weighing 8lb 9, so not taking it too seriously. Would personally be suprised if I produced a small baby simply because I obviosuly have propensity to grow them quite big. And lets face it, theres nothing I can do about either way. Considered using crack cocaine throughout pregnancy to keep weight down , but having failed to take that up will ahve to put up with whatever comes!

i had a nightmare with dd1 too to get her out. so i was determined not to let dd2 go through the same trauma.

1 - do not lie on the bed. stand up or go on all fours (very undignified but is so much better) i stood up and leaned against the wall

2 - push like you are doing a poo

worked for me anyway

loads of luck and dont worry

ps both times i only had gas and air and some diamorphine, so the pain wasnt too bad

I would recommend sports drinks to give you a bit of extra energy if it goes on for longer than an hour. And I agree that being upright or squatting helps them to come out.

You could practice squatting, it is supposed to get the baby in the right position if you do it for a couple of mins three times a day for the last month. You do need thighs of steel though.

Hi Pink

I had my dd by waterbirth and was very relaxed - I definitely agree about the letting your body open up thing. I only pushed for 20 mins and out she shot, into the pool like a dolphin!! It felt like pushing for a poo (sorry!). (even though she was less than 7lbs I still ended up tearing, so I think I pushed a bit too hard)

I found being upright helped lots : kneeling into the sofa, then leaning back to kneel up just before she crowned. Also I visualised the pain as a long black tunnel that I had to go into to get the baby out, so I sort of welcomed the pain and encouraged myself to experience it more, rather than holding back from it in any way.

I also chanted a sort of mantra "open up, like a flower" and visualised my cervix opening as much as I could in the first stage.

Hope that helps.

i thought of some more good advice. come out with us and eat cake

Have no experience of pushing out a big baby DD hurt enough and she was ony 6lbs, it was a relief to push though like the end was near I knew if I pushed hard the pain would stop soon.

Would echo the push like you are doing the biggest poo of your life (sorry but thats what it feels like)

haven't read whole thread so soz if repeating: It is soooo like having the world's most enormous poo!!!! I was so surprised by that; no-one told me so I was horrified and squeaked that I was about to do a poo (mortified) and midwife zoomed into action explaining that the poo feeling was my babs about to make his presence felt!

I took raspberry leaf tea supplements from 34 weeks, they're meant to aid muscles to stretch without tearing. Consultant obs/ gyn said to go for it: 'anything that'll help.'

They worked for me, DS was 7lb 8oz and I was intact with some grazing! I don't think it was anything else IYSWIM!

i know someone who swore by doing squats - all her babies were over 9lb and she never had stitches (tho might be a bit difficult with a 35 week bump)