Pushing
Pushing usually lasts anywhere from a half hour to two or three hours, and is different for everyone. Some women report a feeling of relief with pushing. Most women, if given patience and time, experience an “urge” to push, created by the baby pressing into a nerve called the Ferguson Plexus. For some, this urge might be mild, while others report feeling an overwhelming urge, as if they couldn't not push. Also, any anesthesia, especially an epidural, can affect this urge, diminishing it greatly or eliminating the urge altogether.
Resting Phase or Natural Alignment Plateau
Some women experience a time of either no contractions or greatly slowed and less intense contractions after they have completed dilation. During this time, a laboring woman usually becomes clear-headed again after the transition fog. If you've spent hours working hard in labor, this phase may come as a welcome reprieve. Though the rest is usually greatly appreciated, this phase also has a physiological cause. Your baby may be repositioning himself to a more favorable position in the pelvis, or molding could be occurring to help your baby maneuver the trip through the birth canal. If you are completely dilated and have been without contractions for more than twenty minutes, I may suggest that you try some different positions, but resting is fine as long as baby and mom show no distress.
Women are sometimes encouraged to push during this phase, even though they are not feeling any urge to push. If you aren't medicated, you can remind the medical staff that you wish to wait for your natural pushing urge. Pushing with no urge is not easy or pleasant, especially when compounded by the absence of contractions. Remember that at this point birth is very close! Ten centimeters does not automatically mean push, only your body can tell you when it is time to do that. You will be pushing soon enough so be thankful if you are granted one of these rests!
How to push
Even in natural births, it is not uncommon to hear the directed pushing, where numerous members of the hospital staff are chanting (or sometimes yelling) “PUSH” followed by a brief period of counting over and over. While this technique may be helpful, and even necessary, in medicated births, they are certainly not needed where mom has had no medical pain relief. I have my own version of coaching during pushing, but I promise I won't yell at you or count in your face. I've found that encouraging and reminding mom that she really does know how to give birth to her baby is most helpful during this stage.
Marathon pushing, unless there is an emergency, is unnecessary. Your eyes, veins, and blood vessels shouldn't pop out, burst, or change colors. If you're not getting enough oxygen, then your baby definitely isn't either. As your baby makes his or her way down the birth passage and to crowning, he will move down during your pushing efforts, but may slip back between pushes. Though this may be discouraging to mom, and sometimes even caregivers, it is completely normal and sometimes preferable. This out and in motion, especially as the baby is closer to and even on the perineum, helps the perineum to stretch and protect itself from tearing. It does NOT mean your baby is too big and is NEVER an indication for an episiotomy.
Please, please check out this article by Pamela Hines-Powell, CPM. She is a homebirthing midwife in Salem, Oregon. Her article is all about vertical birth and the pushing stage itself. This is one of my favorite articles about birth.
[Back to Choices]
|
