Push It!
We often get questions about pushing from soon to be parents. Especially from parents who have not had a vaginal birth previously. Hollywood makes pushing out to seem like it’s one and done, and your friends might tell you about how they pushed for hours. Either way, it sounds intimidating!
Image used under Creative Commons Licensing.
During your prenatals or birth planning meetings, we will talk about positions you can push in, as well as the different types of pushing. It is important to remember that sometimes the best laid plans end up taking an unexpected path. Your plans for pushing may change due to concerns about your health, or the health of your baby. During pushing, both you and the baby will be closely monitored to ensure that both of you are tolerating this stage of labour well.
Let’s talk about the different kinds of pushing:
Coached pushing:
This is what you most often see and hear about. A nurse will tell you to put your hands behind your knees, tuck your chin to your chest, curl up, pull back, hold your breath and PUSH. She will count from one to ten. Then she will tell you to take a quick breath and repeat. This will happen several times, the aim to get three to four good, strong pushes during each contraction.
There are pros and cons to this method.
It is often very helpful for women who have had an epidural and are still relatively numb. It can be difficult to engage the correct muscles when you cannot feel the contraction, and someone directing you can be exactly what you need. Coached pushing can also be essential if you or the baby are struggling. Medical urgency always takes precedence over preference during the pushing stage of labour.
Some women find coached pushing particularly difficult, even with an epidural. Women who find it difficult to hold their breath while pushing, especially if they have asthma, can struggle with this aspect. It also means a decrease in oxygen to your baby; if you aren’t breathing, neither is he. Coached pushing can also, in some cases, cause damage to your pelvic floor. This can cause trouble after pregnancy with incontinence, prolapse, and future pregnancies.
Physiologic Pushing:
Physiologic pushing is pushing when and how you feel the urge to. This can be done with an epidural, but you might want to have the medication dose turned off or down so that you can feel the contractions you are trying to push with. This pushing can take any form, including holding your breath, but it is done on your terms.
This type of pushing can result in less significant tears to the perineum as you can feel the tissue stretch and instinctively hold back, allowing the stretch to occur. Waiting for an overwhelming urge to push can also reduce how long this stage of labour lasts, as the baby has been “laboured down”.
Physiologic pushing is not always the way to go. When a baby is in distress or the pregnant women is still completely numb from the epidural, this type of pushing may not be safe or effective.
No matter how you want to push, or how you end up pushing during labour, you will soon be meeting your baby! For more information about pushing, position, labour or doula support, email us at hello@torontofamilydoulas.com to arrange for a doula consultation or birth planning session!