Pushing During Birth ? When, where and how?
Ok, so confession time. When I was pregnant with my first baby I assumed “pushing” was just a part of birth and you couldn’t go wrong. Now technically, you can’t go wrong but I probably would have still assumed my midwife knew more about pushing than I did. I now know that in fact, some women don’t push AT ALL and I know more about pushing a baby out of my body than anyone else on the planet! And actually there may be complications if you hand over the pushing to the midwife.
There is a few ways “pushing’ is talked about. It’s handy to know the difference and the meanings.
This type of pushing occurs when the mother is coached or instructed when to push. This type of pushing occurs more than you think and while we are very used to seeing women doing this in movies there is an actual downside to pushing.
Firstly, to be instructed to do anything you’ll be required to pay attention and follow the directions of the health provider. A lot of women are completely zoned out for labour so it would be difficult for them to leave their “labour land” to come back to being spoken to and expected to complete tasks.
Secondly, the person instructing you to push will most likely be in close proximity to your vagina so it could be that your support person would need to stand aside.
Lastly, Enthusiastic directions from your care provider may well turn in to a group effort with everyone in the room encouraging you to “PUUUSSSHHHHH”
Coached pushing can cause undue stress on your baby, increase your risk of perineal tearing and pelvic trauma. It might mean you’ll be told to push when you don’t feel like pushing.
This might be the most familiar to you because its generally how birth is depicted on the television. The WHO recommended on removing coached pushing from practice in 2003 although its still common.
There is however times when direction on pushing is necessary in cases like shoulder dystocia. Directed pushing is an intervention and may be required if a mother has an epidural. But in normal birthing you don’t need to be told how to push, your body already knows how to do that. Add “No Coached Pushing” to your Birth Plan to avoid it.
This type of pushing is where the mother pushes when she feels like pushing. It is led by the mother. She follows the urges of body and bears down into them to push her baby out. The length of time you would push for is different for everyone but some women report to push 2 or 3 times and the baby is birthed where as other mothers work for longer to move baby down and out. Each “push” can last for 5-7 seconds. If you want to ensure you have this opportunity its best to write “NO COACHED PUSHING’ on your birth plan. Remember that your body knows what to do, tune in to your body and follow it’s lead.
Foetal Ejection Reflex FER
This is a physiological response from your body without the need to push. Mothers may experience this in any birth setting and it is often preceded with a urgent urge to move, change positions, go to the toilet or stop what they are doing. FER has been seen to follow a pause in labour where mother rests prior. with a moment of Your body moves the baby down and out of the birth canal without pushing efforts from the mother. For FER to occur the mother must feel safe and supported without disturbances. Physiological birth is easily disturbed with noise, bright lights and unfamilar enviroments.
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