Wednesday, 4 January 2012

To push or not to push...that is the question

Attended a lovely birth on New Years Day. In hospital, so I was unable to 'catch' the baby but was able to support my client and her partner throughout. Labour was induced for medical reasons and strong regular contractions quickly ensued. After a short while my client said she wanted to push and it became apparent that she was in second stage of labour. She was told by the hospital midwife not to push but to breathe through the contractions. She started pushing anyway and a lovely healthy baby born shortly afterwards.

This had made me think about lot of issues surrounding the issue of pushing.

Firstly, why women are so often not believed when they say they want to push? I have heard that story too often, even with a woman who have had babies before and the head is visible! Whether the urge signals the second stage of labour or not, being told to suppress those feelings and fight them is counterproductive. Just acknowledging that a woman has those feelings can help her by demonstrating that we believe her and trust in the normal physiology of birth.

Secondly, If a woman's cervix is fully dilated and her baby is moving down the birth canal then she is in second stage of labour and her baby will soon be born. Fantastic! So why tell her not to push for heaven's sake!

And thirdly, if her cervix is not fully dilated there isnt any compelling evidence from research that this will cause a woman or her baby harm.In fact early urges to push are common and in some labours may encourage baby into more a favourable position for birth.

Lastly, women's urges often ebb and flow. So encouraging them to be instinctive and push as they feel inclined will almost always result in strong overwhelming expulsive urges only when baby is well down in the birth canal and about to be born.

So I for one will always believe a woman when she says she wants to push and continue to tell her to do just what she feels she needs to do.

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