This birth story exemplifies how a good birth can change and become stressful during the pushing stage, if care providers insist on purple pushing. Mother directed pushing is much gentler and frankly most un-medicated moms do not need any direction in how to push. Their bodies know what to do! We need to get out of their way and let them do what feels right.
What is Mother Directed Pushing?
If the mom is ok and baby is ok, there isn’t a rush to get the baby out. Letting the mother push in a way that feels right for her is better for her and the baby. Some moms AHHHH or grunt the baby out. Some moms sing the baby out. Some might hold their breath and push on their own, but usually not for the duration that they are coached during “purple pushing”
I have seen moms told to “WAIT, don’t push” when the OB isn’t there yet. Waiting for up to 20 minutes fighting that urge to push. Then the OB gets there and suddenly the atmosphere changes. “PUSH, PUSH, PUSH!” After patiently waiting for the OB to arrive, suddenly we are on the clock and everyone is in a hurry to get the baby out. I understand that the OBs may have other patients waiting or other pressing needs. But respect the mom and baby.
I try to remind moms to push how they want. But it is hard when everyone is yelling at you. Sometimes moms get worried that something is wrong and that fear doesn’t help. Also moms are very suggestible while in their birthing time. Even if someone isn’t yelling. I remember when I was pushing Bryson out, the nurse said to me “If you hold your breath and push really hard, he will come out with your next push.” I then worried that he needed to get out on the next push and I did what she said. I had been doing it my own way and had been pushing less than 10 minutes. I did tear and I wonder if I had been able to keep pushing my own way, if that would have been better.
Talk to your OB about pushing in a mother directed fashion. Add it to your birth plan, have your birth partner remind the nurse and the care provider before you start pushing. If they are yelling at you, ask, “Is Mom Ok? Is Baby OK?” If the answer is yes, “Stop Yelling” is a fine response!
I can relate to your reference to being directed to push your baby out. With my first (and only!) hospital birth, the midwife told me to give her two really good pushes and it would be over (I had labored prodromally for 2 days by then–very exhausted). Like you, I tore, and though it was only a 2nd degree tear, it was extensive (went deep into the birth canal) and there were many skid marks to boot.
With my second and third (home) births, I did not push my babies out. In fact, my midwife directed me to *stop* pushing when the head crowned. I tore very minimally (no stitches, healed within days) with both of those births.
No more pushing my babies out! I don’t mind waiting another 5 minutes if it means an intact peranium, thank you!
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