Natural Birth

XP: I've got some tips for labor and pushing!

I watched my video from my first pregnancy last night.  I had a friend film the entire thing, but she left all body parts out of it so it's PG.  I got some ideas for how to do things a little better this time and thought I'd share.  I had a natural delivery so most (but not all) of this applies to those not getting epidurals.

1.   Once you hit transition and get towards the end of labor you tune out the entire world.  My nurse in the delivery room would give me instructions and after repeating herself 5 times, I still don't remember her ever saying that to me.  Tell your husband to repeat only necessary instructions to you.  Tell him that "his voice is probably the only voice you will hear, so if the nurse is saying something important please repeat it to me."  Also, it's best if people give you instructions just after a contraction has finished.  During a contraction you are in too much pain to hear anything, and between contractions you may fall asleep (believe it or not, I did).

2.  If you plan to use the birthing bar and sit in a squatting position, make sure to elevate the head of the bed to help you into the squatting position.  You will waste too much energy pulling yourself up.  I LOVED the birthing bar.  It felt like holding on to a roller coaster bar...and labor is a lot like a roller coaster ride.  I believe you can use it with an epidural too, modified to keep your body supported and help baby down the birth canal.

3.  When you start pushing and they have you do the "count to 10" routine, make sure that your pauses between counts are very minimal...ride out the entire contraction.  So it's "1,2,3....10" quick breath, "1,2,3...10" quick breath, "1,2,3...10" until the contraction subsides.  Do not take a break or lie back down.  I found this to be the most effective and produce the quickest results. 

4.  When you get to the pushing phase they will keep telling you to let the contraction peak.  Well, it's really hard to tell when it's peaked while laboring...you just want to start pushing once the contraction starts.  Ask hubby, or your nurse to let you know when it's peaked based on the monitor...or just go with it when you feel the overwhelming sensation to push.

HTH and wishing you all a fast and safe delivery.  Feel free to add to the list.

On a side note, I thought it was really funny that DH would wipe my face down with a cool rag, then quickly give me a drink of water in between contractions.  I looked like a boxer getting ready to get back in the ring, only he was the one getting punched, LOL.
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Re: XP: I've got some tips for labor and pushing!

  • image Mr. & Mrs. RN:

    3.  When you start pushing and they have you do the "count to 10" routine, make sure that your pauses between counts are very minimal...ride out the entire contraction.  So it's "1,2,3....10" quick breath, "1,2,3...10" quick breath, "1,2,3...10" until the contraction subsides.  Do not take a break or lie back down.  I found this to be the most effective and produce the quickest results. 

    Or you could just not do the counting thing at and push when your body tells you to push. 


    Lilypie - (ZESJ)Lilypie - (QAi1)

  • image Mr. & Mrs. RN:

    3.  When you start pushing and they have you do the "count to 10" routine, make sure that your pauses between counts are very minimal...ride out the entire contraction.  So it's "1,2,3....10" quick breath, "1,2,3...10" quick breath, "1,2,3...10" until the contraction subsides.  Do not take a break or lie back down.  I found this to be the most effective and produce the quickest results. 

    4.  When you get to the pushing phase they will keep telling you to let the contraction peak.  Well, it's really hard to tell when it's peaked while laboring...you just want to start pushing once the contraction starts.  Ask hubby, or your nurse to let you know when it's peaked based on the monitor...or just go with it when you feel the overwhelming sensation to push.

    Sorry but I don't agree with these 2 points.  Self-determined pushing is a great option that not enough women are informed of, and there are studies showing it is better for the baby too.  Except in a few circumstances, listening to your body and pushing when it feels right is a much better way to go than relying on someone counting or on what a monitor says.

    On a personal anecdotal level, I hated the count to 10 thing when I was laboring with my daughter.  I felt like I was suffocating.  I don't think it's a coincidence that when I felt like that, she started to pass meconium.  After all, if I felt like I wasn't getting enough oxygen, she probably did too.  And the meconium was a big factor in my OB deciding I needed a cesarean.  So I've often wondered if I would have had a vaginal delivery if I had pushed the way it felt right instead of letting them direct me, even when it felt very wrong. In fact, directed pushing has been linked to higher rates of meconium and lower fetal oxygen levels.

    But thank you for sharing your experiences. :)

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  • Hm, I guess I don't really understand your point because I felt like pushing the entire time I was contracting.  The first few times of pushing I would take a break in between pushes and the baby would slide right back in to where it was...which is why I think it's important to push through the entire contraction.  I did not do any pushing while there was no contraction.  The hard part for me was trying NOT to push when I felt I needed to.  The nurse did not want me pushing because I wasn't complete (10 cm), or because she wanted me to wait for the contraction to peak before pushing.  At no point did I push if I didn't feel the need to. 


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  • image Mr. & Mrs. RN:

    Hm, I guess I don't really understand your point because I felt like pushing the entire time I was contracting.  The first few times of pushing I would take a break in between pushes and the baby would slide right back in to where it was...which is why I think it's important to push through the entire contraction.  I did not do any pushing while there was no contraction.  The hard part for me was trying NOT to push when I felt I needed to.  The nurse did not want me pushing because I wasn't complete (10 cm), or because she wanted me to wait for the contraction to peak before pushing.  At no point did I push if I didn't feel the need to. 


    It's normal for the baby to slip back in between pushes.  Pushing a baby down is often like 2 steps forward, 1 step back.  It may not have been the case in your labor, but many hospitals will have women push even when they have no urge, as long as they are 10 cm--that was certainly the case for my first delivery.  I'm not sure that it's evidence-based to tell a woman she has to wait for the peak of a contraction to push or for an unmedicated woman to wait until 10 cm if she has the urge earlier.  But it goes beyond just whether a woman has the urge or not.  The way she is bearing down and breathing during pushing, urge or not, can affect the oxygen levels reaching the baby and her chances of damaging her pelvic floor and perineum.

    Directed pushing may shorten the pushing phase but except for a small number of situations (strong epidural or distressed baby for example), there is no evidence that this actually results in healthier mothers or babies.  And there is evidence that it may result in more harm, such as fetal distress, and an increased risk of perineal and pelvic floor damage for the mother, as well as maternal exhaustion.  This is the point that pinksweetpea and I were making.

    Here's some links about this:

    http://www.medscape.com/viewarticle/558117_4

    http://www.ncbi.nlm.nih.gov/pubmed/18307484

    http://onlinelibrary.wiley.com/doi/10.1111/j.0730-7659.2006.00085.x/full

     

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