spontaneous pushing?

margaritachikita · February 2013

Did anyone do spontaneous pushing? I had a baby girl last May, and for pushing I was in the standard, on the back, legs being held up, push for 10-count position. I did have a drug-free birth, and felt great about the whole experience except for the pushing portion. I had read that pushing "felt good" (because you are actually doing something), but to me, it was the most painful and hardest part. I felt very out of control because the doctor, nurses, DH, and my doula were all telling me what to do. I never got that overwhelming "urge" to push that i had read and heard about. still, i only pushed for about half an hour, so the outcome was good, i just didn't like the helpless feeling i had during that time.

Anyway I was just wondering if anyone has done "spontaneous pushing", and if so, what that entailed. Did you have help? Did someone suggest to you when/how to push or for how long? Or did you just do whatever you felt like doing? I feel like i would be scared to not have any kind of help, because i know how out of my mind i was at that point, but i was just wondering if it is possible to push the baby out without all that instruction.

tokenhoser · February 2013

Well, I don't need coaching to take a poop. Similarly, I didn't need coaching to push out the baby. I pushed when I felt like I HAD to push. No one told me when or how long to push. How would they know? The idea of someone telling me how to push just seemed like it would have totally p*ssed me off.

hilwithonelary · February 2013

I was medicated and did coached pushing with DS. I went med free and did spontaneous pushing with DD. while pushing was very intense, I'm glad I did spontaneous pushing. I did try to follow the pushing instructions from Bradley class, but it still felt very instinctual and natural. Your body definitely knows what to do. I did feel out of control and lost focus a few times, but DH and my midwife were very good and calming me and helping me refocus without any yelling, "Push!" or counting.

ETA: Just because you've reached 10 cm doesn't mean you HAVE to start pushing. There's no harm in waiting until you have the urge as long as you and baby are doing fine.

amberthehobbit · February 2013

I pushed whenever I wanted. I had minimal direction. I don't even remember now what my MW told me but essentially instead of bearing down I was more pushing my stomache out. After I started pushing more effectively it was much easier.

At some point I just needed to push. At that point I was laboring by myself and I wanted to push so I did.

I may be the exception though. I was only in active labor for about 4 hours and dilated from 1 to 10 in about 2 hours so it was very intense.

Anyway, yes it's possible but I had a home birth so I wasn't hooked up to a monitor and was able to move around.

annabelle.27 · February 2013

I sort of did the first time. I strongly felt the urge to push, and pushed. I was only directed to hold my breath and to get into hospital position, which I did, but I regretted doing both as neither felt comfortable or productive. I ended up with a csection after three hours of pushing.

With my second, in a homebirth, I was completely at my own devices. I pushed on my knees, bent forward a bit at the waist leaning in to my husband's shoulder. I pushed when my body pushed, as I didn't feel I had much choice in the matter. I breathed sometimes during pushing, and sometimes I held my breath briefly, but it was always with instinct. I performed little movements as my body felt necessary, sometimes lifting one leg, sometimes tilting my hips so one was higher than the other. It worked, and I pushed my son out without tearing, but it still took over an hour.

With both my births, pushing entirely took over my body. I didn't always feel like I was the one controlling it, it just happened. At one point in both my labours they tried to get me to stop pushing, and it was not possible. The first time around it was because they were trying to get baby into a better position and they couldn't when I was actively pushing against them, and the second time it was because my labour was very very short and I started pushing before the midwife arrived. She tried to talk me through not pushing on the phone but it didnt work at all, and she ended up giving up and started talking my husband through preparing to catch the baby instead. It was like trying not to vomit when you are definitely going to vomit, or trying not to sneeze as the sneeze is coming out. My body took over and there was no telling it to stop.

All I am trying to say in this too long post is that I dont think direction is necessary. If you didn't really feel the urge to push, I think you were probably too early, even if you were at 10. Your body may have been taking a short break before gearing up to push, but I am confident you would have gotten there. I have never heard of anyone sitting at 10 for hours and hours with no urge to push, the urge would kick in I think.

BriDaily · February 2013

I used Hypnobabies during my first birth and it was like going up and down on the waves. I breathed through contractions/pressure waves and really only helped my uterine muscles out by engaging my core muscles during the contractions. If you want to call that "pushing" then I guess that is what I was doing. I had a water birth and was very pleased with the overall experience. My midwife just told me to keep up the good work and towards the end basically told me I was going to need to put some oomph into it because my DS was crowning. I don't think she ever said the word "Push."

AmyRI · February 2013

I had the same experience with my first labor as yours, but it worked so poorly that I stopped listening to the nurse counting. I did much better after that. I first felt pushy when I was only 9.5cm and was happy the nurse checked me and told me to wait a few ctx.

Went into my second labor wanting undirected pushing. It ended up being very different as baby was found to be breech at 7cm. It required a lot of coaching... first to avoid pushing, and then encouragement to get baby out fast for her safety. But this time there was no counting and no "start now." My MW gave me techniques for breathing through the urge because I was failing miserably at stopping my body. Then she left me alone until baby's butt was out, and at that point she told me to keep pushing as long and hard as I could just to get her out instead of pausing to wait for the next ctx. In some ways it was a lot of her involvement, but it was still a comfortable and helpful level for me and the lack of counting made me feel in control still. I will also say that the urge with my 2nd at the end was 100x stronger. That felt out of control in a different way, but at least my body was to blame.

NoeliaV · February 2013

My delivery phase started with a very strong, undeniable urge to push. It yanked me right out of my labor fog.

After that, though, I did have some help with when to push, but not too much for how long on those pushes.

I liked it about as well as one can like the pushing part, I think. I could see how different it would be to have coached pushing and think spontaneous is the better of the two for me.

tantdylf · February 2013

I pushed when I had to and didn't listen to a dang thing anyone said.

aylafsu88 · February 2013

I did. I only pushed when I had a contraction and I pushed for as long as I felt like it. My OB never did the whole 10 count or told me when to push. I delivered in the side position and my doula had one of my legs. When I started to push she would prop it up on her shoulder to support it until I stopped pushing at the end of my contraction. The OB sat on the end of the bed while I delivered. During a contraction I would push for @ 10-20 seconds, take a breath and push for another 10-20 seconds. I think I got 2-3 sets of these pushes during 1 contraction. No one really made any recommendations while I was pushing, I just listened to my body and only pushed during a contraction. I took the Bradley class and we did some fake, simulated pushing in one of the classes so I felt pretty confident about what to do. I also knew that my body knew what it needed to do, so I just when with it.

ncbelle · February 2013

With both births I pushed when I felt the urge. In Callum's birth I was encouraged while pushing - like "big strong push!" but not counted for or anything - more like cheering on just what I was already doing. I only pushed 3 times with Eleanor so I don't remember LOL

JKB1986 · February 2013

With my first I had an epi and did coached pushing. They ended up needing to use the vacuum only 10 minutes in because of heart decels. I tore front and back from that.

With my second I didn't have any meds and I was not coached. I felt the urge to push and they checked me and I was 9 with a lip. I held back from pushing for a minute and then I was a 10 and given the go ahead. I only pushed 2 or 3 times and the only thing they told me to do was keep my knees dropped to the side. For some reason I kept trying to close my legs. I was in the hospital position so I'm thinking that probably has something to do with it. I went in thinking I wanted to squat to push but the urge came so fast that it took all I could to get out of the tub and to the bed so I didn't really care when it came down to it.

iris427 · February 2013

I am a big believer in spontaneous pushing. Directed pushing can be helpful sometimes, like if the mother is really numb from an epidural, but generally I think spontaneous is better. There are studies showing, for example, that it leads to better oxygenation for the fetus. I did directed pushing with my first child and I HATED it. I felt like I was going to suffocate from holding my breath for a count of 10, and I don't think it is a coincidence that my daughter started passing meconium then. If I felt like I wasnt getting enough oxygen, I probably wasn't. Her passing meconium is one of the reasons my OB decided to do a csection, so I wonder if the directed pushing is part of the reason I ended up in the operating room.

With my second a home birth I simply pushed the way that felt right to me. I never felt like I was running out of air or that pushing was too hard. Instead of feeling horrible, pushing felt like a relief. And somehow my baby still managed to be born with someone counting to 10. Amazing. snark directed at our medical culture, not the OP

iris427 · February 2013

I also agree that if you don't feel the urge, it might be beneficial to wait until you do. Sometimes the baby needs to "labor down" first, and there is no sense in wearing yourself out pushing at that point.

iris427 · February 2013

https://onlinelibrary.wiley.com/doi/10.1016/j.jmwh.2006.12.011/full

This is a pretty good article on spontaneous vs. Valsalva pushing. Valsalva pushing results in reduced oxygen to the fetus, increased risk or damage to the pelvic floor/bladder, increased maternal stress and fatigue and increase in operative delivery.

Everyusernameistaken · February 2013

I did spontaneous pushing (although I asked "Can I push now?" for the first few...I'm a rule follower haha) and it still hurt like a mother. I'd also been told pushing would "feel good because you're doing something" but I just HATED it. Ths pushing part was the only part of my labour where I was thinking that I never wanted to give birth again. Although I did push for 3 hours, so maybe that's why.

But now I'm already fantasizing about baby #2 so....at least the "forgetting hormones" have kicked in

sschwege · February 2013

As pp said just because you are at 10cm doesn't mean you have to push. With DD I labored down for at least 1.5 hours because I didn't feel a strong urge and I didn't want to get out of the tub. I finally decided I was ready to push when I just got tired of being in labor, but I never had a really strong urge. My water never broke either time though and I think that's the reason I never felt that overwhelming urge.

I guess mine was sort of a mix. Mostly self directed with DD, but their one request was that I give it three pushes, then stop even if the contraction wasn't over yet. I decided when to push and for how long, but after the three DH would tell me to rest. They encouraged me, saying the baby was getting closer, they could see hair, I know a few times my nurse said, "A little more, a little more".

With DS his head was right there when they checked me, so she just told me I could push and two pushes later he was out. Not much direction needed.

Self-directed pushing doesn't mean there will be crickets chirping in the room as you are pushing. It means the mother leads the way and everyone else follows. At least that's the way I've always understood it.

teresajean01 · February 2013

I did spontaneous pushing and can't imagine being told when or how long to push. My exact words to my husband were, "I am pushing." My body knew what to do.

AimnJus917 · February 2013

I had a med-free hospital birth with spontaneous pushing. I unfortunately had to push on my back since I had no one to help into better positions but I knew when to push because I felt the urge. The idea of someone else telling me when to push when I can feel everything is just bizarre to me. I pushed for 2 hours and no one told me to stop when the head was "right there." That's probably why I had a 3rd degree tear + episiotomy.

This time I'm hoping for a birth center birth with a MW, however with my due date 4 days ago, my natural birth is slipping away. I'm a basket case.

hamiltks10 · February 2013

Like another poster above, I only pushed when I had a contraction and I pushed for as long as I felt like it. My midwife never counted or told me when to push.

She did, however, give me some tips while I was pushing to help them be productive. She said to take a deep breath and then push...breath then push....breath then push. She said I should get three good pushes during each contraction.

I had planned on laboring down/breathing down, like they teach you in hypnobirthing. But for me, the pushing really did feel good and I felt no pain through those contractions. My son was born after pushing through maybe 3 contractions. The only thing I would change is I'd try to push a little slower...take a little more time in hopes that I stretch and not tear like I did.

bugsmami · February 2013

I never felt the urge with my second. In retrospect I should've waited longer, but I was tired of the cntx. My midwife said I could so I did...it was harder for me than the cntx... not a relief like I was expecting. The midwife let me go at my own pace,though and it took about 20 min.

nak...

MrsBigTime · February 2013

I had help, but not necessarily with pushing. My MW's and RN helped me stay focused and often had to bring me back because I was losing control. When I was pushing my body completely took over and I found myself panicking and they'd bring me back to reality and help me to refocus. They helped me find a good position, and in fact, they got me out of the bed and suggested I try standing up beside the bed and squatting. They gave me a lot of direction but allowed my body to do what it was already doing on it's own.

They helped me with breathing and keeping calm and encouraged me to groan/growl instead of scream (that bit of advice helped a lot. "Lower, Stephanie" they'd say and it worked! My mind would focus and my pushes would be more effective). They gave me positive reinforcement about my pushes also assured me I wasn't in fact pushing my butt hole out, even when I argued with them saying "No, really, I think I am!"

We didn't count to 10 or anything like that, I simply pushed for that whole contraction and when LO was crowning they'd have me stop pushing to give my perineum time to stretch.

FWIW, their help in bringing me back to the situation and helping me refocus out of my panic was the most beneficial part of their assistance during this stage of labor and I am so thankful that they were there to do that.

dfissori · February 2013

I had a med free birth and my body started pushing before I was 10 cm so the nurse was yelling at me not to push. It was horrible because your body really does know what to do and takes over for you. It's like you aren't doing it...but you are. When the Dr. arrived, and they "allowed me to push" (I had stopped resisting the urge to push before that!) there really wasn't a lot of coaching. I was beyond that point because I was simply following what my body decided we needed to do to get baby out. They did say they recommend holding the push for 10 seconds but I didn't do that at all and no one counted or mentioned it again. The Dr. told me not to arch my back but curl around baby but that didn't feel right so I tried it a few times and didn't much after that. Everyone was pretty helpful in making suggestions but they didn't say it again. I was able to do what I needed and that's really all you can do to deliver your baby.

Trust your body because it really does let you know what you need to do to birth your baby. Good luck and happy birthing!

MyNameWasTaken · February 2013

I was told to act like I was taking the biggest dump of my life. It worked. Past that, nope, no coaching, I just felt the need (I wouldn't say overpowering urge) to push, so I did.

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