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Natural Birth
Urge to push before fully dilated?
Hello, I gave birth to my beautiful first son back in February. My husband and I took the Bradley method class and I was fully prepared to have an all natural birth. We labored at home all day and I was 6cm dilated by the time we arrived at the hospital and I was surprised because the contractions weren't even too bad for me. The hospital I went to was a very natural-birth friendly one so we didn't have issues with standard interventions and they told me they'd avoid asking me if I wanted drugs unless I requested it.
I was doing really well...until my water broke. That's when the contractions were much more painful and intense. When I was at about 8cm I started getting a strong urge to push! I wanted to push soo badly but the nurses said I wasn't fully thinned out yet on one side and had me lay on my side to try and move things along. It was excruciating not being able to push! I think the worst pain came from having to resist the urge and breathe through the contractions.
This kept going on for so long. In hindsight, I'm assuming this was transition? But I was surprised at how strong the urge to push was even though I wasn't fully dilated nor thinned out yet. Is this normal? Eventually the pain was so intense and so frequent I couldn't take it anymore. (I also stayed in bed and did not move around much, which I want to say made it worse). I ended up getting an epidural because the doctor said I'd be too tired to push (was in labor for 30+ hours) and told me pushing would be even "more painful" so I folded.
Anyone experience this? I REALLY want to try going all natural for my future delivery. The urge to push was so strong and I still have this lingering feeling of unsatisfaction because I wasn't allowed to push. Next time I'm thinking I'm going to just push anyway!
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Re: Urge to push before fully dilated?
I am by no means an expert, but from what I understand pushing before fully dilated can result in swelling of the cervix.
It's too bad the doctor told you pushing would be worse. Most, though not all women, find pushing to be a relief. I know I did. I once read about a woman who chewed gum to sort of resist the urge to push. Can't speak from personal experience though as I never really had a strong urge to push even when fully dilated.
Oh I also wanted to add...because I was all numbed out, the baby came out SUPER quickly. I pushed for 30 minutes and the doctor had to stop me because he was coming out too fast. I tore a lot (3rd degree) and had a lot of blood loss...which I think resulted in my BM not coming in and ruined my BF relationship =(
I'm afraid of these things happening again the 2nd time around, esp. tearing and bleeding. I'm hoping that if I go all natural, the pushing will be much slower and therefore less tearing/bleeding?
I'm sorry, that sounds awful! My MW said that 2nd time moms are less likely to tear, if that's true then that's one thing in your favor. If you decide to go med-free you can push in different positions that will open up your pelvis and make pushing easier. Even if you opt for the epi next time you should be able to at least push on your side, which is much better than flat on your back. Also I would request 'self directed pushing' meaning that nobody counts or tells you to push harder. You decide when to push and for how long.
Even though I had an epidural, I had a small urge to push, and I never made it to a 10. They told me to push to see if pushing would get my cervix all the way to a 10, and it either did, or it never did and that's the reason I tore so badly. I almost cried when the doctor told me not to push because it was a constant, no-relief-unless-I-pushed kind of thing. They ended up vacuuming DS out though, since he was turned towards my side and I wasn't 10cm.
I don't think that was transition. I went through transition at home (without realizing it), and that was the worst. When I got to the hospital, the contractions were stronger and closer, so I must have gone through transition already. It was crazy.
I had a home birth with my second and I'm pretty sure the urge to push hit before I was 10 cm, though I'm not sure. I just followed the urge. At first, it was just light bearing down with each contraction, and eventually progressed to full-on pushing. I can't imagine being told not to push. It would be like being told not to throw up. I can totally understand how fighting the urge to push would make contractions excruciating. FWIW I am one of the people who found pushing to be a relief, though some people do find it to be more painful.
I wonder if light bearing down, directed by the mother, can actually help dilate the cervix the rest of the way by increasing the pressure of the baby's head on the cervix. I also wonder if a mother is less likely to push too hard and cause swelling of the cervix if she is unmedicated, and can feel her body more and listen to its signals. I can definitely see how pushing before full dilation with an epidural would be problematic.
I'm sorry that you had a rough experience!
I myself have never had the urge to push before I was fully. But I've had a lot of patients who start feeling pushy around 7-8cm. A coworker/friend of mine had her fourth last year, and I was at the delivery...she feels pushy right around 6-7cm with every single delivery. It is her least favorite part, and she made sure to tell us all that.
She did amazing, though (she's a hypnobabies instructor and a doula and an L&D RN herself...), but it did not look comfortable.
I hope it goes more smoothly for you next time!
I had the opposite experience--I wasn't fully dilated and had no instinct to push at all, but my LD nurse suggested giving a few practice pushes a try (both to see if it helped move things along by putting some additional pressure on and to see if I had the oomph to push at all after three hours in transition). It didn't do much for me (if that's any consolation
) I also ended up getting an epidural (long story, long labor, but four hours in transition did me in) so I can't say whether pushing would be more or less painful, but I've heard women say both. I will say--in response to your worries about BFing--I had the epi, tore, and still did skin to skin and BFed almost immediately. So it can be done, even if you end up needing/having intervention again. I do think that the immediacy of doing skin to skin and BFing ASAP helped me deal with the disappointment of needing intervention--I highly, highly recommend having that request in place if at all possible!
My pro-low-intervention-instinct says that your urge to push was more of a prep thing for your body than "real" pushing, since you weren't dilated fully yet. I'm sorry that you didn't have the birth experience you would have hoped for
This is actually what I did when I got to 9cm with a lip. It felt so good to just relax and let my body lightly push. I felt so Zen the entire time, everyone told me I was making natural birth look easy. It totally backfired and I ended up swelling badly and being told I had to fight the urge to push (impossible). I fought it (and swelled more) for 4 hours before my doula told me I had to get an epi if I wanted to avoid a c-section.
I feel terrible for anyone who feels the urge to push before they are fully dilated because it was hands down the only horrible part of my birthing experience. I'm really hoping that I don't have a repeat next time. My baby was OP (he turned when I finally pushed him out), so I plan on spending most of labor on my hands and knees the next time around.
My 2nd labour was 4 hours from beginning of induction to the birth of my DS. At my first check I was expecting to be 34cm because the pain was so reasonable, I was at 10cm. 6 pushes later DS was born. For me pushing was the easy part but I did get a 2nd degree.
My point is, having experienced such a difficult first labour, you might be quite surprised how well you will cope the second time around.
Although I never experienced your scenario, I arrived at the hospital ready to push and was told not to push until the doctor got there, which was next to impossible, so I feel for you in your situation. You reminded me of an interesting article about this, written by a midwife. It's called The Anterior Cervical Lip, how to ruin a perfectly good birth, it talks about dilation physiology, and what would cause a woman to push before fully dilated, bottom line I think is to follow your urges.
https://midwifethinking.com/2011/01/22/the-anterior-cervical-lip-how-to-ruin-a-perfectly-good-birth/