Unmedicated Hospital Birth Series: PUSHING
Welcome to the first blog post of a new series: Unmedicated Hospital Birth. Here are all the things I wish those planning to birth unmedicated in a hospital knew, before arriving at the hospital.
Today we will be talking about..pushing! This stage of labor usually goes in a very specific manner in the hospital setting. Coached pushing, lithotomy position (laying on back with legs in stirrups), etc.
Hospitals tend to offer more “managed care”. AKA - they’re not seeing a lot of physiologic, undisturbed birth. About 95% of those giving birth in a hospital will have an epidural, and epidural births are different for lots of reasons, one of them being - pushing!
Coached pushing (“okay, hear comes a contraction…ready…get a big breath and hold it in! 1, 2, 3, 4, 5….) can actually be really helpful when birthing with an epidural. However, if you do not opt for an epidural, coached pushing is really unnecessary.
Coaching someone to push if they do not have an epidural would be like “coaching” someone on how to go to the bathroom. I’ve never even coached my potty training toddler on that! Because our bodies just know what to do. Pushing is exactly like this, there’s really very little that you need to know going into it.
However. There are 2 things I wish everyone birthing unmedicated in the hospital setting knew about pushing, before arriving at the hospital.
Wait to push until you feel the urge
“You’re 10 cm! Time to push!” ... or, is it? Often, it is found upon vaginal exam that your cervix is “complete”, or you’re “10 cm”. The next words you’re likely to hear are “Let’s have a baby!”. Technically, you absolutely can start pushing at that point. However, if you are not feeling an irresistable urge to push, there’s a good chance your bodies still priming everything to get ready to push.
If you are not feeling any urge to push and you start before your bodies pushing with you, you risk exhausting yourself. You uterus does almost all of the work, if you wait until you feel your body pushing.
There is no harm in waiting until you feel that urge. The timespan between “complete” and feeling the urge to push is usually 15-30 minutes or so, but it can be much, MUCH longer (think: hours). This is normal too. If you get a break between transition and the urge to push…take it! Take a nap! Rest. Trust.
Also… do not worry that you won’t know when you feel the “urge”. You’ll know. Imagine the feeling of throwing up…but backwards :)
2. Breathe in whatever way feels natural
“Coached pushing” involves holding your breath and pushing as hard as you can while a provider counts to ten. Then, taking a quick breath and doing it again. This is what we typically see in the hospital setting. But there is another way!
By instead breathing instinctually, you are less likely to tear. You are also less likely to exhaust, as your body knows when you need a shallow breath, a big breath, to grunt…to yell!
If you’re being encouraged to hold your breath, remember you are not required...tell your provider you want to breathe and push instinctively.
You may hear “If you hold your breath your pushes will be more productive”. This can be true, but also - you are more likely to tear and more likely to exhaust yourself. If your pushes are productive at all, no need to rush it along. Your babies coming and you know exactly what to do.
TLDR; You can push HOWEVER you need to. Make the noises, move your body to whatever position feels right, do nothing if you’re not feeling like it’s time yet. Your body knows what to do.
If you are local to the Omaha, Nebraska area and looking for doula support in the hospital or at home, schedule a Discovery Call today!
