Women in Labor Stop Pushing, See Amazing Results

The staff at this hospital initiated a project to stop telling women to push.What if we stopped telling women to push when they’re in labor? That’s the philosophy behind a new program at a U.K. hospital, and the results are amazing.

If you’ve ever seen a woman delivering a baby in a movie or a television show, you have heard the rallying cry: “Push!” If you’ve had a baby yourself, you’ve likely heard it too.

Related: Twin Sisters Give Birth to Baby Boys On the Same Day!

The staff at Medway Maritime Hospital in Kent initiated a project to stop telling women to push. The Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives put out a call for action after seeing a sharp rise in severe perineal tearing affecting nearly 14,000 women in 2013 to 2014.

Over a 12-month period after the program was implemented, the incidence of women with severe tearing went down from 7% to 1%. How have they gotten such amazing results? Largely, simply by not asking women to push when they are in labor.

Guidelines also discourage women from staying on their backs in labour — they are encouraged to try alternate positions. Women are also encouraged to slow down during labor, and nurses coach them to breathe through contractions instead of pushing.

Midwives were also discouraged from pulling a baby out once their shoulders emerged and instead supporting the baby’s weight as it emerges, all of which reduces pressure on the perineum. Holding a hand against the perineum while the baby crowns and is born also provides important counterpressure and support for the perineum.

Related: 11 ACOG Recommendations That Could Improve Maternity Care

The program has been so successful at Medway that the results were published in the European Journal Of Obstetrics & Gynaecology And Reproductive Biology, and there are plans to roll it out nationally.

The results of this program and study won’t come as a shock or surprise to many midwives and obstetrical care providers, but it is great news for women everywhere that these methods are finally getting formal recognition as the better, safer way for women to labor.

46 thoughts on “Women in Labor Stop Pushing, See Amazing Results”

    1. Hey Margo! If you click on the link in the article for European Journal Of Obstetrics & Gynaecology And Reproductive Biology, it will take you the the study abstract.

    1. Hey Gemma: The study is titled “Can the incidence of obstetric anal sphincter injury be reduced? The STOMP experience.” The link in the article will take you the the abstract.

      1. Hearing about 9 lb babies and little to no tears is awesome. I think this is so great if they would begin to realize this. I know everybodies akin is different but…….My first delivery in the hospital with a 6 lb 7 oz. baby. The heads of both my kids were not much bigger than my husband’s fist. The ob/gyn wanted me to hold breathe and push. Bad idea, no reason to rush. Coached pushing is so the norm in hospitals here in the US. I advocate no coached pushing after my 3rd degree tears then stiches. Was that really necessary?

      2. Hearing about 9 lb babies and little to no tears is awesome. I think this is so great if they would begin to realize this. I know everyone’s skin is different but…….My first delivery in the hospital with a 6 lb 7 oz. baby, the ob/gyn wanted me to hold breathe and push. The heads of both my kids were not much bigger than my husband’s fist. Bad idea, no reason to rush. Coached pushing is so the norm in hospitals here in the US. I advocate no coached pushing after my 3rd degree tears then stiches. Was that really necessary?

  1. The author has a bachelors in midwifery? As an RN I have never heard of such a thing. To my knowledge one must be an RN before getting a masters in midwifery in order to be a midwife…

    1. If you look on the university’s website you will see that they offer a Midwifery Bachelor’s degree. It does not have a prerequisite of RN. She also lives in Canada, and that may change what is required for specific programs.

    2. Hi Sarah! Yes, I have a Bachelor of Health Sciences degree in midwifery. It is most definitely a thing. 🙂 Ryerson University also offers a post-baccalaureate program for health professionals, such as RNs. If you’re interested, here is some more information on the program: http://www.ryerson.ca/midwifery/

    3. In the UK, direct entry midwifery is normal. BSc in Midwifery is not unusual at all. Many RMs (registered midwives) are also nurses, but it is not required.

      Also, for the editor, ‘nurses’ do not coach women to push or not – Midwives provide care for all women in the UK, with appropriate referral to higher level of obstetric care when clinically indicated. We simply dont use nurses for labour.

  2. When I was in labour, I got told to push and I didn’t feel the urge to push at all. It was the most stressful part- I was being told ‘push when you feel the urge’ but I didn’t feel the urge so they just told me to push! I pushed for an hour and eventually they had to perform an episiotomy.. i wonder whether I had to push at all?

  3. The midwife supporting my perineum at the birth of my second child was a revelation! ?
    It made the experience so much more tolerable –
    and felt to me as if it alleviated a substantial amount of torture-like sensation (like a ‘Chinese burn’?) round the vagina during the birth of my first born.
    In my experience – it should be COMPULSORY in midwifery training.

    1. I find a lot of these comments interesting. It’s amazing to see how different OB practice is depending on your region. I’ve been a OB RN in the NorthWest (USA) for 10 years now. And since the very beginning of my practice providers have always encouraged the mom to slow down her pushing, breathe and ease the baby’s head out. I’ve never seen them encourage anything different. Most of our providers take pride in not cutting episiotomies and love when the birth is controlled, preventing tears, specially 3rd/4th degree tears. When a mom does incurre a 3/4th degree, the providers usually have a sense of guilt over it, like they feel bad and wonder what they could have done differently. Sometimes there’s nothing they could have done. That urge to push is primal and some women cannot control it, no matter how hard they try

  4. That is wonderful! I was always told to push at the wrong times due to the monitors being slightly delayed. With my last baby, I didn’t tell them the baby was coming for fear they would start coaching how to push. I found it wasn’t even really necessary to focus on pushing, more like the effort of blowing hard a few times as long as I did it when it felt right. A midwife poked her head in the door a few minutes before the birth and grabbed gloves, so that was nice, but the nurses thought I was in early labor. All went well and the baby was born so easily and much more quickly in comparison to the four previous ones where there was a circus of people yelling push and don’t push and causing me to work against nature. Much better and safer though if the mother can say the baby is coming without fear of birthing attendants trying to manage how it proceeds. Also nice if you can rock, or roll over onto your side or knees instead of staying on your back, very helpful.

  5. My midwives always instructed “DO NOT PUSH” with all my births but instead blow through the contractions. Three sons: 10 lb 8 oz, 10 lbs and 9 lbs 6 oz and not even a hint of a tear!

  6. This is not new news. As a former childbirth educator, Bradley and otherwise, for 25 years beginning in 1978…I taught this over-strenuous ‘don’t push’ for many years. (it was invented by nursing staffs in the first place). The midwives I worked for used to support gentle breathing…no forced pushing/bearing down for extended period of a contraction)…the M.D. I liked best practiced it as well. Women who are connected with the practical aspects of birthing, and want optimum health through a good labor..know who to find for that. The mainstream will jump to conclusions…by creating this headline showing a new discovery. It’s not new. It works, that’s important….but to deny that this happened before now is creating an self-indulged generation who can’t reach back as far as last Tuesday for valuable information to their benefit. Thanks.

  7. I’m sorry. I had 4 natural labors. And when I think it’s bs to listen to a doctor when they think it’s time to push. I know when I have that feeling that the kid is stuck in my ass all I want to do is push it the hell out. ????

  8. Its interesting reading the comments above. I’ve been a midwife for 15 years and work at medway maritime hospital where STOMP is not a preferred method of coaching a delievery but a necessity.
    The woman can go with nature as much she wants but the most crucial time to encourage a woman not to push is as the head is advancing and almost crowning. It does go against the natural urge to push but with the slow delivery of the head with excellent communication, pressure on the perineum with warm swabs completely guarding it and fingers gently placed on the babies head allows you to assess and coach efficiently. It completely controls the speed of the delivery. Once the head is delivered there is no gentle traction to deliver the shoulders and the mum births the shoulders and body with the midwife just supporting the baby which alleviates the pressure on the perineum.
    At medway we have over 5000 births a year and last month we had just 1 tear that exceeded a 2nd degree tear.
    A woman’s ability to control the delivery never fails to amaze me and to go against your natural instincts is a huge achievement. We’re very proud to see such positive changes in the interest of a safer birth with minimal trauma x

  9. Well massive big up for The Rosie in Cambridge, and the Norfolk and Norwich, who both adopted this approach for my children’s births in 2004 and 2007. No tears for me with either birth.

  10. It’s great that info like this is finally coming out. Whenever the medics interfere, you can almost certainly guarantee problems. Medicine understand nothing about health. Nature is already perfect.

  11. My last child was born at home with a midwife in attendance 33 years ago – my second birth in 16 mos. I was only in labor an hour and a half and he felt like he was coming out like a freight train. My midwife put her hand on my perinium, locked eyes with me and said “don’t push! Breathe!” I did as told and she stretched me and eased him out slowly, a big headed 8 lb boy. I didn’t have a nick or tear on me. I’m grateful to have had the benefit of her experience and good advice.

  12. Need to stop giving women drugs too. To speed it up then when mother is exhausted or baby’s not ready To come out you get the c sec.let nature take its own course. Slow it down relax. Oh and yes…3 kids 🙂

  13. I had 3 children with no injuries, no meds and midwife deliveries in US hospitals. They have known this for a long time and tend to be more patient and flexible during labor and birth than doctors are. This is a very important study and should be mandatory reading for all OB-GYN practitioners and nurses. I used to be one of them , too before I became disabled.

  14. When I had my first, I pushed for 2 1/2 hours. It was awful I tore and had stitches. My face had broken blood vessels. When I had my second. I felt like I had to push and the Dr told me but yet. It was so much better. Recovery war so much easier.

  15. I pushed with my first three, two of which were normal homebirths, the third was in a water birth at home. Pushing wore me out and made me feel emotionally exhausted as well. My four, which was also in the water, I just waited and while gravity did its thing. The results were amazing! I didn’t even know how it started, but I was pushing the baby out without any real conscious decision or intense effort. It really changed my entire birthing experience. No tears to speak of (I actually don’t remember if I tore at all). Love that they are finally pushing this method now!!!

  16. I absolutely HATED pushing. My 3rd and 4th were born at home and I maybe pushed once with both labor’s and then stopped bc it was not relieving at all. I let my body naturally push them out. I would rather breathe through contractions than push. No damage to my peri area either and they came in at 8lbs 12oz and 8lbs 5oz. My midwives never once tried telling me to push.

  17. This is at LEAST 33 years old. When I was having my 33 year-old son, my doctor in America told me to breath through several urges to push towards the end so the perineum could stretch and he didn’t even have to cut me. Why? Because he read a British study that said this is what they were doing. And as far as telling someone to push, at some point it’s more of an effort to NOT push because your body is doing it anyway. I never got all that yelling, and all it does it make for an anxious atmosphere, which isn’t good for anyone!

  18. So basically.. The baby does the whole labour? That is mind blowing, but it makes a lot of sense from a spiritual perspective.

  19. Hello everyone
    Thank you Kama for this positive birth story. As a midwife for 13+ years I am saddened that this is new to so many.
    All midwives are trained in physiological birth which is exactly what you are describing here in the second stage of labor. A woman’s body and her baby work together to create the magic of birth.
    The biggest risk to this process is the many many interruptions to this physiology. They can be as unintended as walking into a hospital, to brightly lit birth suites and constant interruptions to the woman’s birth space, to social inductions of labor, to excessive pharmacological pain relief, to coached pushing. True physiological labor and birth is so rare in hospital systems these days that even midwives must fight hard to enable and protect each woman’s unique experience.
    Respect women,
    Respect birth,
    Allow miracles to happen…

  20. This sounds promising. I think the essence of a stress and pain free labour is all about letting it progress naturally. No one should tell you how how do what we innately know how to do. All 3 of my labours were without complication or real discomfort but my last was amazing because I had done hypno – birthing type meditations and it just flowed. The midwives didn’t give me any advice as they couldn’t even tell when I was having contractions. I knew when I was ready to birth my son as I had the urge to breath him out rather than push. Two breaths and he was born – in his protective sac too. Probably the least traumatic and most peaceful birth I could have imagined and all in around 3 hours.

  21. I had 9lb 12 oz (head circumference 38cm) and 9lb 7oz (37cm head circumference) babies and had no tearing with either. My first was a water birth and the 2nd came very quickly (within an hour of waters being broken) but the urge to push with my 2nd was soo intense that the midwives had to slow me down. Never once was I told to push. This was in public hospitals in Western Australia, Australia.

  22. My first birth was a natural one. I wasn’t pushing at all until the nurse told me to “push as hard as I can” so I did. Only to have her yell moments later “STOP” because I ripped myself horribly. I was always really angry about that after, even though it wasn’t her fault, it’s what she was taught. I ripped because I did what she told me to. I’ve always known that. Now here she some facts to support my hunch.

  23. It’s amazing to me this article says NOTHING about prolapses which often occur from pushing. I have a terrible prolapse. I’m scheduled to have corrective surgery in 2 months which will be my second. When I had my first they told me it would probably last around 10 years. Well, it’s been 10 years so it recurred right on schedule. They tell me this one will likely last about 15 years. I’m getting a much more experienced surgeon this time. One who pretty much only does these kinds of procedures and they are using some newer techniques and graft tissue.

    The prolapse occurred while pushing during my third birth. This is such a common occurrence and so awful to live with it’s just anathema to me that it’s so rarely talked about. I had actually refused to push with my second till I felt like it. Pushed maybe twice at the very end, but I had an epidural so I wasn’t fixated on getting it over with. They were unable to do an epidural on my third. They tried, more times than they are even supposed to, but they just couldn’t get it placed. That would probably have been okay, except had not been in the mindset that I was going to go natural so it was a very abrupt shock and I had a hard time accepting it. I felt very desperate and hysterical. When I started to get close they wanted me to push. I kept telling them I can’t I can’t I can’t. My husband, mom, and sister were all very encouraging and I did finally get up the courage to push. It only took 5 or 6 times, but it didn’t matter. I didn’t really understand what had happened until quite a bit later. If I’d just not pushed she still would have been born I wouldn’t be dealing with my vagina trying to fall out 12 years later.

    For reasons that don’t matter, I ended up having a fourth which I carried on top of the prolapse. I never felt any pelvic pressure whatsoever. When I went into labor it was very very fast. I started going into transition in the car and almost had the baby in the parking lot. He was born about 20 minutes after we got there and I did not push even once. I was laying on my side screaming bloody murder, because it was so fast it was insanely painful. Then he just sort of ejected like a bullet. No one pulled him out. No one caught him. He just appeared on the bed. My husband was actually on the phone with my parents explaining we had just got there and it would probably be awhile while also operating the remote on the TV. I’ve honestly never forgiven anyone who was so nonchalant that day. At least the doctor was pissed he didn’t get his fee. That’s at least some consolation.

    Point is, pushing is completely unnecessary and it can do a lot more damage than a little tearing. I’d rather have the worst tear possible than a rectocele where the rectum bulges into the vagina so much you have to use your thumbs to basically push it out where it’s supposed to come out.

    These tears everyone is so fixated on are honestly insignificant when compared to the life long headaches these prolapses cause They come in many different locations, sizes, and flavors, but they are all awful and even worse, incredibly common. I am glad it does seem to be hitting the social consciousness a bit more and women are speaking about their frustration and the betrayal they often feel that NO ONE TELLS YOU! That’s honestly the worse part. How can they not tell you that these things are not just possible? Especially when they are so common. It just seems unconscionable not to tell patients what they are, how they occur, and what it will mean for the rest of your life if one happens.

    The worst problem in not talking about it is that no one is screaming loud enough for something to be done. If they had, they might have stopped telling women to push a long time ago, which I’m convinced doctor’s know doesn’t need to be done. They just want to get out of the room faster so they can move on to the next one. Not okay.

  24. I didn’t know this was a knew thing, have been a midwife for years, always supported the perineum and asked women to breathe instead of pushing like crazy when birthing the baby.

  25. My daughter gave birth to my Granddaughter in a tiny country hospital in Seymour, Melbourne, where the midwives were superb. Here they used wet warm flannels on the perinium to sooth and apply moisture to the tissues, but above all else encouraged her not to push. – at least not until my daughter had the greatest urge to do so. It was a gentle birth and all without analgesia, Mum was alert and less tired than other women might have been had they received drugs and been pushing for an hour. I share my daughter’s experience as I too feel pushing too early is unnecessary and causes trauma beyond the birth both physically and psychologically. Unless the baby is in distress or there are reasons for birthing earlier, I feel pushing is old school and we as Midwives, as well as Obstetricians, need to take rethink and refine our practise. Of course everything is relevant; size of baby, past trauma, position of placenta, injury or presence of disease, Hx etc

  26. I don’t agree with this based on the fact that it doesn’t state anything about wether or not this is beneficial for the child or how it would affect the baby but only on the point that it stops the mother from tearing which is physical and I would be more concerned about the being of my child rather than anything else.

  27. I’ve had 4 kids and pushed for over hour with first 3 and had awful births. No. 4 I refused to lay on my back and refused to push when asked to. Instead I waited till my body pushed itself…two pushes and he was out…best birth ever!

  28. This is so interesting reading the article and everyone’s comments and experiences. My 1st delivery started naturally, active labour was long (27.5 hrs) I did have some pain meds and an epidural (that lasted maybe 2 hours… But was welcomed relief after 24 hrs of strong ,2 min timed contractions). I didn’t push until there was no denying the need, nor would I have if told to. Maybe 5 pushes later my perfect 8lb 14oz baby girl was born, not in any distress and no tearing for me. I wonder if many women are pushing “correctly”? Your face shouldn’t be strained at all. It’s more of a body push. Kind of like proper breathing while playing a woodwind instrument shouldn’t give you even the slightest trumpet cheeks if you’re breathing from your diaphragm. If a Midwife or OB Nurse could chime in on that, it’d be great! My second delivery was handled differently as my youngest daughter was premature. Still no tearing and only given a guided push when told ” you know you likely don’t have to wait till 10 cm”. My 3rd delivery was induced for medical reasons, but because there was no “immediate rush”, I was allowed to labour how I wanted. Free to use the amazing exercise ball, walk, use the bathroom, whatever I wanted. Labour was active and as long as my first, and pushing was only done on my say so. Again, maybe 5 pushes and a perfect 5lb 5oz premie baby boy was born. No tearing again. All very pleasant deliveries. Except feeling a hand IN my uterus…. That wasn’t pleasant lol. I’m in Ontario Canada btw.

  29. The birth of my almost 8lb baby was terrible….and at a birthing center in Austin, Texas with 2 midwives in 2013! I had read books on natural birth and it sounded so beautiful (much like some of the stories you all have shared). Instead, after being in a tub for hours on all fours, I told the midwife I didn’t want to do this (I was scared and sleep deprived). I wish she had encouraged me to rest. But instead she said, “When women say that, it usually means its time to push.” (WHAT?) I pushed for 13 hours straight (the longest the midwife had anyone push before). At one point I begging to be taken to the hospital, which they talked me out of. I became so dehydrated and weak, but they could not get an IV in me. I moved from birthing stool, to squating in shower, to pushing while they had me pull on some kind of stretchy rope, all the while the nurse pulled back on my vagina to reduce the chances of tearing. I was beyond scared and believed I was going to die. I did have my son with no major tearing, but the experience was tramatic and made me fearful to have another for years. We are trying again now (4 years later) and I feel empowered with this article. Thank you!

  30. I was with my daughter-in-law at her first birth two weeks ago as her doula. She was in labor “forever” 48 hours or more. She had a “half dose” of stadol which may have allowed her to catch a nap hours before pushing. So she was basically unmedicated. We were “laboring down” as I understood it for two hours. She pushed gently during that time. Because it seemed to not be accomplishing much, when the nurse suggested counting, etc. I was afraid to protest because I knew she could end up with surgery if some “progress” did not occur. Because it took so long to dilate perhaps due to the posterior position which we did not know it had resolved until her head came out, the doctor was willing to do anything to prevent surgery. If she did not give birth before his shift was over three hours after she actually gave birth he could not control what the next doctor would do. Anyway I don’t know if she got pit then or a couple of hours before she was “cleared” to push. In any case she did directed pushing for four more hours. So I was left wondering if she could ever have pushed this 5# 10oz baby out if she had not ramped up her effort. I have not done much doula work in recent years, so I really need to find out if I was right to not insist on “breathing” the baby out or if I did the right thing to do with what the nurse suggested. She did not argue with starting out the way I thought was best.

  31. It fascinates me that this is a newsflash every few years. Mothers know this. midwives know it.
    OB RNs know this. Doulas know it………😳

  32. For my fourth child, I asked for a mirror to have a full control and awareness of when and why I should push instead of just taking instructions plainly. Really enjoyed the whole process.

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