Personally, I hated it. Three kids, and each one I would have coped with contractions for another calendar day before I would have willingly pushed.
So when I have a mother who is a fierce non-pusher, I get it.
I recently attended a lovely birth for an almost-mother-of-three, who I watched paddle around her birth tub like a dog caught in a swimming pool, looking for a way out. She spun circles, flipped from front to back, moaned and groaned, cried, and howled.
I’d seen all the signs of transition—the shakes came and went, the hot-cold temperature swings, the long, strong contractions that piled up on one another. Now I was just waiting for her to give in and grunt. I encouraged her to listen to her body, find her way. I don’t generally reach in to check a cervix, or “give permission” to push. I would rather she follow her instincts and birth this child with the seasoned wisdom of her body and the intellectual memory of two prior births. She’s an old pro at this by now, and I don’t want to distract from her ability to run this show.
After a bit, I suggested she push a bit, “Just see how it feels.” Sometimes a little push makes the floodgates open and a baby pours out a few short minutes later. It’s like a sneeze that sneaks up on you—once you’re in it, it’s coming out!
Not this lady. I’m pretty sure I heard her fake a push, just to get me off her back. I love when this sort of stuff happens in labor—cracks me up. A woman is so far in her head, so deep in her body and hormones and sensations, that she misjudges her acting abilities. I could do a stand-up routine with the hilarious comments and antics with which I’ve been blessed.
“Reach down and feel your baby’s head,” I tell her. Once she realizes the baby’s knocking at the door, she’ll often give in and move it on out. Nope. She is not interested in that. She shakes her head violently, and spits out a few negative comments.
“Can I reach down and check?” Nods. Yep, her baby is just lurking right inside the vagina, just a couple of knuckles deep. His heart tones are strong and steady. I tell her I think that when she’s ready, that baby could be born with just a few pushes. I use an upbeat tone of voice, matter-of-fact and pleasant. No response, no acknowledgement.
She’s not ready. Eyes closed, swirling around the tub again. Groaning and even screaming. I’ll wait her out a bit longer.
You like it or you don’t, the push is powerful stuff.
Funny how labor messes with your head. You have months to come to terms with it. And still, on the day baby is ready to make its way to your arms, you still find yourself bargaining for divine intervention, courage, a way out. It might be pushing, it might be vomiting, it might be even letting yourself go into active labor. Everyone has a wall to climb, a bargain to strike. Sometimes it takes a few minutes, sometimes it takes longer.
My wall was pushing, three babies in a row. I lay on a bed and faked sleep for a full hour after I reached 10 centimeters with my last boy. The sweet midwife gently woke me a few times to ask if I’d like to push now. Pshaw! I am sleeping, sister. Leave me be. I fake snoozed, listening to whispers and shuffles about the room, while I tried to find a magical escape clause. At the time, nearly 14 years ago, I had no idea I would someday be a midwife. Little did I know how well prepared I would be to recognize a non-pusher, and how to help her face the inevitable.
Like most midwives, I’m willing to make space for a woman to come to terms with her fears, on her own time, in her own way. This is the beauty and strength of midwifery. I know physiologically she’s ready to move forward, but emotionally she’s not ready to let go of fear and walk through the fire. If baby is fine, I can wait.
Yet some women are like me. We have to be seduced, sweet-talked, encouraged, and eventually pushed. A good midwife knows when to say when.
I don’t get all Army Sergeant when kinder, gentler techniques fail. I do, however, get serious and tell them it’s time. I will bend over the birth tub, let her feel my hand or fingers, and say, “I’m going to keep my hand right her while you go ahead and push now. I’ll tell you how you’re doing. Okay? Next contraction, push like you’re pooping. Your baby is ready to come out.”
In this case, four pushes later a pink little head slipped out. Incredibly, this mother—who so hated pushing—was now able and willing to hold that baby in place so that her older children could be summoned from a neighboring room for the big reveal!
Baby Oliver came up swimming into his mama’s arms, with a standing-room only crowd oohing and ahhing at his beautiful cry.
In the week since the birth, we’ve talked about pushing a few times. It’s still fresh in her mind. Her eyes get dark and she shakes her head. This is truly trauma, even in its most humane and gentle form. I don’t have any idea of how to make it easier for her, should there be another baby in her future. All I can do is sympathize—on a very visceral level given my own memories—and praise her for the courage it took to do the hard work of bringing a baby into the world.
We push our babies out. We are pushed ourselves. You like it or you don’t, the push is powerful stuff.
About Jana Studelska
Jana Studelska CPM/LM, is a licensed midwife practicing in northern Minnesota and Wisconsin. She has been working with babies and mothers since 1998--as a La Leche leader, a certified doula, a childbirth educator, a regional birth network board member, and finally as a credentialed midwife. She is an author and writer, and has won several national awards for her work. Currently, she is the MANA Region 4 Representative for the Midwives Alliance, representing the upper midwest. She lives in Duluth, MN, with her husband, teen-aged boys, and a herd of dogs.