Talk to me about self-directed pushing

[liliaceae]

So with my first birth, I had an epidural and didn't feel the urge to push. My OB told me when to push and it actually worked out really well. However this time I'm planning on a natural child birth, and I want my pushing to be totally self-directed.

Can you all tell me about your experiences with self-directed pushing? Did you feel an overwhelming urge to push? Did you just know when and for how long to push? Did you push during every contraction--right when it started, in the middle? How did you know when to stop pushing? Anything else??

[kitkat5505]

For me there was no stopping it when my body decided it was time to push it just would whether I pushed with it or not. At first it would be just a few contractions felt pushy and after a little bit every contraction I had to push, I couldn't have stopped it if I tried.

[Veritaserum]

When it was really time to push, my body took over. For some of my babies, I felt no urge to push until the baby descended and started to turn around the pubic arch. There was no stopping it.

During pushing contractions my body just did it. In between I rested. Contractions tend to space out during pushing which gives you a nice break. Sometimes there's a break in contractions (they might stop) after full dilation and before pushing. If that happens, rest up.

I did open glottis pushing. That means instead of holding my breath and turning purple, I grunted and pushed and blew, doing shorter pushes (6-7 seconds).

Once the baby's head crowns I do what I can to slow down. It can work well to push between contractions at that point to ease the head out slowly and (hopefully) prevent tearing. Perineal support is helpful there, too.

[FiveLittleMonkeys]

Like the previous poster's have said, once you get to a certain point, your body just takes over. I waited until I absolutely could not stop myself from pushing (and then some - waiting for my dh to get home!). I pushed with contractions, with an open mouth and some noise. I pushed until it stung, and then I stopped. When I got another overwhelming urge, I again pushed until it stung and then stopped.

I think with my last baby, it took about 3-5 pushes like that until he was born. He was almost 10 pounds, and I had no tears of any sort. I think that letting my body tell me when to push and when to stop really helped to let my skin/tissue stretch slowly and avoid tearing.

[wild fire child]

I fell asleep in the bathtub and woke for every contraction, one of which I realized I was pushing. After the next was pushing too, I got up and told everyone. I never tried to push, never intended to, didn't try to stop or start, it just happened.

[battymama]

My aim was to try and "breath the baby out" well it was more like trying to hold back with every ounce of strengtj so she didnt come shooting out. (which she did anyway)

[boscopup]

With my second baby, I just let my body do the work. I didn't actively try to push the baby at all. My body did it for me. You can't stop your body from pushing!!! So just let your body do the work, and forget the hospital style purple pushing.

[Belle]

The urge to push was unmistakable and not something I could not do. With my homebirthed baby my midwives heard me starting to push on the toilet and encouraged me to get into the tub. I pushed once more on the toilet and ran to the tub between contractions. It was great that no one wanted to check to see if I was fully dilated before getting "permission" to push. My dh didn't realize that I was pushing and tried to get me to relax. I don't think the thought occurred to him that I wouldn't need the go-ahead to push beforehand. I started pushing and making grunting noises as soon as I got into the tub. It was very easy compared to my first birth in a hospital where I purple-pushed. I made lots of grunting noises and pushed for about 4-5 seconds or so. I could feel her moving down. When I felt the slightest burning sensation I stopped pushing and just panted through about 4 contractions while she was crowning.

[jecombs]

When the time came to push, it was an overwhelming urge. After a couple of ctx I figured out how to work with my body to assist in what it was already doing. My MW did suggest that I let the ctx build a bit before working with the pushing, just so I didn't tire myself out. It was a good thing, because I pushed for almost 3hrs, so I needed to conserve my energy.

The only thing I wish I had done differently was not to push with every ctx. I thought I was "supposed to" so I did. I should have taken more time to rest -- I needed it. So, don't feel like you have to push with every ctx, especially if you're tired.

I just pushed for as long as I felt comfortable, then took a breath or two and pushed again if I still felt the ctx going on. After the ctx peaked, I would stop pushing. Once DD started crowning and I felt the ring of fire, I stopped pushing to help avoid tearing. Like someone else said, I tried to breath the baby down. DD was posterior and had a nuchal hand, so I ended up with a 2nd degree tear. Not too bad, considering the circumstances!

[katmann]

I felt the urge to push, but had to bear down with each urge for it to be really effective. Although I've heard many women say what pps have said, I had to do a lot more work than just "breathing the baby out." I wish I had been more mentally prepared. And I had a mw assisted HB, which was great, but I think a lot of the reading that I did (Ina May, MDC, etc) gave me a false sense of how easy birth would be.

[*MamaJen*]

It was pretty much a reflex -- in the middle of labor (a home waterbirth) I suddenly realized I was pushing. It wasn't something I was trying to do, it was just something my body was doing, like breathing. After a couple of contractions I kind of realized how to work with it and was deliberately bearing down in addition to the pushing reflex. That part of labor felt strangely good. Not really good, exactly, but kind of satisfying. It didn't hurt.

[MegBoz]

Wow, I guess I'm the only one who didn't feel she couldn't stop it. It's a good thing too that I could resist the urge to push... as I got the urge before I had even left the house & the hospital is a 20 min drive away!

I felt an overwhelming urge to push, but I could control it. I REEAAAAALY wanted to, and at the peak of a few ctrx, I did let go the littlest, brief push, but I mostly controlled it.

I got to the hospital & got checked to make sure I was 10 cm (My choice! I was paranoid because I'd heard horror stories of Moms getting the urge to push before being 10cm, then the cervix swelling & causing problems.)

Then I pushed with each ctrx, but I ended up getting 1, maybe 2 good pushes in before the ctrx would wane. I would just stop & wait for the next ctrx, because I knew it was good not to rush - to give myself time to stretch.

I did feel like I put some effort into it. It wasn't just 'breathing the baby out' and it wasn't just "letting my body do it." I did actively push DS out. He was 7#4oz. Took about 40 min to push him out & I did have a 1st degree tear (although could have been since I had to push him out while lying on my left side instead of hands & knees how I started. His HR dropped & that resolved it.

I had NO IDEA when to stop pushing! I was totally surprised when it was my doula who finally told me to "reach down & feel" - before she said that, I had no idea he was almost there! I was excited to get him out, so I kept pushing with each ctrx. If I'd stopped actively pushing then, that may have also helped prevent tearing. I didn't really realize.

As far as what it felt like, my doula said after a few pushes, "Relax your bottom & push from the middle." She was right - I was stressing my booty too much. I understood what she meant after she said that.

I started with sorta grunting through each push - Ha - like when lifting heavy weights. But my doula suggested I try holding my breath. I tried it & felt like it gave me more power, so I kept that up. As I had in my birth plan, no one counted. THose 2 comments from my doula were the extent of any "coaching" I got.

[liliaceae]

Thanks for the replies ladies! This is really helpful.

[angelapittman]

With my first child, I had her in the hospital and had an epidural but could still feel the urge to push. It was just an overwhelming pressure "down there." With my second, whom I had at home, I also KNEW when I had to push. I waited too long to call my midwife so she hadn't arrived yet so I yelled at my husband "Call Marcene, tell her NOW!" It was hard for me to hold back until she got there. Luckily, she was only a block away.

[snowmom5]

It sounds like there may be two different types of pushing being discussed here - one being what I would have called self-directed pushing (pushing in response to an urge) and the other being the fetal ejection reflex (which has been described as being as involuntary as throwing up, in a very intense, violent fashion where your body seems taken over by other forces). But then again, perhaps there's an in-between in terms of control, as in the kind of throwing up you can hold just long enough to make it to the bathroom vs. the kind you where you can't make it. (sorry for the gross analogy.) Just thinking out loud....

[Devaskyla]

I've never gotten an urge to push, much less had my body pushing uncontrollably. At some point in labour, my contractions just get too painful to endure without doing something & pushing makes it hurt a bit less. Once the baby has moved down a bit, the contractions don't hurt as much, but the other physical sensations are so nasty, I kept pushing so I could make them go away.

[wbg]

Originally Posted by Devaskyla

I've never gotten an urge to push, much less had my body pushing uncontrollably. .

Me too!! Usually I am just feeling totally overwhelmed by it and someone suggests I try pushing and so I do, and in a heartbeat, out comes baby. My babies have a habit of coming out very quickly so I keep aiming to breath the baby out. Not had much luck with that yet! Once I start it is such a relief and I seem to just let go!

[Dahlea]

I was checked and found to be totally dilated-I had been pushing for a little while anyway, because I had to! Then I just felt the urge, and pushed as hard as I wanted for as little/long as I felt and then I would break. It was, in my opinion, much better than having someone tell me what to do, though he was my first, so I have no previous experience.
My body just wanted to push, so I did!

[JorgieGirl]

Originally Posted by Devaskyla

I've never gotten an urge to push, much less had my body pushing uncontrollably. At some point in labour, my contractions just get too painful to endure without doing something & pushing makes it hurt a bit less. Once the baby has moved down a bit, the contractions don't hurt as much, but the other physical sensations are so nasty, I kept pushing so I could make them go away.

Ditto!

[mckittre]

I think it depends on how well your baby is stuck! I had to push for almost 4 hours with mine. (was wishing for a bit of this "can't help it - baby shoots out" sort of thing). It felt better to push than not to push so I couldn't really take a break, but it was hours of hard hard work, nothing involuntary about it.