Coached Pushing VS Pushing w/ your body's urges?

[MrsD08]

I am a huge planner and when I found out that our insurance doesn't cover a midwife I was really bummed. But, then I found a Doula was is just beginning her own business. She was offering 2 couples free doula care during the labor/delivery and postpartum. I asked if she'd extend the offer to us even though we're not pregnant and she agreed! Yipee! I am still amazed by this! But anyway....I have some paperwork to fill out on birthing preferences.

Can someone explain the differences between coached pushing and pushing w/ your bodies urges. Can you do both? I'm not getting a lot on-line for info...

TIA!

[MaerynPearl]

This probably is not the correct forum for that question... this forum is for questions and support in getting pregnant...

[MrsD08]

I know this is the TTC Forum, but I didn't know if there were any other big planners....sorry.

[MrsD08]

Is there a way to delete it so it's not in the way anymore?

[jecombs]

Coached pushing is when the Dr./nurse/coach tells you "ok, push 1-2-3-4-5-6-7-8-9-10". It has really become in-style because so many women have an epidural in labor and can't feel when to push. So, dr. watches the fetal monitor and tells Mom when she is having a contraction and how long to push. It can be very, very irritating to those of us who birth without medication and can feel what our body is telling us to do. With my DD #1 I found the count-to-ten method to be wayyy to long for me and beyond my comfort zone. Luckily, I had an MW that knew NOT TO COUNT for me.

Coached pushing has also become known as "purple pushing" because often Mom pushes so long and so hard that her face turns a shade of purple. You can also burst capillaries in your face, which are also purple.

I can't believe your insurance doesn't cover an MW! You may want to look at an OB who practices with some MWs. My MWs practice in the same group as a bunch of OBs, which is why my insurance covers them.

[MrsD08]

Originally Posted by jecombs

I can't believe your insurance doesn't cover an MW! You may want to look at an OB who practices with some MWs. My MWs practice in the same group as a bunch of OBs, which is why my insurance covers them.

The practice I will go to has MWs and OBs. Maybe I will call the insurance back to see if they will pay for a MW if she is part of an OB practice. All of my preferences lean towards having a midwife and I am SO afraid that if I have an OB he/she won't care about my preferences...

Thanks for the answer even though it's in the wrong forum...

[jecombs]

You can always PM the mod of this forum and ask her to move it for you.

[jenniferadurham]

Awesome info jecombs!! Totally makes sense! I never thought of it that way! I will be sure to remind myself of this when I'm in labor!

MrsD08...when I post something in a forum and am not sure where it should go...I start with something like "I'm sorry if this doesn't go here...not sure where it should go...please move this to it's correct spot "


No worries! You will learn where everything goes the longer you are here! And if you don't know...ask...MOST of us don't bite!

[MrsD08]

Thanks Jennifer!

[BathrobeGoddess]

Moved to birth and beyond...

[meganmarie]

If you don't have medications, and you can really *feel* your pushing contractions, you may find that they have kind of a rhythm to them, like surges and peaks. You may find there are ways to push effectively with them, or not so effectively. You may even want to spend some time just breathing and relaxing, not actively helping push (called "laboring down") which lets your body work on its own and gives you a little rest. The point is that it seems to work better for many women to let instinct and inward-focus take the lead when it comes to "how to push" as opposed to some nurse yelling "push now! push harder!" and counting to 10.

My doula stayed right by my ear during pushing, speaking in a low voice, telling me I was a warrior birth goddess doing an amazing job and being so strong, so incredible, and just keep it up, I was almost there. She never told me what to do. Now THAT is useful coaching LOL!

[nia82]

My insurance didn't cover midwives, but I picked a practice of an obgyn with a mw. The mw was on call when DS was born - luckily! They cover that since I was technically an obgyn patient.

Pushing... Well I had no urge to push (and I had no epidural, still just felt slight rectal pressure). My contractions came 5 minutes apart... I just didn't feel it. I went along with the coaching for a while but it is horrible - sometimes I could push less than "10", sometimes more. At some point (I pushed 2.5 hours) I just pushed no matter what, without contrax and finally had DS. I think the counting confused me even more.

[fazer6]

You can try the difference between purple pushing and exhale pusing next time you go to the loo for a bm. First push without breathing really hard till your face goes red. Next push but while you push open your mouth a bit and exhale.

You'll see which is a softer, calmer way of pushing. The softer pushing reduces hemeroids and can also minimise tearing.

I think sometimes you don't feel the need to push because your body is in a natural plateau and taking a break. I'm sure there's something on that on gentlebirth.org Have a read of the midwifery archives if you'd like more info on birthing.

[Belle]

Hmmf. Let me tell you about my two pushing experiences.

Purple pushing in the hospital.
I had the urge to push at 9.5cm. Everybody told me NO! don't push! You'll swell your cervix if you push before you're fully dilated. I was in agony from being denied pushing. That was absolutely the worst part of labor. Finally the OB got impaitient with me not dilating at her command and manually dilated my cervix. Then she said I could push. Somebody yelled PUSH! 1..2..3...4....5 NO! you can't breathe yet! And quit grunting, its counter productive. 6......7........8.........9...............10. About three pushes like that and I was seeing stars from the lack of oxygen. I told them this and what did they do? The simple thing would be to just let me breathe when I needed to but they put an oxygen mask on my face between the contractions. Dd's heart rate dropped because she wasn't getting enough oxygen either and they had me push so bad I tore.

Natural pushing (at home)
I had no idea how dilated I was but I was in my own little world laboring on the toilet when I started pushing. My midwife peeked her head in and politely suggested that I get in the tub if I wanted my baby to be born there. I pushed twice more on the toilet and ran to the tub between contractions. My dh tried to get me to relax (he didn't realize yet that I was pushing). My MW's apprentice told me to push however I felt like. (A polite way of telling me to ignore dh) I grunted, breathed when I felt like it, and nobody messed with my cervix. I felt her moving down with my pushes. I had no visions of stars and it was easy to give birth. Their was no drop in her heartrate and I did not tear.

[mamatolevi]

Coached pushing with my first labor and first vba2c. ugh. I had an epidural due to the induction (pit was cranked) the first time and while it wasn't working well at all, I had no urge to push but was at 10cm but felt I was supposed to. I pushed off and on 3 hrs to no avail. got baby to crowning eventually and by then was so utterly exhausted that pushing was completely ineffective. off to c/s for "CPD"

Coached pushing for my first vba2c was different; no epidural and I was left alone by dr and staff after I was almost dilated. It was hard to push that way. I'd already been pushy with ctx, but not really doing much with them. My doula noticed I was "pushy" and since we found I was at 10cm we just rolled with it. Dr/staff came back in and they did that count to ten thing and it was tiring. I couldn't get enough air between 'counts' and when I tried to get an extra breatch was told I should be pushing instead. However, b/c I actually felt like pushing it felt good to push. the counting was very effective and I got the baby out quickly. probably 3 or 4 ctx. I was in a supported squat position on the bed (end of bed broken down and bed at more than 45 degree angle) with knees up behind my ears. barely tore, didn't feel much in the way of a ring of fire.

for my second vba2c, i had fetal ejection reflex. holy crap! I'd read about it but wow. It was completey beyond an urge to push and there was no stopping it. My body actually had started pushing before I was quite 10cm. There was no counting at me b/c I'd put in my birth plan that I didn't want it unless it was just my doula or husband doing it. Things were going so fast and the reflex pushing was so effective that my doula and dh didn't need to count at me. It was definitely a longer time pushing, maybe 30 mins v. the 10 or so I'd had before. I was on hands and knees and tore about the same (small tears that didn't need stitches) as my first vba2c. really felt that ring of fire, but then I was also having fairly brutal back labor and it didn't feel as good to push as it did the last time - I think b/c of the back labor.

[katelove]

Directed pushing is also associated with an increased risk of maternal exhaustion and foetal distress.

I have a clause in my birth plan about no direction during second stage as well.

[JessieBird]

DS arrived in a birthing centre with MWs - I had no direction or coaching and there was no mistaking my body's urge to push! Like PP, I too had been on the toilet for some time and hadn't been checked internally for quite a while when the urge to push started huge and sudden. I also didn't really feel the contractions and sometimes it felt like an eternity between them but something would just come over me, like a strong instinct or maybe simply impatience, and I would push in whatever way came naturally for as long as it felt right to do so. It was the most incredible experience, there is no way to describe it. I won't lie, it took a while - I pushed for 3 hours and moved through many different positions but it always felt like I was doing the right thing and headed in the right direction. I never felt scared or lost or like I needed to be told what to do. I had no pain meds. No regrets there! It was awesome and I could only actually feel physical pain in the usual sense for one push when he crowned. The rest was all psychological - like moving through this incredible accomplishment that no one else could help me with. (Though admittedly I only have the one experience and I can't really say if things would have gone faster if I'd had some coaching. They certainly couldn't have gone any better!)

If you read the first section of Ina May Gaskin's book - oh I can't remember the title but the one that has about a hundred short birth stories in the front half of the book, all the different descriptions of what pushing can feel like will give you a very good idea of what to expect, and in turn will help you to figure out what you are comfortable with. I found it very helpful when it came to discussing my birth preferences with my MWs.

[*MamaJen*]

For a lot of women having natural births, pushing is completely a reflex. My body started pushing on its own. Seriously, at some point I just realized I was bearing down during contractions. It was a powerful, unavoidable urge to bear down. It wasn't like I was doing it deliberately, though after I realized it was happening I sort of started working with it and controlling it. But it was a reflex action -- I couldn't have stopped pushing any less than I could have stopped throwing up if I was really nauseous (not the best analogy, but it gets the point across.)
I didn't need anyone to tell me how or when to push -- my body was doing it all on its own. As I was actually pushing the baby out, I was able to control the force of it. At one point it felt like I was stretching too much, so I sort of eased up until the next contraction. That's probably a big reason why I didn't tear at all.
If you have an epidural, then you might not be able to feel anything -- I guess that's why directed pushing exists. However, directed pushing plus an epidural pretty much means that you'll tear.

[Astraia]

I definitely had coached pushing. Which totally surprised me, being a homebirth with midwives. The whole time I'm doing what they're telling me to do I'm cursing them out in my head :P

When I first started pushing it HURT. It felt so WRONG to be pushing, and I made no progress for a long time. My muscles were cramped up, I was instructed to not breathe or grunt just put all my energy into pushing. I had fingers in my vagina telling me where to push, people telling me it felt like pooping, etc etc. I'll admit, I was wimpy about a lot of this on purpose because it hurt.

Then suddenly it stopped hurting and I had to push, I couldn't not push because my body would do it for me regardless. It felt better to bear down and go with it. And I mostly ignored the instructions to push without breathing, to not stop and just keep going even when the contraction ended. I breathed when I want, I pushed when I wanted and stopped when I didn't and everything went fine

Altogther I pushed for 1 hr 43 minutes. The first hour did a whole lot of nothing, IMO, and I could have just waited and pushed when I felt the urge and the pushing phase would have been shorter (probably just the last 45 min or so, since that's when it felt "right" to be pushing), I would have been less exhausted AND a whole lot less cranky. I probably also would not have torn if I'd been free to push as I wanted and in the positions I wanted.

[mom2reenie]

My experience with pushing has been different each birth

DD--I felt the urge to push and pushed for 2.5 hours. It was a homebirth with doctors and they never counted, but did encourage me to push when I felt the need.

DS1--Hospital with midwife. One non-stop contraction for 20 minutes. I never felt the urge to push, but baby was in distress and the nurses and midwifes were very encouraging. Nobody every counted, but kept telling me to push.

DS2--Hospital (different hospital than DS1). Doctor didn't make it. Water broke, dilated to 10, body pushed 3 times and baby was out. Inbetween the pushes, I was talking and laughing. Nurses never counted, just let my body do it's job.