labor question

[momtothebean]

Okay, so I know its still early, but I'm thinking about it already. Has anyone, in their previous labors, refused cervical exams during labor? For DD, I had several exams and all it did was stress me out and make me feel like I wasn't progressing fast enough. Sure enough, after almost 24 hours of labor DD was born via c-section because I appeared to be "stuck" at 8cm. (I don't know if that is true, but the OB did say that she was tangled in the cord and probably wasn't going to come out on her own.)

In any event, I was looking for some stories from mamas who refused cervical exams. If you refused, how did you know when to push? Isn't there a risk that you'll start to push before being fully dialated? I guess I'm just confused about what I'll feel and when its time to push since I didn't get that far with DD.

Hope its not too early for this question! Thanks mamas!

[franjapany]

I had a homebirth turned into c/s with my firstborn. I didn't have any vaginal exams until I had labored for about 40 hours and nothing seemed to move. We then established (mw and I) that I was fully dilated and probably had been for quite a while. After another 10h we transferred and the doc diagnosed that DS was a brow presentation (*really* rare and quite difficult to diagnose) and the c/s followed.

The reason I didn't let the mw check before was that I wanted to give birth in my own time and I felt that any countdown of dilated centimeters would just annoy me. I also figured my baby would come when he/she was ready.
I honestly don't regret having gone down that road, because that way I had a really relaxed and calm labor. I don't even regret that it was that long. Personally I would also find any exams during labor extremely evasive and contra-intuitive.

As for the knowing when to push part I obviously can't talk from experience. Even though I was fully dilated I never felt the urge to push. But as far as I know there is a natural reflex caused by the baby's head touching the pelvic floor. Once the baby is down there the cervix is fully dilated anyway or else the baby wouldn't have got that far, kwim? Before that you shouldn't feel the need to push.

[MJB]

I had 2 checks in labor with my first (at the hospital, 4cm and 9cm) and checked myself once (at 6cm) during my UC. The urge to push, for me, is unmistakable and my body started pushing without my conscious awareness, which I've also seen in many other births. I have been at births where the mom had an urge to push before they were complete. If you are pushing with force for 20-30 minutes without feeling the baby moving down, it's time to ask for a cervical check.

[MammaB21]

You can absolutely decline being checked. But, it could bring up some issues with your provider. Are you seeing an OB or a midwife? Midwives are usually more willing to let you labor along without being checked, although even some midwives have a hard time with unmanaged labors.

Ina May describes the cervix as a sphincter meaning it can (and will) go backward in dilation when your body is telling you that you aren't in a safe place. Getting checked, for some women, can slow or reverse progress. It certainly did for me!!!

Talk to your care provider about their take on it. If you are having a hospital birth, the hospital might have certain policies they 'need' to abide by. But you can still get minimal checks. Like one when you arrive and one right before pushing. If you stay firm with no checks, you can always change your mind in the course of labor if you want. That is what I did, but it didn't have a favorable outcome for me. So be cautious because while in labor sometimes you'll be anxious and curiosity will get the best of you.

As for pushing, chances are you'll know when it's time to push. In a non-medicated, non-intervened with birth, the pushing stage should be a natural urge. Sometimes you won't even realize your body has begun to push baby down. The 'pushing' faze that is referred to is generally speaking of moms who have had epidurals. Lying on your back, unable to feel means your pushing needs to be coached, and baby isn't going to just slide down on its own. When upright and not medicated, baby usually does the work, and mom starts pushing little pushes with contractions. For me, DD was crowing before I knew it. She was out about 2 minutes later. I never even actually 'pushed' that I remember. At least not in the sense that I had a choice in the matter. There was no conscious decision made to begin pushing. My body and my baby just knew what to do and when to do it. I'm not saying that some women don't have a hard time with pushing. You won't know that for sure until you're there and in the moment. But generally speaking, it shouldn't be something to worry about.

[lisalulu]

My first was born in a hospital with a CNM and she only checked me once and that was because I was starting to get discouraged and asking for drugs. I was 7cm. With my second, a homebirth, they never checked. I don't know anything about refusing but I will say, like the pp, that you will know when its time to push

[tracymom1]

Not in your DDC, but just wanted to jump in for a second...

I was never checked with DD - I started pushing when I felt the need to. I started pushing very slowly and worked my way up to full strength. I tend to believe that the body will certainly know when it is ready to push.

That being said, I was and L&D nurse for several years, and it may be best to have SEVERAL conversations with your OB regarding this BEFORE going into labor. As soon as you get to the hospital, make sure you say it several more times to the nursing staff and any residents/med students you encounter. When it comes to hospital birthing, there are a lot of guidelines that are followed and most of the time the staff gets a little confused when you refuse things. There may be some eye-rolling and sighs, but they will do (or not do) what you ask if you mean it.

Happy birthing!!

[Stream]

I don't have any issue with being checked, but my midwife only checked me when she got to our house, and even then, she asked me if it was ok with me before she went poking around. I actually had some difficulty giving myself "permission" to push, I think because was a little hung up on needing to know I was complete (my first birth, at a FSBC, had lots of cervical checks). Once I got over that (well, plus the little bit of fear I had about pushing), I pushed her out in three pushes and all was well. My first birth took 90 minutes of pushing-- I don't think that had a thing to do with the cervical checks, but even with my hesitancy to get started the second time, I was much more efficient.

[CallMeMommy]

I never got checked. Didn't help that the midwife didn't get there until about 10 minutes before DS was born and I was already pushing, but even if she'd been there I don't think she does routine checks, only if you ask or she thinks something's wrong. That was one of my big reasons for looking into homebirth, I knew if I was in the hospital I'd just be telling everyone to keep their damn hands out of me. And I didn't know when to push but my body sure did, the fetal ejection reflex kicked in all on it's own and he came out just fine

I know this isn't going to be a popular opinion, but IMHSHO most healthcare providers who start doing routine checks even before labor just have a curiosity as to what your cervix is doing and abuse their status as a HCP to satisfy that curiosity (whether it's a conscious thought or not). The information serves absolutely no purpose in 99.9% of cases, and you wouldn't drop trow and spread your legs if your next door neighbor wanted to know.

[secondimpression]

There's an excellent article in Midwifery Today called The “Rule of 10” Versus Women’s Primal Wisdom. I very highly recommend reading it!

Also, you have the absolute right to refuse any treatment or procedure you do not want for any reason whatsoever (even though doctors and hospitals frequently confuse "standard of practice" with "law"). If anyone gives you a hard time, demand the liability release forms. The term "assault and battery" can also work magic. An informed mother is extremely difficult to coerce into anything she doesn't want!

[amyrobynne]

I've had two homebirths. With the first, I had 4 days of prodromal labor and had a cervical check on the 4th day to see if all the ctx were doing anything. I was 3 cm. The next day, I had 24 hrs active labor and I was checked 12 hrs into it, then frequently while pushing because it was a long pushing stage.

With my second baby, I labored 8 hours but early labor took most of that time. When we finally called the midwife, she barely had time to set her stuff up before I pushed him out. I was worried that I was pushing before my body was ready, but when the midwife saw me sort-of-pushing, she saw that I was really close to having the baby and suggested I come to bed and take off my pants Two pushes later and he was out. So I was sort of in pushing denial. I was never checked. But that feeling of having to push wasn't something I could ignore with either baby.

[momtothebean]

Wow mamas, thank you, thank you, thank you. It is so helpful to read about what other people have been through and how it felt. It certainly lessens the anxiety when you can get some sort of idea as to what the body will be doing.

I do have very supportive OBs (their practice is comprised of several OBs and 2 midwifes and I am guaranteed that it'll be one of the OBs or MWs during labor). During labor with DD, a midwife was there with me and she always asked me if I wanted to be checked before she did anything. I guess I just didn't realize the negative effect it would have on me until afterward. I am definitely going to talk with them about this issue and make sure we're all on the same page. I just don't want the same stress again.

Then again, discussing this choice with DP makes him very scared. Being a man (god bless him), he doesn't really grasp the whole concept of labor since he wasn't physically going through it and he's just concerned for me and the baby. He's very supportive, I just need to be able to explain to him how and why it'll be okay just to labor and try to have the baby without being checked every two hours.

To that end, I've ordered Ina May's Guide to Childbirth, Birthing From Within and The Thinking Woman's Guide to a Better Birth. I hope we can read some of this stuff together.

Any other suggestions about how to make DP feel more comfortable and assured that things will be okay without a zillion cervical checks?

[laughymama]

Would your DP maybe be willing to read up on the birthing process and how the body works? Maybe that would help him feel more confident and reassured.

I mean, what's going to happen if they don't check you? It's not like the baby will just stay up there.

I understand that it's hard for him to really grasp that though since he has never experienced it. I'd just teach him or give him resources he can look through himself that talk about the process and how things happen. Can't hurt.

And I know I'm late but just to add to the Mama Power, go you!
My midwife does not check me unless I want her to or there is some complication that warrants checking. I like that. I won't feel so stressed I think or pressured.

[franjapany]

Originally Posted by secondimpression

There's an excellent article in Midwifery Today called The “Rule of 10” Versus Women’s Primal Wisdom. I very highly recommend reading it!

wow, thanks so much for that link! what an interesting article!

[seattlemamma]

Originally Posted by CallMeMommy

and you wouldn't drop trow and spread your legs if your next door neighbor wanted to know.

My first was born in a hospital and I couldn't believe how many times the nurse checked me! She kept saying not to push the Dr. wasn't there yet! I went into the Hospital at a 7 within 3 hours was at a 9. I really wanted to push. An hour later(seemed longer than that) the Dr. came in and said, "Let her push it will happen naturally. I was really glad the nurse was not around when I gathered my senses about me. As soon as I started pushing, five minutes later she was born.
Second and third were born at a birth center with a hands off midwife. I kept asking her if I could push with the second child and she said, "whenever you feel like it hun."

Stream-I actually had some difficulty giving myself "permission" to push, I think because was a little hung up on needing to know I was complete

The third one I just knew. The fourth was a UC. I had practiced hypnobirthing with all but the first and my body just gave birth on its own. Seriously, I never really had to push with the last two. One minute I was in my own little world the next the baby is floating in the water! I used a lot of imagery of flowers and stuff opening up. It seemed to help.

An Interview with Unassisted Birth Advocate Laura Shanley~Most people can relate to this sexual analogy (which I am borrowing in part from Michel Odent) Imagine you’re having sex and everything is going beautifully. The energy is flowing and sexual excitement is building. But suddenly someone walks in the room, taps you on the shoulder and says, “Excuse me, what’s your social security number?Instantly you would come out of a creative, intuitive, artistic frame of mind and go into a rational, critical, thinking one. As a result, most men would instantly lose their erection, and sexual desire would probably cease for both partners.

This is exactly what happens when medical personnel are timing, measuring, counting or even simply observing a woman giving birth.

Observation changes all natural bodily functions.”

For full article:

http://mothering.com/jennifermarguli...-laura-shanley

[Vaquitita]

bumping cause I'd like to hear more mamas experiences.

[dannic]

My first was a very managed labor at a FSBC. I had to be checked every hour and during contractions. It was horrid. My second, I felt the pushing urge during the drive to the BC, and try as I might to NOT push, I had the babe on the side of I-10, lol. So no checks there!

My third was born at home and my midwife never even offered to check. In my own space on my own ground, it came very naturally--I began feeling the urge to push, reached down and could feel the babe's head. I waited to actively push until the urge was unbearable and then called my crew (MW's) in. My 9 lb dd was born three huge, ouch! pushes later. My water broke with her head crowning and that hurt. But pushing is always such a relief to me.

At one point my mw said, "You're doing so well that I have no idea what stage you are in (I was in transition) so you're going to have to tell me when you need/want me and when you need to push." It was such a different experience from my first birth and it made me really confident in my own ability to call the shots.

that's my experience!

[AmyKT]

I had a fairly straight-forward natural birth in a hospital with a CNM with my first, and although labor was pretty quick, I got the point that I wanted it to be over with, so I asked the mw to check me and she said I was at 9+ with a little lip. She recommended I hold off for a while but I insisted I wanted to push (just to get it over with) so she went with it and I had coached pushing for 90 minutes. It resulted in a second degree tear, and that may be why I have urinary control problems now. I hope to avoid that this time, but I don't exactly know how. Maybe if I never get checked I won't end up racing too quickly toward the finish line.

I'm going to the same CNMs at the same hospital this time, and I so wish I could have a home birth, but insurance doesn't cover it.

[MonP'titBoudain]

With my first, I was at the hospital and had a coached pushing stage with maybe 3 cervical checks leading up to it. I never felt the urge to push, but I had been given Satidol and was not quite with it yet.

With my second I was at home and the midwife asked only once if she could check. I was almost complete, but I knew that anyway. When the urge to push came, it was unbelievable and undeniable. And dd was (bellowed) out in two pushes.

I probably won't have any checks this time. The mw I'm with now, is kind of opposed to them (she would do it if asked, but since I won't ask, and I know she won't offer, it isn't likely to happen).

As far as how you can help your dh understand, personally, I think the best solution is a doula. A good doula is as much, if not more, about helping the birth partner help you as she is about helping you directly. Many men seem to find that "authority" helpful and calming and she also can help mediate between the pressures a hospital staff is applying and a husband's fears. I think doula's are worht their weight in gold at a hospital birth (and no, I'm not a doula!)

Also, in my experience, reading is only sorta helpful. My dh, and the male partners of most of my friends, tend to leave the woman to do the reading and then get the abridged version from them. So, read all those books. They are wonderful. But, I guess if I were you, I'd be prepared to be consolidating, streamlining and filtering the information for my dh!

[mamabearsoblessed]

I refuse cerv checks as well with my second and third births and intend to this time as well, At 1 point with dd2~ my most recent birth almost 2.5 yrs ago ~ I said to my mw, "after this contraction check me quickly~ if I'm not a 6 at least~ lie and tell me I am'
she said 'I don't know if you need to be checked~ I think you're hitting transition~ and you know that' God I love her
Sure enough I was 7 and I was in transition and in my I can't do this stage and for me my body hits 7ish and pushes baby down and out ~ my body starts pushing at that point and I go 7 to crowning quickly. I've never had to 'know when to push', I have no control over the matter . I have heard othere mamas say they never have the overwhelming urge but for me I am completely at the mercy of my body and Baby .
Though I say I go quickly from 7ish to crowning~ I do not have fast and furios labors, intense, long and furious YES. I've been induced w/ all 3 births for different reasons~ only the last being truly neccesary and they were 21, 17 and 14 hour labors, pain med free. Baby comes very quickly for me once I hit 'my point' and transition.