How not to push?

[Rosie023]

I Experienced an amazing waterbirth homebirth recently with my first and unfortunately had a 3rd degree tear. I know I was pushing with all my might and this caused the tear. How do I avoid it next time around? I mean my urge to push was completely overwhelming and I felt like my body was pushing all on it's own, like I'd split in half. Excuse the analogy but it was like when you have to run to make it to the restroom because you have diarrhea and there's no holding it in...it's uncontrollable. Does that make sense? If I had been told not to push as babe's head came out, does panting really help? I feel like nothing could have stopped my pushing. Any advice for next baby?

[phathui5]

[JamieCatheryn]

I've had to hold back my involuntary pushing with both births so far with an anterior lip. The "horse lips" blowing thing where you sort of blow a raspberry with loose lips can help hold back the pushing a bit. Something I'm trying this time is Hypnobabies, the tools of which should be useful for the whole time but controlling my early urge to push was something I really hoped to get out of this, as that was the only *really* difficult part in my other births. Maybe using that "off switch" I learned I can relax my body and not push so much even at that point.

[phathui5]

Jamie, 

Did you know that you had an anterior lip because someone was checking your cervix? 

[JamieCatheryn]

Yes, with my first they did in the hospital, with my second I checked myself when my body started pushing but something felt wrong, and my mw confirmed it. Some can just push through it but that didn't work right for me, I swelled and then even once past the lip had to apply arnica and hold off for 15mins more to let the swelling recede.

[tinifry]

Did you try perineal massage? I did it with my first about once every couple days and only experienced a small tear even though I didn't hold back at all. I've been doing it again this time and I feel stretchier and have less of that burning sensation.

Of course, my daughter was posterior so I didn't really feel an urge to push, but I was pushing pretty hard because I was in a lot of pain and had everybody encouraging me. This time I'm trying to do the hypnobirthing birth breathing, where you breathe the baby out rather than pushing (breathing down and out, imagining a J), but mostly because I'm hoping to avoid such a painful experience. 

[ChristaM]

I think some of it takes practice. I pushed and pushed with my first but intentionally chose not to with my second. I basically had to meditate my way through laboring dd2 down. I kicked everyone out of the room (this was a hospital birth), sat in the lotus position on my bed, with the lights off and my headphones on, and breathed her down. I didn't call anyone until she had crowned. Third labor was a but more fast and furious, but being alone with no coaching (obviously easier to accomplish with a home birth!) makes laboring the baby down much easier.

[SplashingPuddle]

I pushed like crazy and had only a small tear, and my daughter came quickly. I did little advance massage either.  I wonder if each birth is just so different and that includes tearing.

[eabbmom]

What position were you in?

[farmergirlj]

I know what you mean when you say the urge to push is uncontrollable. My pushing stage is 10-15 minutes tops and I always tear bc of it. I sometimes puzzle over how strong and focused that urge is. There is no denying it and often I can barely realize whats happening around me, all I want to do is push! My midwife taught me to say a breathy "hee hee hee". At first I doubted her on this advice but she was right. I don't know how but it stops my urge to bear down and gives me a little more time to stretch so I don't tear as badly. As far as not pushing when delivering the head, I have no idea if that is true or not but every single time I have delivered I have had to stop pushing, perhaps it was when the head was coming?

[100%mom]

I had that strong urge with my girls but not my boys. I didn't tear though. The midwife had me do the blowing and it was hard for me to do because the urge was sooo strong!

[callieollie]

I have no advice for you because I experienced the same thing with my last two babies. I can't even say I felt an urge to push. My body just started pushing. I sort of describe it like my body was vomiting.  When you vomit, there's not really an "urge" to vomit, you may notice that it's coming or feel like you are going to, but once you start vomiting, you can't really stop it. That's what it was like for me. My body just was pushing and I couldn't stop it at all. The first time this happened, my dd was born after 4 minutes of pushing. The only break I got was in between contractions when I had a chance to catch my breath. With my second dd, the same thing happened. I didn't have an urge to push until I was all of a sudden pushing.  I pushed with her for 14 seconds and then she was born!  I tore with both.  My first child (3 1/2 hours of pushing with epidural, posterior, on my back pushing) I had a 3rd degree tear from a vacuum extraction. I feel that really set me up for tearing with my girls.  With my first dd (the 4 minutes of pushing one), I had a second degree tear. Much more manageable and less painful than the 3rd. She also had her hand up by her head though so that probably didn't help. With my last dd (the 14 seconds of pushing), I'm not sure what degree of tear it was, but I believe I tore a blood vessel of some sort. I lost a fair amount of blood (they guessed 800 mL) and at first weren't positive where the bleeding was coming from until they took a closer look, stitched me up and realized that it was all from the tear.  I would LOVE to not tear. I'm just not sure how to stop it from happening.  I did hypnobabies and they recommend pushing in between contractions so you don't have the force of the contraction with you.  I think that would help me, but my problem is that I never realize how close I am to giving birth until the baby is born!  

[berrymama]

I have had 2 fast labors (3 hrs, and 1 hr, respectively). With my first, when I got the urge to push I didn't hold back at all and pushed as hard as I could. As a L&D RN, I had seen a lot of labors where women 'backed off' from pushing when the head was crowning and need encouragement that it was ok to push through it. As a result, in my head, I was thinking 'don't back off! push through it!" I ended up pushing DS1 out in less than 15 minutes with a nuchal arm and a 2nd degree tear.

My second labor was at home, fast and accidentally unassisted (again about 15 minutes from start of pushing to birth, probably 3-4 contractions). As a result, I had my own hand on my perineum, checking my progress with each push and eventually feeling the crowning. In this way, I was able to control the speed of the pushing (this was actually recommended by my midwife ahead of time. I am glad we had discussed in advance, as she wasn't there to tell me to slow down!). Having your own hand there provides biofeedback and allows you to naturally feel the strength of your push, and adjust accordingly. I ended up having my 10.5 lb boy with no tears.

[JamieCatheryn]

I agree, touching the head, supporting your own tissues and keeping track of the progress helps a lot. I just had my 3rd on Saturday morning and was shocked to know I was truly in pushing stage when I arrived at the birth center this time. In the car I was trying to go "ahhhh" (plus some yelling and cussing!) and hold the pushing to a minimum. Once I got in there and checked and found complete I kept going ahhh and gently pushing for the first half of each push and just adding focused effort at the very peak of them. I pushed between the contractions for the rest of the head instead of waiting for the next one, to do it gently and to get it over with sooner. It took another contraction to get the shoulders, his chest was bigger than his head actually. We were at the BC for 9 minutes before the birth.

[cottonwood]

I'm not sure exactly what you're describing, because you say both that your body was pushing all on its own but also that you were pushing with all your might. I guess the obvious thing is just stay with the first part of that, don't add anything extra. But also, maybe you might want to try birthing on dry land. People say that water helps the tissues soften, and certainly the heat helps, but I wonder if 1) the tissues can become waterlogged and this interferes with the stretching and 2) natural lubrication is washed away. Have you ever had sex or even just done foreplay in water? That might give you an idea as to the difference.