Pushing contractions vs. dilating contractions

[Fluffy Peanut]

Do pushing contractions feel different than dilating contractions? I'm just curious because I never felt any pushing contractions with my first. Actually, I think I might have felt some right before I transferred to the hospital (I had an attempted homebirth with my first and pushed for 6 hours. I never felt an urge to push and ended up with a c-section because I couldn't push my baby all the way out). I thought I felt an urge to push towards the end, so I pushed and I remember feeling my uterus flexing and pushing down with great force and it didn't hurt while I pushed with it. Most of the contractions I pushed through hurt REALLY BAD and they weren't doing anything to help me push the baby out, so I KNOW they weren't pushing contractions.

So anyway, here I am, pregnant with my 2nd and due in 2 weeks, 2 days (6/16). I have a planned hospital birth with a CNM, but I might switch to a homebirth (my doula is a midwife in training and is willing to deliver my baby if I choose to homebirth). I am getting kind of scared because of the pain I felt with pushing last time, so I am trying to distinguish the difference in sensation in dilating contractions vs. pushing contractions.

TIA!!

[cottonwood]

Good question! The only difference I noticed was in intensity. (Although some people have intense contractions throughout their whole labors, so it's really not an accurate gauge of anything.) However! I did know when to push -- or, rather, I knew when the baby was coming. Basically, my body started pushing the baby out, I had no choice in the matter, and instinctively it felt right to bear down along with it. Very much like when you're having a bowel movement.

I never got that urge with my first, though, because we short-circuited my body's normal process by having me push too soon, i.e., at 10 cm. dilation, rather than when my body was actually ready.

Here's another clue: often, before the body is truly ready to push the baby out, there will be a lull in labor. The body will dilate fully and the baby's head will descend into the pelvis, which leaves a space that the uterus has to continue contracting down until it fits snugly around the baby again, until which it cannot move the baby down farther. (Sheila Kitzinger calls this the "rest and be thankful" stage.) Once it's snug around the baby again it can continue its efforts to move the baby downward. So, if you've just gone through transition and suddenly nothing much seems to be happening, you'll know that your body is gearing up to push the baby out! All that's needed from you is patience.

[HerthElde]

Yes, they definitely feel different (for me anyway). The urge to push feels like "throwing up downwards", to quote my chiropracter :LOL
Your best bet is DO NOT PUSH until you can't stop yourself - let your body do the work for you

[violet]

I'm with Katzmama and blueviolet - the pushing contractions are the ones where you can't do anything BUT push. I actually held back because I wasn't sure I was dilated enough (homebirth, no internal checks, first babe). But then I felt the baby's head and figured that meant I was fully dilated

I would discuss this with your desired attendents - dr. or midwife ahead of time. For many docs it's standard procedure to start you to pushing at 10cm. and not wait for true pushing contractions which leads to the problems blueviolet described with shortcircuiting the body's natural methods. I saw my family doc following the birth and he actually asked about pushing contractions. It went something like this:
"did you feel the urge to push at some point?"
"Oh Yes! At the end the pushing contractions were unavoidable. I actually held back a bit at first or she would have been out in 2 or three."
"That's interesting. I've been considering letting my patients wait until they feel the urge to push rather than starting at full dilation. There's some evidence that it goes more quickly and efficiently that way"

I was too surprised to say anything. He's been considering letting women push the natural way?????? Who is he anyway that he gets to choose what's right for these mothers? I just don't know how we've let birth out of our capable mother hands and into THEIRS!

Ugh, but that's another thread. And yes, the pushing contractions were the most painful ones, but also the most exhilerating and there was a brief lull for me, just enough to catch my breath. I felt like I had to hold back to stay on top of the pain and to keep a bit of control and I think that helped me not to tear, but that was what my instinct told me to do. I think our bodies intuitively know what to do when they are in that situation. Just be sure your attendant is on the same page as you before you get to that point.

violet