Anyone not have the urge to push? - Page 2

[Tummy]

Originally Posted by pamamidwife

I agree with the previous poster that perhaps given more time, you would have felt something. Not that we NEED to push - our bodies do it for us.

Could not have siad it better.
With my first Hospital VBAC I was told when to push... I had been induced with 3 drugs, and had an epi.. I had NO CLUE!.. three hours of pushing, a 4th degree cut and a vacuum.. finally a baby:

My next three 100% natural (including my 2HBAC) I did not push until my body was pushing. I never really had that "urge"... my boyd just started pushing on its own.

[cottonwood]

Originally Posted by kyartz

I can't remember if I wrote that my labor with DD was back labor. Does this "positioning" sometimes lead to not feeling the urge to push?

It is thought that the pressure of the baby's head is one of the things that prompts the pushing urge. So if there is a malpresentation, the body generally will not push, in effect allowing more time for the baby to rotate into position.

A posterior baby might be considered "malpositioned" depending on the shape of the mother's pelvis and what position she is in.

Back labor isn't necessarily an indication of a posterior baby, but FWIW in my experience of four births with excruciatingly painful back labor, the first was an extended second stage, and the other three were very quick second stages. The difference was that the first (though a homebirth) was very managed and directed, and the others were allowed to occur spontaneously.

My main focus with the birth was to avoid the hospital and a scene where I'd be subjected to mainstream birthing practices, and by the time the midwife was urging me to push I'd been in labor for over a day and was really tiring. I remember being concerned that if my energy got much lower, that I might end up not being able to push the baby out.

I had two long labors, so I know what you mean about when you talk about energy concerns. With my first, this was definitely an issue, because I was being asked to excert so much force, for so long, to try to get the baby out. My recovery was so long and hard because it was so hard on my body to have to work so hard when already exhausted. With my other long labor, near the end I felt completely wiped. In between contractions, I rested with my forehead on the edge of the tub, eyes closed, panting, feeling like I couldn't move one limb of my body even an inch. I hadn't planned a waterbirth, but I remember thinking, there is no way I can get out of this tub, even with help. (Maybe with a hydraulic lift! ) Then suddenly I was filled with adrenaline (like Michel Odent talks about in the above quote) and I leapt out of the tub. It was pretty amazing. Two involuntary contractions later, my daughter was born.

Note that with the first I was told to start pushing when completely dilated. With the other we didn't check dilation. If we had, I am certain that I would have been found to have been dilated for some time before my body was actually ready to push the baby out.

I also hope it's an easier birth and that I bounce back more quickly, although I must say that going into a pregnancy having had no decent sleep for over 3 years and being worn down by the demands of parenting a toddler, I wonder how I'll make it!

I cannot possibly express the magnitude of the difference between my forced pushing stage and those that were allowed to be spontaneous. With my first I felt physically damaged (even though I hadn't been cut.) I was in such bad shape, and hurt for so long. Even though it was a beautiful spring, I didn't step foot out of the house for the first three weeks.

With my others, even though I wouldn't call any of them exactly easy births, I felt physically well post-birth. I was up and walking around and doing things just fine. My vaginal area felt a little raw for the first week or so, but there was no pain, anywhere.

It makes a huge, huge difference.

[mwherbs]

frequently posterior babies will cause an early urge to push depends on how far down into the pelvis a baby is enguaged- because the bigger part of the head gets down far enough to create pressure on the bowel wall- often these kidos do ok with that too -- I would guess that it has to do with once hitting the right resistance and effective pressure they spin around or else fit the way they are comming

[cottonwood]

From the latest issue of Midwifery Today's E-News (http://www.midwiferytoday.com/enews/enews0808.asp):

Q: Does anyone have tips to help a mom who never gets the urge to push during second stage? She is completely unable to push with the contractions even though she gets in great positions: kneeling, squatting, hands and knees, birth ball, birth pool, etc. Two babies have been born fine as mom allowed her uterus to do all the work while she breathes through contractions. Is it best to let the uterus do its work alone or is there something that can help an "urgeless" mom?

— CLM, doula

A: The best way to avoid such a situation is complete privacy and silence. The art of midwifery is the art of creating the conditions for an authentic fetus ejection reflex (i.e., a short series of irresistible and powerful contractions). Such a reflex is more likely to occur suddenly is there is nobody around but an experienced, motherly and low profile midwife/doula who is not staying in front of the laboring woman and who is not guiding her. It is more likely to occur if the baby’s father has been given an urgent task, preferably outside the house (in the case of a home birth). It is counter-productive to give rational information about the progress of labor, or to behave as if you were expecting the fetus ejection reflex now. It is counter-productive to suggest postures. It is counter-productive to reassure with words when the laboring woman is suddenly expressing a fear (kill me… let me die…, etc.): this is a good sign of the sudden release of adrenaline announcing that the fetus ejection reflex will start shortly…if the mother is not brought back to our planet. During a fetus ejection reflex women find by themselves appropriate and complex postures, adapted to their particular case.

— Michel Odent, MD

[Undercover Hippie]

I just had a doula client who had this concern. She'd had 2 babies previously--a long first labor with interventions, then a second labor that was completely natural and relatively quick with a good OB and a wonderful doula--and yet she had never felt the urge to push. With the second she pushed in the position she wanted, a standing position, and she still pushed for 1.5 hours and was exhausted and her recovery was long and difficult.

She was very worried about repeating this experience with her third baby. We talked a lot about not having any vag exams until she definitely felt pushy (so no one could say, "You're 10, push!" if she wasn't ready) and letting everyone know she would wait to push until she felt the urge. We talked a lot about pushing being like pooping--and how our body knows when to poop, and we certainly couldn't poop on command just because someone else says it's time. We also discussed how long she would want to wait. I asked if she thought that she would get worn out by continuing to deal with the ctx while she waited but she felt that it wouldn't wear her out as much as pushing ineffectively--so true! Anyway, long story short, towards the end of this labor she said, "What do you mean when you say I'll feel pushy?" and the nurse and I tried to describe it to her. With the next ctx she said, "Then I think I do feel pushy!" It continued to get stronger and she only had to push through 3 ctx to have the baby. She was amazed and said it was "the best birth ever!" Her recovery was much faster too.

So, what I'm trying to say is that your second pushing experience really can be different than your first! Good luck!

[FitMama]

With DS1, I labored about 19 hours and was very tired after transition. All I wanted to do was rest. Of course, I was in a hospital, so they were coaching me to push. Having never done this before, I didn't know that my body might truly need that rest. My Bradley-trained DH said he could see the head and that I just had to push more. : Being the type of person who loves a challenge, I ended up pushing like crazy and out came the baby. I tore quite badly. I never really felt a physical urge to push.

Reflecting on all that really altered my perspective with DS2. I specifically wrote this into my birth plan: "I may need to rest between tranition and second stage, please allow me to do so."

As it turns out, I didn't need that rest period with DS2. My water broke, I pushed twice, and then he practically came flying out on push #3 .

[boscopup]

I felt the urge to push the first time, but after that one push, I was no longer feeling an urge to push. I think it was my body telling me to WAIT. Baby was coming too fast! The nurse told me to push with the next contraction. I didn't feel the contraction, so I just pushed when she told me it was happening. That got baby's head out. Then the third push (again, not feeling an urge to push), baby's body was out. My baby wasn't even 4 lbs (29 weeker), and I tore because I pushed him out too fast. In hindsight, I should probably have waited until my body felt like pushing.

So different situation from yours (kind of the other end of the spectrum - pushing stage went too fast), but I think listening to our bodies is the way to go! I'm hoping I'll be full term this time so I can birth with my midwife out-of-hospital, and I know she'll have no problem with me pushing when my body tells me to (or let my body do the work and not actively try to push myself). And maybe I can avoid a tear this time, because I know a full term baby of mine won't be 4 lbs! Probably more like 8-9 lbs, based on DS's size at such an early gestation. I'd rather not try to push that out in 3 pushes.

[Zyla]

With my first and third babies I felt the overwhelming, powerful, can't-stop-it urge to push as soon as I reached 10cm (and maybe a bit before). With my second it was entirely different. My waters never broke on their own that time, and I labored hard for 53 hours total. Once I reached 10cm I suffered through over two hours of super painful painful, non-pushing contractions with no result -- all at the urging of my midwife, who was fluttering around, doing this and doing that trying to get me to push him out. : Finally, I told her to break my waters. She did and I was then hit with -- wow -- the most intense urge to push and he was born within 15 minutes.

I sure wish I'd had a better midwife, one how could have matter of factly let me know that this could be a nice resting stage for me, and that the baby would come down when ready.

[grace's voice]

That's it... I'm putting it in my birth plan this time that I do not want to be told to push... I want to follow my instincts this time!

[siobhang]

I had a similar experience to several PPs here - first was with an epidural (induced labor at 8pm, contrax monitor not working, nightmare situation) and I felt nothing at all - no pressure, no urge, nothing. i still managed to push my son out in 15 mins.

I think it was so fast because he was sitting in my birth canal for hours but everyone was asleep, including me, thanks to the epi, and since the contrax monitor wasn't working correctly (we found out in retrospect), they thought I wasn't contracting effectively until they tried to put a catheter in my bladder and found the baby RIGHT THERE - I swear, I would have had that baby in my sleep if they hadn't checked.

With ds two (who was breech), I was determined to go natural. Breech babies tend to come out faster than normally positioned babies, I've been told.

Right at the end of transition, I felt this overwhelming sense of pushing - it wasn't an urge to push, it was my body pushing the baby out and there was NOTHING I could do to stop it. But the doctor wasn't there yet (the nurses had failed to believe my doula when she told them it wouldn't be very long) so I had about 15 minutes of NOT pushing, which was similar to trying hard not to vomit. I kept screaming, "I am pushing!!" to dissapate the power of those pushes (esp. since the doc was the ONLY one who had any experience with vaginal breech deliveries).

Once he got there, I was able to put power behind those pushes and my second child was also born in 15 minutes.

Urge sounds so sedate - like an urge for ice cream. for me, it wasn't an urge, it was my body taking over and pulling me along for the ride...

Oh, and during the second birth, one of the nurses tried to tell me when to push and I completely ignored her - again, it is like telling someone to vomit on cue.
Siobhan

[charmander]

With DS, they told me to push, and that's when I pushed. (hospital birth -ugh)

With DD, (home birth), I did no pushing whatsoever. My body did it for me - it really was wonderful....I knew it was supposed to be like this.

[kyartz]

Clarification

I'm so appreciative of all of the responses and dialogue this post has generated. It's really gotten me thinking about how I'd like to approach this next birth and I feel armed with much better information than the first time around.

I had my 16 week appointment today and asked the midwife to review my chart and DD's birth, and found out that in fact it took 4 HOURS to push her out, not the lesser time I had estimated. Good God. No wonder I was so beat for so long after that. She had me start pushing right after I had dilated to 10cm, about an hour after she broke my water (with my permission).

This time I'm gonna wait until I feel an urge to push and not waste my precious energy pushing when baby isn't ready to come out!!!!!!

Kristen