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full dilation = time to push?

post #1 of 66
Thread Starter 
Even here at MDC where people tend to be a little more educated about the physiological process, I hear this a lot. I thought it myself back when I had my first, but I didn't think why that might be, it was just because "that's the way it is". In other words, what I had been told. And then I thought something was wrong with me because I didn't feel the urge to push throughout that whole managed second stage -- not once. It was supposedly "normal", though, in that it took two hours to push my baby out.

To me, this seems on a par with the myth that episiotomies prevent tears. I can't believe that in this supposedly scientific age, people still believe this. It's just very frustrating because of how much harm it has the potential to cause. My voluntary (guided) second stage was awful. Okay, compared to lying on my back trying to not yell out (another great myth about what birth is supposed to be like) during excruciating contractions, it was a little better, at least I got to do something with that energy (since I wasn't allowed to move around and bellow) and know we were progressing toward something. But it was horrendously hard on my body and in itself caused injury, and it was hard on my psyche too as I was led to believe that I wasn't doing it "right" and if I only focused more or were a stronger person, it would go faster and be easier on me.

I'm still angry thinking about it (this was ten years ago) because it wasn't true. In reality, my body simpy wasn't ready. (Nor was I in a position conducive to helping it get ready.) I could have spared myself that whole two hours of ridiculous effort and indignity and hurt to my body if I'd just moved around and bellowed like I felt like instead of trying to force the baby out at some artificially chosen time (and risking distress to him in the process.)

"Full dilation" does not mean the body is ready for the baby to emerge. It means that one little part of it is ready. It doesn't mean that everything else is ready. When all is ready, the body will make it happen; there will be no mistaking or avoiding it. And it will be comparatively quicker easier and safer than if voluntary pushing had started earlier. So why are women still routinely told to push before then?
post #2 of 66
Yep.
post #3 of 66
Good question.

I also thought you couldn't push until 10 cms. I was only 9 cms and had to push so bad, and was trying to hold it in, but my mw told me to just go with what my body was doing, and my baby was born in less than 5 minutes.
post #4 of 66
I never felt the urge to push. I was told when to push, and it was awful. I was at 10 cms and all that, and I even asserted myself enough to take a few minutes to see if the urge to push would come, but it never did.
post #5 of 66
Probably for the same reason when you are ready to push, they start yelling at you to wait and don't push. Failure to respect a woman's intuition.
post #6 of 66
When I birthed DD, after 72 hours or so of dilating ... I finally reached my 10 cm, and the midwife told me to take a nap and get refreshed, because DD hadn´t dropped down yet, so pushing would be futile at that point.

She let me sleep for 1/2 hour or an hour, and when I woke up she had me get up and do some squatting to help push DD down. I pushed 3 times for a total of 15 minutes and she was born.

Gotta love a midwife who knows what she´s doing!
post #7 of 66
This is something I've never fully reconciled about my dd's birth.. but kind of on the opposite spectrum. Overall, it was a wonderful birth and I totally did my own thing. But my labor was fast and intense and my dd descended so rapidly and I had the most intense pushing urge from about 6 cm on and was encouraged by my mw to not to push, to blow through the ctx. I feel like I've heard a million times that women shouldn't push before full dialation and doing so can result in cervical swelling and swollen cervical lips that can prevent the baby's passge. I guess I've always felt a level of confusion about why my body wanted/needed to push so badly before all of my body was technically "ready". :
post #8 of 66
I wish someone around me had really focused on this the first time around. I was so tired and ready to be done that I wanted to push as soon as possible. Unfortunately I pushed and pushed and pushed without the urge for quite a while, I wish I had tried to at least rest. Unfortunately this meant by the time I actually pushed him out I was semi-reclining, I had already pushed while squatting and hands and knees for a couple of hours and just didn't have the energy anymore. I ended up with a small tear, I thank that could have been avoided.
post #9 of 66
Quote:
Originally Posted by Shonahsmom View Post
I guess I've always felt a level of confusion about why my body wanted/needed to push so badly before all of my body was technically "ready". :
I always feel pushy around that point. I think it a psychological thing for me. I want to push through the intensity. I know I can't go back, so I want to get it done. When I do push at that point, it does not feel right (and I have had swelling and lips and all that stuff). I figured out with my second that that pushy feeling is a sign to go deeper (for me into hypnosis). The real urge to push was different - came on softly, I gave a little push and felt the baby move and then things picked up.
post #10 of 66
Quote:
Originally Posted by Shonahsmom View Post
This is something I've never fully reconciled about my dd's birth.. but kind of on the opposite spectrum. Overall, it was a wonderful birth and I totally did my own thing. But my labor was fast and intense and my dd descended so rapidly and I had the most intense pushing urge from about 6 cm on and was encouraged by my mw to not to push, to blow through the ctx. I feel like I've heard a million times that women shouldn't push before full dialation and doing so can result in cervical swelling and swollen cervical lips that can prevent the baby's passge. I guess I've always felt a level of confusion about why my body wanted/needed to push so badly before all of my body was technically "ready". :
A friend of mine had this happen to her from about 5 cm on and because of it she just could not dialate past that. Turns out she was tearing her cervix! OUCH! I don't know if it's psychological or what. She ended up getting an epidural (she's VERY into NCB so that was a huge leap for her) and she still says to this day that it was the only way she ever would have had her VBAC, she just couldn't stop herself. Like the pp said though it didn't feel good to her to be pushing but at the same time it wasn't something she could stop.


I had a very managed medical birth and I remember feeling pushy around 8-9 cm. I have a feeling I would have been just fine pushing then and I did a little bit because it just felt so freaking good.
post #11 of 66
Quote:
Originally Posted by fourlittlebirds View Post
I'm still angry thinking about it (this was ten years ago) because it wasn't true. In reality, my body simpy wasn't ready. (Nor was I in a position conducive to helping it get ready.) I could have spared myself that whole two hours of ridiculous effort and indignity and hurt to my body if I'd just moved around and bellowed like I felt like instead of trying to force the baby out at some artificially chosen time (and risking distress to him in the process.)

"Full dilation" does not mean the body is ready for the baby to emerge. It means that one little part of it is ready. It doesn't mean that everything else is ready. When all is ready, the body will make it happen; there will be no mistaking or avoiding it. And it will be comparatively quicker easier and safer than if voluntary pushing had started earlier. So why are women still routinely told to push before then?
(bolding mine)

I both agree and disagree. I think that almost all the time, you're absolutely spot-on right. However, birth is also the great humbler. Birth reminds us that every birth is different, every woman is different, and you just can't say *anything* will happen in a certain way during birth.

You've probably read my story or heard me talk about this before, so I'll make it really short, but bottom line, even after over 7 hours of pushing contractions that I breathed and bellowed through uninhibited and alone (except for dh, who spent part of the time asleep), even after that "lip" of cervix was pushed aside, even after all that, I still had no pushing urge. I was too tired to wait through another 8 hours of that excruciating pain for the moment that my body finally decided it was ready to give me an urge to push. So I pushed with the contractions despite having no urge to push. My baby was born 25 min later, and it would have been over an intact perineum if the doctor hadn't given me bad advice when birthing her shoulders (head was done slowly, carefully, controlled by me, and gently with no tearing).

I agree that full dilation does not necessarily mean it's time to push. And I think it makes a lot of sense to wait a while for an urge to push - definitely take a nap if possible. But I just don't think it's necessarily true that your body will definitely have an unmistakable urge to push, or the fetal ejection reflex, or push the baby out on its own if you don't do it yourself. Sometimes, it just doesn't happen that way.

Julia
dd 1 year old
post #12 of 66
If you never get the urge to push, it doesn't mean you need people telling you to push. If you "never" get the urge (I'm guessing they didn't give you long to wait, betsy; you might have gotten an urge at some point), you wait and your uterus pushes the baby out. There's usually no need for directed pushing.
post #13 of 66
Quote:
Originally Posted by fourlittlebirds View Post
So why are women still routinely told to push before then?

I delivered in a hospital with an OB. She never once told me to push, or directed my pushing (until I got out of control with the pain, then she helped me focus by directing me until I was able to follow my body again). I was fully dilated for over an hour before I got an urge to push. She sat and did paperwork until I got the urge...

Off topic, but, that is one of the reasons why I hate it when people knock the whole medical field. There are good docs out there and we just have to find them!!!
post #14 of 66
Quote:
Originally Posted by SublimeBirthGirl View Post
If you never get the urge to push, it doesn't mean you need people telling you to push. If you "never" get the urge (I'm guessing they didn't give you long to wait, betsy; you might have gotten an urge at some point), you wait and your uterus pushes the baby out. There's usually no need for directed pushing.
(bolding mine)

. . . . Not always true. Not true for me. I waited. And waited. And waited. And waited. My body did not expel my baby without a LOT of physical effort from me. Once I started pushing, the baby was born within 25 minutes.

It was this kind of attitude (that it WILL happen, no matter what) that led me to not even try a little push at any time during those extremely painful 8 hours - because I was waiting, waiting, waiting for that pushing urge. I knew that when my body was ready, I would have the urge to push and I could deliver my baby. Except that it didn't happen.

I still have to ask the doctor if he actually did push a cervical lip out of the way . . . if that was inhibiting my pushing urge, however, I should have had an urge after it was out of the way. Or my body should have pushed the baby out spontaneously at that point. But neither of those things happened.

That doesn't mean I needed someone to tell me when to push (i.e., look, a contraction, PUSH!), but I needed to know that *now was the time to start pushing* (as opposed to the prior 8 hours, where I just suffered and waited for the urge, all the while breathing, relaxing, moaning, etc.).

Julia
dd 1 year old
post #15 of 66
I was told not to push with my 8 year old and my 3 year old because the doctor wasn't there. I was like...unmmm...I can't stop it, my body was doing it on it's own and I couldnt' stop. I agree that when the body is ready it will happen!
post #16 of 66
Quote:
Off topic, but, that is one of the reasons why I hate it when people knock the whole medical field.
I can understand your frustration, but no one is knocking an entire field of medicine on this thread It's wonderful to hear that there are physicians out there who attend lovingly and non-interventively to the women who have hired them. Sadly, this is not the norm.

Quote:
There are good docs out there and we just have to find them!!!
I think it's important to remember that many women around the world believe that normal birth does not require a doctor or 'medical' assistance and/or intervention. (Modern medicine is, of course, a blessing when necessary).

I really like this explanation of birthing paradigms by Robbie Davis-Floyd

post #17 of 66
Very interesting thread! I remember during my VBAC, the nurse checked and said "10 cm! Time to start pushing!" so I thought OK, just figured that was it. Shortly into pushing, I got the "urge" to push and told my doc/nurses whenever I felt it (I think I just yelled "NOW" cuz I was concentrating so much). We worked as a team, my nurses were so great helping me change position and push and helped me take advantage of my urges there.
post #18 of 66
Quote:
Originally Posted by gini1313 View Post

Off topic, but, that is one of the reasons why I hate it when people knock the whole medical field. There are good docs out there and we just have to find them!!!
Well some people don't access to good caregivers, whether through insurance or geography. Plus, how many doctors have told women all the right thinsg, only to morph into something else entirely at the birth.
post #19 of 66
Quote:
full dilation = time to push?
This concept is just one more reason I totally believe that internal 'exams' are unecessary and in many cases, detrimental/disheartening/disempowering to pregnant and birthing women.
post #20 of 66
Quote:
Originally Posted by georgia View Post
I can understand your frustration, but no one is knocking an entire field of medicine on this thread It's wonderful to hear that there are physicians out there who attend lovingly and non-interventively to the women who have hired them. Sadly, this is not the norm.
I know no one was in this thread, thus why I said off topic. Just I hear that alot, and I know there are good docs out there and they definitely have their place
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