If you had no urge to push, what do you mean by "pushing contractions"?
How do you know? By your own admission, you didn't wait to see. What if you had started pushing much earlier? Maybe you would have just pushed that whole time with no progress, wearing yourself out and hurting yourself. Maybe that 25 minutes of pushing that you did do just happened to coincide with a relatively high degree of readiness on the part of your body, even though it was not yet fully ready to spontaneously move the baby down. I was able to push my baby out (in two hours of pushing) without a pushing urge, too; that is certainly a choice, but it doesn't mean that I had to. But please understand, I'm not saying that the choice you made is not valid. I don't know enough about what your body was doing to be able to make a judgment about it, and I didn't say that there is never any reason to try to get the baby out as soon as the cervix is fully dilated. I am only saying that the assumption that the mother must push at full dilation even without an urge is wrong, is contrary to the natural unfolding of labor, and usually makes for a longer, harder pushing stage than she would have otherwise.
Ok, point one. Why did I call them "pushing contractions"? When I arrived at the hospital, my doctor (a family MD who did homebirths for 25 years) asked me, upon hearing the first contraction, "How long have you been having these pushing contractions?" I had no urge to push, but there was incredible pressure and intense pain with each contraction. That started shortly after transition.
You don't have to trust or believe me, but I have thoughtfully analyzed and re-experienced my birth until I feel fairly confident that I know, at least in broad terms, what was happening. I experienced normal early and active labor, lasting about 11 hours. Regular contractions from the start, increasing in intensity. I recognized the release of endorphins multiple times during this 11 hour period (recognized as similar to "runner's high"). I went through transition (hiccuping, shaking legs, transition from just regular contractions to contractions with intense pressure). It took about 30 min. I transferred to the tub. I had a break - ctx slowed down to one every 5 min. I rested, and my water broke. I waited to see if they would speed up a bit again, but it didn't happen. I checked dilation and could not tell what was going on. I asked dh to check, and he thought he felt hair and no cervix, but honestly, I bowled him over with my assertion that I did not know how dilated I was and that it didn't make sense to push unless I had an urge to do so anyway.
Fast forward another half hour or hour, and I got out of the tub to see if things would speed up again. Anyway, the sensations I had with contractions from the end of transition until the last contraction I had as I pushed dd's body out of my body were all exactly the same. There was no differentiating between 6 p.m. ctx and 1 a.m. ctx. All the same. No difference in feeling, no urge to bear down, no reflex, nothing like that. Again, you don't have to believe me - this is just what happened. I'm not making it up to debunk our understanding of how birth works, but I feel it's worthwhile to present the actual, real possibility (since it did actually happen) that a pushing urge may not present.
I completely agree with you that the assumption that mom should push the moment she reaches 10 cm is inappropriate and is poor "management" of labor. I don't think labor should be managed at all; that's why we had a UC/transfer. I transferred because I finally felt, after that many hours of really intense "pushing contractions" that dd should have been born. So off we went to the hospital.
I think it's possible the lip of cervix (if there was one in the end - again, I'm going to see if the doctor can tell me if he actually did move anything out of the way when dd was born) inhibited a pushing urge, but that doesn't mean that (a) I couldn't have pushed over the lip or (b) that I was necessarily destined to get a pushing urge after the lip was moved. For what it's worth, I did not have any change in sensation whatsoever after the second VE (during which the lip was supposedly moved). There was at least one contraction before I started pushing, and it was no different. Also, the contractions WHILE pushing were no different. I had a hard time knowing when to push. No one was telling me to do it or telling me I was having a ctx from the monitor - they waited for me to start pushing. It required tremendous physical effort to push and in no way did my body assist me in pushing out my baby (except in that the contractions of course assist that process generally - but without my conscious, physical pushing efforts, the baby was not descending at all. I had one or two contractions where I threw my head back and screamed; I could not feel the baby descending. When I did as my doula suggested and pushed with my chin down, silently, I felt significant progress.
Maybe I could have had my baby at home if I'd just taken that break after transition and then started pushing shortly after my water broke. But we'll never know. I waited because I anticipated a pushing urge and did not want to disregard my body's signals. Labor had been going great and I was in a great rhythm with my body. I saw no reason to counter that by attempting a push when I was getting no involuntary pushing urges or other signals from my body that it was time to do so.
I know I didn't have a professional there to document cervical dilation, confirm what stage of labor I was in, or what have you. However, I think in retrospect it has been pretty easy to look back and evaluate the physical and emotional state I was in, and assign reasonably certain stages of labor to my birth.
I don't know if I would have had a pushing urge, had I stayed home another 4 hours, or 6 hours, or 10 hours. All I know was I was exhausted, had been in tremendous pain for about 7 hours when we finally called the MD, and I was not prepared to wait much longer. Hindsight is 20/20 and sometimes I wish my dh had just said, "Why don't you try a little push?" I probably would have tried it. But who knows what would have happened then? I don't have the answers to those questions and I don't think anyone does.
Finally, I'm not "admitting" or denying anything. I'm just sharing my opinion and experience. Sure, anyone could pick apart my birth story and say my opinion is totally off-base because I didn't have an expert to tell me how dilated I was, or because I didn't spend another 2 hours roaring through extremely painful contractions "just to see" if a pushing urge would present itself. I felt that I had waited as long as my mind and my body could tolerate. I was extremely patient. And I don't think waiting longer would have benefitted anyone.
If I had waited, and I had had a pushing urge 4 hours later, all I'd have to show for it is more damage to my pelvic floor and 4 more hours of PTSD-inducing trauma to work through. I don't regret the decision to push with the contractions despite not having a pushing urge. At that point, waiting was doing more harm than pushing without an urge. And I think my body gave me a pretty good thumbs up for doing so when dd was born after only 25 min of pushing. I don't believe that the time I started pushing merely coincided with the time my body was ready to push because the sensations were exactly the same the entire time. There was no delineation between pushing contractions while relaxing and pushing contractions while pushing (except that I hated the way pushing felt - I think it's the most awful sensations I've ever experienced. I was only able to convince myself to keep going by saying to myself, "You can't put the baby back in - the only way this is going to be over is for you to keep pushing." Bummer, I was so hoping for an orgasmic birth!).
I hope to have a pushing urge/reflex next time, but I'm not going to assume anything, because birth (and our bodies) aren't that simple or predictable. I think we always do a disservice when we discount others' experiences because they don't fit into our view of natural birth.
dd 1 year old