Question Re: Pushing and Hospitals - Mothering Forums

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#1 of 51 Old 09-29-2005, 12:23 AM - Thread Starter
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Because I have no other option but to birth at a hospital...

Why is it every picture, video, documentary etc of women pushing the baby out in hospitals is done flat on her back???

Do hospitals "allow" you other pushing positions?

Does the hospital force you to push in bed?
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#2 of 51 Old 09-29-2005, 12:30 AM
 
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I think that's probably because most women giving birth in hosptials have had pain medication, so it's less likely they can/should be anywhere but bed. If you don't have meds, it probably depends on your OB/midwife's preferences.

I haven't given birth in a hospital, but attended a friend's birth in hospital and she was free to move around as she pleased, and ended up pushing squatting on the bed with a squat bar.
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#3 of 51 Old 09-29-2005, 12:32 AM
 
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I didn't have an epidural, and I had a good doula, so I labored in just about every conceivable position at the hospital. Even during external monitoring the nurses had no problem with me sitting up as long as I could keep the monitors relatively in place. Then again, I apparently was scarily focused while in labor and no one wanted to mess with me.
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#4 of 51 Old 09-29-2005, 12:33 AM
 
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Habit is the primary reason

epidurals dictate position alot of the time along with easy position for care provider to see and do epis and any sort of instrumental delivery.

over 20 years ago I was assisting a woman at a hospital birth and she was kneeling upright with elbows on the elevated bed- doctor wanted to check her since she was making pushing noises- he said turn around and I said just check her there and he tried to but could not understand what he was feeling or doing so still ended up having her turn around and then that was the way she pushed the baby out--
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#5 of 51 Old 09-29-2005, 12:40 AM
 
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Some of it is habit and some of it is training. I've had OB's that had no problem with other positions and some that are adamant that they push the baby out on their back b/c 'what if they have a shoulder dystocia?' . That is how they are trained to deal with most obstetrical emergencies and of course they are ever vigilant for the rare complication.
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#6 of 51 Old 09-29-2005, 12:41 AM
 
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I had a hospital birth, and they let me push any way I wanted. . .but closer to delivery I wanted to bush in bed, not really on my back, but like in an almost sitting up position, holding my legs back. The only thing was. . . tho I was at a ten I don't think I was quite ready to push. . .and felt kinda pressured into pushing. . .counting to ten, push again. . .from what I have learned here, it's better to not push until you can't help but push. . .kwim? Don't push until your body just takes over and almost pushes for you. . .

SORRY!! I went off on another tangent. . .
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#7 of 51 Old 09-29-2005, 12:53 AM - Thread Starter
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Thanks for the replies! I dread being forced to have another flat-on-my-back-labor.

Suppose I can go over more of it in detail with the OBGYN and my doula as well.

I was not on pain relief meds with my last (I was on pitocin and anti-biotics for my MVP,) but was forced to lay flat on my back during the entire delivery - btu this was likely due to my severe preeclampsia - and the hospital was out of the dinosaur ages.
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#8 of 51 Old 09-29-2005, 01:59 AM
 
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Definately go over it in detail with your OB. Despite how nasty the hospital nurses might want to get and how much "policy" they want to site, what matters is that you have your OB on board. At least that's what I've found in my situation. My OB is so touchy that when I went into the hospital with pre-term labor the nurses wouldn't even do a vaginal check without getting her permission first. It might be more inconvenient for the hospital staff when you push in a different position, but since when did we exist to make their lives easier?

A happy woman
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#9 of 51 Old 09-29-2005, 02:17 AM
 
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actually, being flat on your back is somewhat preferable than being on your sacrum/tailbone. At least flat on your back with your legs up, your pelvic outlet is open.

egads. hospital births. good luck! OBs are surgeons, known for their surgical skill. how can they surgically open your vagina if you're not on your back?

/sarcasm
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#10 of 51 Old 09-29-2005, 02:18 AM - Thread Starter
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Quote:
Originally Posted by operamommy
Definately go over it in detail with your OB. Despite how nasty the hospital nurses might want to get and how much "policy" they want to site, what matters is that you have your OB on board. At least that's what I've found in my situation. My OB is so touchy that when I went into the hospital with pre-term labor the nurses wouldn't even do a vaginal check without getting her permission first. It might be more inconvenient for the hospital staff when you push in a different position, but since when did we exist to make their lives easier?
I went over my birthing plan with my OBGYN last Friday, which included:
- I want the birth to allow a choice of birthing positions.
- Natural pushing – non-directed unless there is a medical need or concern.

And he was totally fine with it. I just got to thinking tonight of hospitals forcing you to lay flat on your back because the only pics I see of hospital births are in this position! Also, it dawned on me, that with my last the Dr. didn't show up but to catch the baby, otherwise, the hospital nursing staff was in charge of my entire L&D and I wasn't clear on hospital policies etc.
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#11 of 51 Old 09-29-2005, 02:32 AM
 
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just know that many OBs agree to one thing, but there's always a "good reason" why they don't adhere to it in birth. Just make sure you have people willing to put up a stink for you.

Or just stay home as long as humanly possible and birth your baby on the way.....then turn around and go home before they can get to your babe! (sorry PMS)
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#12 of 51 Old 09-29-2005, 02:50 AM
 
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Quote:
Originally Posted by pamamidwife
egads. hospital births. good luck! OBs are surgeons, known for their surgical skill. how can they surgically open your vagina if you're not on your back?

/sarcasm
HOW could I forget that one?!?!?! "We're going to need a little more room here....."
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#13 of 51 Old 09-29-2005, 02:53 AM
 
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it irks the heck out of me every time i see one of those L&D shows with the lady flat on her back trying to kinda do a crunch with each push .. dh laughs at me sometimes cause ,especially when they are saying its been long pushing and ushes dont seem effective etc, i'm all but screaming at the tv... ya know.. kinda like the dh's at a football game .. AANNNYYYWAAYYYY... my first i was more kinda reclined i guess... leaning back but not layng back either, second, had a diff doc, had me laying totally flat, my legs kept cramping on me while trying to push and it felt like i was getting nowhere and fast! he was my longest delivery(dont shoot me for the complaint) was 17 minutes, my third i told the doc i was sitting up or in any position i wanted.. she just asked me not to pick the toilet...lol .. i was 9 minutes delivering a baby that was "too big" for me to deliver.

Personally i felt the sitting up was WAY more effective in the pushing.. i hate seeing woman suffering thru labor.
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#14 of 51 Old 09-29-2005, 03:08 AM
 
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Along w/ all the suggestions already I'd suggest taking a tour of the hospital you're planning to birth at. At mine, they mentioned the option of a squat bar rather than stirrups, which I'm definitely doing whether I squat or not, and also allow freedom of movement, even walking out into their courtyard w/ a fountain - very nice! I think it will depend on your hospital, but my OB and hospital I seem to have lucked out on a lot of counts. Good luck with your birth!
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#15 of 51 Old 09-29-2005, 01:51 PM
 
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"he was my longest delivery(dont shoot me for the complaint) was 17 minutes, my third i told the doc i was sitting up or in any position i wanted.. she just asked me not to pick the toilet...lol .. i was 9 minutes delivering a baby that was "too big" for me to deliver."

How the heck did you make it to the hospital in time?
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#16 of 51 Old 09-29-2005, 02:53 PM
 
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I would just stay out of bed and not ask for permission to do anything. They can not physically strap you down to the bed. If you are not in bed when the urge to push strikes, they can't make you push that way. You also have the right to say no to anything. If the doctor says to lie down and push, just pretend you don't hear or say that you're going to push in the position that feels right. No one is going to physically pick you up and throw you on your back -- you have to comply.

So don't comply and don't ask permission! But do it with a smile...
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#17 of 51 Old 09-29-2005, 03:04 PM
 
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if you had preclampsia, your bp was high this might be why they had you lying down in labor-- laying down can keep your bp down some-- in the same turn gentle pushing will also keep the bp lower-- if you had very high bp it would be hard to be able to move around- they would be afraid you would have a seizure and get hurt- the nurse's diligence in keeping you in bed would be there
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#18 of 51 Old 09-29-2005, 03:11 PM
 
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The nurses at our hospital are fans of the semi-sitting position... which as Pamamidwife said is not any better than lying flat, and maybe worse since your tailbone can't open. All the hospital beds here have squat bars but I've never seen/heard of anyone actually using one. I know I wanted to use the squat bar with DS but I never thought of it and no one suggested it--it's such an intense time for you and DH, and a nurse may not suggest it if that's not their inclination... yet another reason to have a doula with you! But I do know people who have birthed standing up at our hospital... one doctor saw a midwife catch a baby that way and now she will do it too. I think the nurses/doctors are just scared of the unknown. They are not trained or experienced with anything except flat on back or semi-sitting positions, so they don't feel comfortable with anything else until their eyes are opened!
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#19 of 51 Old 09-29-2005, 03:41 PM
 
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The hospital I'm at likes semi-sitting position and is really into using tug-of-war. It really comes down to the particular care provider though. If an OB likes you flat on your back, that's probably where you'll end up. Here's an interesting thing I heard the other day at abirth: This OB, who's really natural birth friendly, says to this mom, "Midwives talk alot about squatting and how it opens up the pelvis and brings the baby down. This position (on herback in stirrups) mimics that. Your legs and pelvis are open. I don't think gravity is as important as anopen pelvis" I'd never heard it put like that,thought it was really interesting. 1st time mom, pushed baby out in 20 minutes. Interesting. While I don't think flat on your back is the bestway to go, I do think it'sbetter than sitting on your tailbone too much. And to be honest, I laboredon myback natural) with my second fora little while because I was tired and because my body realized that being flat helped himfind the way he needed to go.

Talk to your OB, get it in writing if you need to. Make your wishes known and makesure they are on board with those wishes or be prepared to battleforyour wishes to be respected.

Namaste, Tara
mama to Doodle (7), Butterfly (2), and Rythm (due at home 1/06)
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#20 of 51 Old 09-29-2005, 11:59 PM
 
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Most hospitals will allow pushing any way you want as long as you are not compromised with an epidural or something. My birth center/hospital provided stools, balls, bars, and anything else that a woman would want.

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#21 of 51 Old 09-30-2005, 07:53 AM
 
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With my third baby, I ended up lying on my left side, clinging to the bedrail. One leg was flat on the bed, DH held up the other one. It was a position I did not imagine birthing in :LOL However, my body told me to do it, and it took care of the last bit of cervical lip I had. DD came half an hour later.

I used a squat bar with DS1, but not for the actual birth.
DS2 came so fast all I could do was get on the bed and lay back.

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#22 of 51 Old 09-30-2005, 08:46 PM
 
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Quote:
Originally Posted by MrsMoe
Because I have no other option but to birth at a hospital...

Why is it every picture, video, documentary etc of women pushing the baby out in hospitals is done flat on her back???

Do hospitals "allow" you other pushing positions?

Does the hospital force you to push in bed?
I think it depends more on your care provider than the hospital. I just had a hospital birth with a midwifery practice. I made it to the hospital with very little time to spare so we didn't have time to discuss whether I could push out of bed or not. It ended up they did want me on the bed (as opposed to the bare floor or toilet) but laying down caused me awful pain and I was screaming that I had to get up so they raised the head of the bed almost vertical for me to hang on and I pushed on my hands and knees. It was MUCH better than pushing lying down. The only bad part about that position is I didn't get to see him come out.

DS1 March 2003DS2 Sept 2005,
and 3 , in our happy secular
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#23 of 51 Old 10-01-2005, 12:37 AM
 
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My doc let me push however I wanted. I squatted for a while, then was semi-reclining. It just felt good that way, for some reason. They all said, "Just do what you gotta do, Honey!" and it all went really well.
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#24 of 51 Old 10-01-2005, 12:42 AM
 
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My babies have all been c-sections, and I've never pushed so I'm curious...what would they do if someone insisted on pushing in a position they didn't like? Are we talking about a team of nurses holding you down on the bed, or just another stupid fight with "care providers"?

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

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#25 of 51 Old 10-01-2005, 12:47 AM
 
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I had a CNM help us in the hospital setting. The first baby, I was in the bed with legs only partway open. I refused flat out to be "splayed open" like the nurse wanted. The midwife said as long as she could see, I could do anything I wanted.

The second baby, same midwife, I stood at the end of the bed. She knelt on the floor and caught my ds. He came out in three pushes. Gravity really helps!

Of course, I was not hooked up to anything either time. So there was no need to worry about tubes and wires and such.
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#26 of 51 Old 10-03-2005, 09:00 PM
 
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FWIW, my friend's labor was "augmented" and she had an epidural, yet she used the squat bar successfully. Didn't push the baby out like that, she was semi-sitting with legs held up for that, but she was able to use it.

I don't know how she wasn't scared out of her mind, since the table was about a million feet in the air...
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#27 of 51 Old 10-03-2005, 10:03 PM
 
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Quote:
Originally Posted by adenlilysmama
The nurses at our hospital are fans of the semi-sitting position... which as Pamamidwife said is not any better than lying flat, and maybe worse since your tailbone can't open. All the hospital beds here have squat bars but I've never seen/heard of anyone actually using one. I know I wanted to use the squat bar with DS but I never thought of it and no one suggested it--it's such an intense time for you and DH, and a nurse may not suggest it if that's not their inclination... yet another reason to have a doula with you! But I do know people who have birthed standing up at our hospital... one doctor saw a midwife catch a baby that way and now she will do it too. I think the nurses/doctors are just scared of the unknown. They are not trained or experienced with anything except flat on back or semi-sitting positions, so they don't feel comfortable with anything else until their eyes are opened!
I used a squat bar to push w/ my first in the hospital. I liked it a lot. The squat bars at the hospital where I had my 2nd were so flimsy and high in the air like PP described, there's no way I'd have ever felt safe using it! My first, though, I ended up pushing the last while in a sitting on the very edge of the bed position. I don't know if that's considered a good position or not, but I was too tired to squat anymore (I pushed for 2.5 hours) and the only other real option was lying down, i guess. My doc had me try all kinds of weird things, btw, from sitting on the toilet to standing holding onto my partner. But I settled on squatting and didn't want to do any of the others for more than 1 push.

Then w/ my 2nd I was on my back w/ an epidural, all the better for the doc to give me an episiotomy.
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#28 of 51 Old 10-04-2005, 12:27 AM
 
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Quote:
Originally Posted by Storm Bride
My babies have all been c-sections, and I've never pushed so I'm curious...what would they do if someone insisted on pushing in a position they didn't like? Are we talking about a team of nurses holding you down on the bed, or just another stupid fight with "care providers"?
When I had the first 2 in the hospital in 78 and 80 they still used restraints-- I was strapped to the delivery table-- also strapped to the labor bed with the first. although times have changed I think that the new restrains are monitors and epidurals-- sort of the passive restraint system. But I have seen quite a bit of will exerted at some births as well -- so the nurses do gather round and might hold a woman in place and scream in her face and be very harsh and rude and also worrisome -- now push and help your baby, do you want your baby to die then help by doing something-- then they start the 10 count and yell hold it hold it, at this point an aid or nurse may be holding legs or doing fundal pressure or pressing on mom's back-- a while back we had some clients having their 6th and last baby at home(first homebirth) the couple needed interrupters (because they did not speak the same language)for their births-- they asked us to please not yell or hit the mother when she is pushing that everything should be said to the interpreter and then dad would relay the message-- the doctor was screaming in the woman's face and actually hit her on the forehead because she had her eyes closed and she was curled over looking down and the doctor wanted the mom to look at him while she was pushing.
ask questions of your doctor, talk to the nursing staff and remember you can fire a nurse if you need to
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#29 of 51 Old 10-04-2005, 02:48 AM - Thread Starter
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Quote:
Originally Posted by Storm Bride
My babies have all been c-sections, and I've never pushed so I'm curious...what would they do if someone insisted on pushing in a position they didn't like? Are we talking about a team of nurses holding you down on the bed, or just another stupid fight with "care providers"?
I think they could physically force you if they felt like it, yes.

My last birth 7 years ago in a small town hospital - I was physically pushed down by a nurse many many times through out my labor. I was sitting up in bed - and she would come and shove me back down. After her doing this many times over and being very nasty - I screamed at her that she was fired and to get the hell out of my room. She left and never came back. God, I was so so upset, and I just know she was a major reason why my BP was skyrocketing.

mwherbs - they strapped you to your bed! OMG!!! Just... WOW!!!! That makes me very very upset to hear that.
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#30 of 51 Old 10-04-2005, 09:00 AM
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MrsMoe: The hospital you are gonna birth at "Sais" you can use the squatting bar, or whatever. But trust me, they prefer you in the stranded beetle position.

or at least propped up with your ankles behind your ears.

The nurses there RARELY see an unmendicated labour/birth and dont know how to handle it. Seriously. If you get a clueless nurse, tell her to either get you a nurse that HAS a clue, or just leave.

A friend of mine delivered at that hospital, under the care of the same midwives I saw *same ones that delivered my dd too lol* and the nurse that was on duty that night, broke the bed down, and tried to get my friend to push in the stranded beetle position.

So, just a little FYI, your Doula is gonna have to do some real hard talking to you and your DH for proper pushing positions in that hospital.

*Mom and baby friendly my rear end...*
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