[Greaseball]

I interviewed a midwife yesterday and asked my many, many questions. One of them was "How long spent during the 2nd stage do you consider too long?" and she said 2 hours. I told her I pushed for 4 hours with dd and she was shocked. She says that she and her backup do a pelvic press if the pushing phase gets stalled. It seems harmless enough, but I worry that it might be dangerous, and that maybe pushing takes a long time because it's what the baby needs. My first birth is nothing to compare to; it was on my back, etc.

When would you do the pelvic press, and can it ever be dangerous?

 

[cottonwood]

I'm not a midwife, but I can't help myself when it comes to the topic of pushing, hope you don't mind.

I don't know anything about the safety of the pelvic press. What bothers me is that a mechanical solution is being offered without questioning why the second stage is taking that long in the first place. Attempts to help second stage along have to start with the assumption that 1) second stage has actually started and 2) that there is something inherently wrong with the mother's physical makeup or with the physiological process. IMO, the problem is probably not that second stage is prolonged but that the midwife is mistaken about the body's readiness to push the baby out. IMO again, if the pushing doesn't happen spontaneously and fairly quickly, the body/baby probably are not ready. It seems like the logical, prudent thing to do, then, would be to try to create an atmosphere conducive to the process (i.e., privacy and no outside pressure/expectations,) and just chill and let it happen in its own time.

 

[Greaseball]

She did say that sometimes after complete dilation, contractions will stop for a while and the woman can rest, and then they start when she is ready to push. She also said that when pushing is ready to happen the body does it automatically; it's not something I would have to be ordered to do. So I liked those answers. I just don't like the idea of having my bones and joints manipulated.

 

[pamamidwife]

If it's a position issue, then opening the pelvic outlet with pelvic press can help. Most women LOVE the feeling of having it done, others don't. It isn't something that is required when pushing goes on longer - some babies take longer (posterior, asynclitic, compound presenation - with the hand(s) up by the head, or big babies).

Still, a limit of 2 hours no matter what? Every woman should push her baby out within that time and if they don't, there's concern? Or, is this a general rule that can be flexible?

Many times a longer pushing phase can be helpful with a big baby - with molding of the head. Even then, opening the pelvic outlet can help baby come down smoothly.

I haven't done much pelvic press during second stage to be honest. I know a few midwives in my area that really, really love it. I would be open to trying it, though, if the woman wanted to.

 

[Jilian]

I am not a midwife but I just wanted to share a piece of my birth story.

I pushed for a little over 2 hours with the birth of my son. The only concern my midwife had with me pushing for so long, was the fact that my son's heart rate was dropping. To help stimulate him, she would put her finger in and rub his head. Once he was born, we realized why he took so long to come out, he had his hand up by his mouth. If we would have rushed his birth, I would have ended up with a severe tear. I did end up with second degree tearing, but it would have been much worse if he was forced to come out faster.

I agree with the comment: "She also said that when pushing is ready to happen the body does it automatically; it's not something I would have to be ordered to do."

When I was in labor my stomach started pushing all by itself (with no help from me at all). I wasn't prepared for it and was really scared when it happened. My midwife told me that it is normal and it was my body's way of telling me that it was time to push. I was also able to take a 1/2 hour nap before pushing (and I had a drug-free labor!).

It is truly amazing what your body can do!