Coached vs Spontaneous Pushing in Labor
We’ve all seen it on TV and movies. The (usually) unrealistic birth: water breaks, contractions start, they almost don’t make it to the hospital, mom is screaming while doctors are telling her to push, we see her knees up by her ears. There’s so many parts of this that’s unrealistic, but let’s talk about how this teaches us to expect to be told when to push, and how harmful that is.
Coached pushing, sometimes called purple pushing, is when doctors or nurses will tell a mom to hold her breath and push, as she curls around her stomach and pulls her knees up to her shoulders. Spontaneous pushing is the alternative. Women who have not received medications such as an epidural usually don’t need to be told when to push. If a mother is unmedicated, her body will likely tell her when it’s time to push. Sometimes, that results in needing to push at 8cm. Other times it’s not “feeling ready” at 10cm. Often times, whenever the urge does come, mom’s describe it as “uncontrollable.”
Pushing when your body is not ready can lead to exhaustion and stress for the mother and the baby. A mother holding her breath for periods during an extended pushing phase can also reduce the amount of oxygen reaching the baby.
Like most interventions, I believe there is a time and a place. Sometimes a mom cannot feel the urge to push, or maybe baby needs to come out as quickly as possible. Some moms like the structure and the “cheerleading” that goes with coached pushing, but the benefits to spontaneous pushing are large. Mom may be able to save more energy by only pushing when her body is also doing so. She may recover better, not having put all that breath-holding strain on her body. Spontaneous pushing reduces the risk of severe tears and pelvic floor damage. Mom and baby may even feel more relaxed as the environment may be quieter and “gentler” during the birth.
It’s important to go into birth knowing the benefits and risks of different interventions, and having an understanding of your preferences. Birth doesn’t come with promises and you don’t know what may arise, but mother’s deserve better education than what is offered at most hospitals. If that’s you, shoot me an email, I’d love to work with you!