Pushing

Submitted by louiseds on June 1, 2009 - 5:30am
Body: 

Hi All

I have been doing a bit more of my TMI navel-gazing, thinking about the action of pushing, whether it be emptying the bowels, emptying the bladder or birthing a baby.

I remember being told at antenatal classes that during labour, when the time came, I should push in the same way as I would if I was emptying my bowels, downwards and deep into my bottom. However, remembering back to giving birth I don't think that's what I did, and I certainly don't think that is what is called for.

Emptying the bladder is closer to birthing, but still not quite right (and not quite as major, either!!). I have never experienced that uncontrollable urge to push that some members have experienced during second stage labour. That may be something else again!

I remember pushing during second stage as quite low down, with little diaphragm involvement. It was not so much straining as 'bracing', down low near the pubic bone, during the contractions, whereas straining to empty the bowels is pushing right back into your bottom, diaphragm and all. Pushing to empty the bowels (which I think is different) is lower and squeezing in with the abs, rather than pushing down.

I may have confused everybody now! Does anybody have the faintest idea what I am talking about, the different ways you can push and strain? (Or should avoid). What is OK, and what is not, when you have POP, or so you don't develop POP?

Cheers

Louise

granolamom

June 1, 2009 - 7:57am

I think I do know what you are talking about louise.
with my first birth, I was numb from waist down adn was instructed to do the evil 'purple pushing' exactly as you describe, down into my bottom as though I was pushing out a bm.
with my second, well, he got stuck on a cervical lip and I was instructed NOT to push until that was all clear. two hours later I most certainly DID have that uncontrollable urge to push, but it was more like you say, bracing to release almost. if that makes any sense.
with my third, I had been in active labor for over 21 hours so I was plain exhausted by the end. was in full squat on a birthing stool when he crowned and mw asked me to push just once and out he came, with a big splash. that's when my water broke.
with number four, I had already discovered my prolapse and so I did things a bit more mindfully. birthed on hands and knees and did not pay any attention to the 'instructions' given to me to push or not. I had done some reading (thanks sue!) on the 'no push birth' and that's what I was determined to do. my uterus did all the pushing, all I did was some of that bracing and tried my best to keep my bladder out of the way, which I must say I think I did a good job of.

I think that people experience the need to push, whether it be to empty bowels/bladder or to birth babies, in different ways, and the pushing itself probably varies too.
I think in terms of POP, one is best off being mindful of where one's organs are and where one wants them to be. and also to pay attention to the direction of the force generated by the pushing and to keep that force off the bladder.

an interesting side note, with my first three babies (pre prolapse) I felt rectal pressure at the very end, as though I needed to poo. with the fourth, I felt intense bladder pressure as though I needed to pee. assuming that's prolapse related, what do you think?

louiseds

June 1, 2009 - 9:48am

Hi Gmom

It may have been to do with the fact that you had POP, or it may have been to do with the fact that you were using your body differently, ie WW aware, and on all fours. I am not convinced that a woman in full labour can use her body in any way other than what her body needs to do, except that vertical orientation and leaning forward will cause gravity to act towards the pubis, rather than towards the anus. I have not used a birthing stool, so I am in no position to speculate. From my googling, it would seem that there are birthing stools and birthing stools. It looks like with some of them you could still be sitting on your coccyx and pushing the tip of it into the back of the rectum when you are leaning back. It looks like some of them would be not much better than lying back on pillows on a bed. It will be interesting to see what happens this time for you. You will be getting pretty skilled at this birthing business!

I gave birth upright the last time, kneeling on the lowered part of the obstetric bed and leaning forwards slightly onto the main part. I cannot remember any rectum pressure, but quite honestly I was not really aware of any sensation, other than the stingy stretching by a very big baby (very average really) trying to come out of me. No, the sensation was definitely further forward than my anus. No pushing into my bottom at all.

But I can see where the idea of pushing down into your bottom comes from. If you believe the anatomical diagrams, and you are llying on your back, down into your bottom is the only direction you could push, because that is the direction gravity would act.

L