I recently enjoyed my first kayaking on ocean waves. My husband and I were flattened a couple of times just trying to get the craft out there. Surrounded by the vastness, we let the oars rest. Mild swells lifted and dropped us with soothing rhythm and frightening ease. I could not begin to control the power carrying me. I could simply be in awe and work with it. I was reminded of birth.
Rachel Reed gives us a researched article called Supporting Women's Instinctive Pushing Behavior During Birth. She respects a woman's ability to birth and provides practical suggestions for giving good support. I've included these suggestions in my post.
"Evidence supports the notion that women instinctively push in the most effective and safe way for themselves and their babies during birth. A birthing woman is the expert regarding when and how she pushes. Providing directions implies she needs our guidance and that we are the experts. Facilitating women’s instinctive birthing behaviours rather than directing them is evidence based and reinforces women’s innate ability to birth.
Suggestions for practice:
Can you relate to her explanation of a woman's instincts to push? In my case, the ladies assisting me got a bit excited when Baby crowned and started cheering me to push. It was rather distracting. Thankfully though, up until then I (mostly) rode the waves instinctively.
- Include information about the physiology of birth in antenatal education/preparation. Reinforce the message that women have an innate ability to birth without direction.
- Provide an environment that facilitates physiological birth and instinctive behaviour – low lighting, minimal disturbance, comfortable furniture that supports mobility and movement (floor mats, beanbags, birth pool, shower).
- Avoid asking the woman if she needs to push, or feels ‘pushy’ as this may suggest that she should and could interfere with her inward focus and instinctive behaviour.
- If the woman tells you she feels the urge to push, reassure her that this is good, but don’t encourage her to push. There will come a point when she is spontaneously pushing rather than feeling an urge to.
- Avoid vaginal examinations to ‘diagnose’ full dilatation. If you are not going to provide instructions about pushing based on cervical dilatation, there is no benefit in knowing this information.
- Do not disturb the woman’s instinctive pattern of pushing and breathing. Avoid directions and, if you must speak, gently reinforce her ability to birth.
- Avoid directions or distractions as the baby’s head is emerging to facilitate the woman’s instinctive perineal protecting behaviours (such as gasping, screaming, closing her legs, holding her baby and perineum)."
More pushing tips: from Aidan - I heartily agree!