Insert Salt and Peppa (is that how you spell it?) singing that infamous 90s pop song “Push It”…Ahh push it, come on, push it…
Pushing. Stage Two of labor. Pushing, pushing, pushing.
What’s your image of pushing…the first thing that comes to mind?
I know what mine was, some seven years ago… Mama on her back, spread eagle, legs jammed into her chest, crotch pointed toward the sky, all while she struggles to do the impossible: a sit-up. Her breath is held, eyes are typically scrunched closed, face is in a painful grimace and nurses, doctors, and family members shout at her to “PUSH” like a cheerleader at a pep rally. “P-U-S-H! Push! Push!”
You see it all the time on TV, be it sitcom or “reality” cable birthing show. You hear about it from women who’ve given birth. Directed pushing. Cheerleader pushing. Hold-your-breath-while-we-count-to-ten-pushing. It seems the way to go. But does anyone realize that there is a different way to push? A way that when left to her own devices to push, is NOT the aforementioned scenario.
In fact, about 95% of women, when given the freedom to push however they like, do NOT end up on their back (or holding their breath or following someone else’s instructions on how to push). Rather, they are squatting. They are on hands and knees. They are lunging. In short, they are in any position but supine…that is, if they are not medicated (I only say this because if you have a medicated birth, chances are good that you are too numb to do anything but push on your back being as you lack feeling from the waist down…not to mention the likelihood of being catheterized as well as tethered to a blood pressure cuff, IV, and fetal heart monitor…in short…you ain’t going nowhere).
Fast forward about seven years and my experiences with pushing are anything but what my preconceived, pre-pregnancy notions of pushing were.
In the two labors I’ve had, the pushing phase was a combined five hours. Of that five hours, two pushing contractions were on my back.
Two out of a bazillion.
And I recall them vividly, carnally, and oof, painfully.
All the rest were upright. Five hours of them.
Five hours of standing. Squatting. Lunging. Crawling. Walking. Leaning. Dancing. In short, anything but on my back.
Not that I didn’t try pushing on my back, just for shits and giggles, I suppose. But after one on my back with baby number one, I said, NO WAY. That’s enough for me.
Then with baby number two, something told me to try one push on my back. Some instinct in the far reaches of my mind. Boy do I remember that contraction. In short, by laying back for a contraction, my son regressed in my pelvis and on the next contraction was able to get past my tailbone. With the contraction after that, he crowned.
While the birth of baby number three ebbs closer and closer, pushing on my back is not on the agenda (unless that instinct from my second birth kicks in and directs me to).
Often times, when I talk about my homebirthing ways, I am surprised to learn how surprised others are that I pushed while squatting. More confusing than the reason for choosing homebirth to them is the fact that I was not supine while giving birth.
Unintentionally, the conversation takes on a “What do you mean, you pushed upright?” turn. And I explain.
I have seen this wave of confusion turn to intrigue then to “Well, gosh, I guess that does make sense” after I detail the logic.
A great, informative, logical, and brief paper on pushing can be found here, at Lamaze’s website. It emphasizes the advantages of pushing in any position but supine and I wholeheartedly concur.
But how does one push upright, despite all the advantages, when entering a system that is, as a rule, unsupportive of it? How does one stand to deliver?
My knee jerk reaction…stay home to give birth.
But being that only 1% of American women do that, reality tells me that’s not the answer (but of course, I think it should be, but that’s just me, disclaimer).
My other knee jerk reaction is to give birth unmedicated. That way, you will feel your way through the pushing phase and follow your body’s cues which will likely get you upright.
So you have to plan. Not hope, but plan, to birth unmedicated.
You have to plan it in your mind. Plan it with your partner. And plan it with your chosen care provider. (If your chosen care provider is unsupportive, consider it a red flag and find another one. Next! One more informative link from Lamaze may just convince you.)
If stats and science and studies don’t convince you about pushing while upright, especially if you are first time mama (which I completely empathize with and remember) I offer you this: your body will know what to do. Even more so, if you can keep all your bodily sensations about you, avoid the numbing effects of drugs, and have freedom to move, your body will guide you. (And don’t forget that invaluable support team!)
Just like my body guided me out of that one supine push with my first labor and guided me into one supine push with my second, yours too will do what it needs to do to birth your baby.
Now sing with me…ahh push it, come on push it! Pick up on this!