When to push?

I bet it was girl! I agree about pushing for more than 2 hours, what is happening and what about maternal exhausten for goodness sake.....

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Yes indeedy a girl very comfy back-to-back ta very much so she was, and yes the exhaustion, even I feel knackered when they've pushed for sooo long and find it rustrating for them and equally as upsetting those are the deliveries I always shed an ickle tear at, relief, happiness you name it the raw emotions all show there face in those situations xx

Made me giggle:

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3rd year Student Midwife

Oh dear, it isn't like Mary Cronk says!

Our ladies are assessed when they start to get pushy (with the exception of OP babies it seems obvious when they are fully)

They are then subjected to directed pushing until the baby crowns and then pant through while the perineum stretches.

Some midwives I have worked with encourage other positions such as all-fours, but they are a minority.

Most have epidurals, but not all and some with epidurals have pushed their babies out.

Don't even get me started on physiological third stages!

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I have seen multips go from 3cm dilated to head crowning on more than one occasion with no oedematous cervix. it is definetely an individual thing and if they want to push there is no stopping them. Unless it is OP I would not even bother to tell any woman to stop.

Hmmm, I agree!

Last week a lady (not one of ours) was 3cm (multip) sat up to have epidural sited and then vertex was visible!

Baby was born a few minutes later!

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I thought I was the only one with the smell sense indicator. I talked about it openly once and got looked at like I was mad, because at that point I just assumed everyone had the 'skill'. I asked a tutor about it and she said its relatively rare but you know it when you have it.

Never heard the cold ankles and legs one tho... interesting... saw the purple line at a homebirth, literally growing before my eyes, was amazing....

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StudentMidwife.NET Founder & Director

What do we live for, if it is not to make life less difficult for each other?
(George Eliot, 1860)

I personally don't do VE's at all if I can get away with it..which is quite easy to do as an IM. I trust the woman's body to do its thing and I trust my instincts, my senses and my knowledge of normal physiological labour to guide me. If you do a good palpation you know if you're dealing with an OP baby and assess labour accordingly. If we sit back and let a woman labour without guidance or intervention then she will naturally take up positions to help rotation of the head and if she gets pushing sensations then there isn't an awful lot you can do. If you try and stop her, she will get stressed, and this in itself will slow things down.

I have had a direct OP at home with a primip who had a great 1st stage and a 3 1/2 hour second stage. She had involuntary pushing for about 4hours (didn't see the purple line at full length when the involuntaries started) and I let her do what she had to do. She and the baby remained well throughout and she was obviously pushing an OP baby out. I actually thought at one point that we were going to witness a face to pubes delivery! But she turned at the last minute and was born with excellent APGARS and a very happy mum. She had a fair anount of moulding which is normal for this kind of delivery and I had warned my lady about it beforehand so she wasn't too shocked.

I doubt she ever got near to an oedematous cervix as she moved about a lot, was never actively pushed and her involuntaries were strong enough to assist rotation and decent but not so forceful that she was pushing really hard on the cervix....her body knew what it was doing.

Lovely delivery!! Very tiring for me however as long second stages are stressful for the midwife!

The only times I have know a true oedematous cervix is when a woman has been labouring on a bed, not been given the opportunity to move about at will and was actively pushed for part of the labour.

This is a huge subject and one which has been the highlight of many dissertations I am sure....in answer to the subject of this thread 'When to push..' I say whenever the woman wants to push.

I must stress that when I comment, I do so from a 'normal' perspective...things can be very different in a not so normal situation!

Vic xxx

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Vicky
Liverpool Independent Midwives

Oh, I want to be an Indie!

Imagine no VE's ?!

How lovely that sounds!

You are my hero

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Just reading posts, could you tell me what an OP baby is

thanks
E.