Rethinking the Pushing Stage

It’s extremely common for pushing stages to be managed, with laboring people reclining on their backs and being told to grab behind their knees and pull them open towards their ears, while tucking their chins, and holding their breath for a count of 10. Is this really the best way? Does it support physiology? And what effect does it have on the baby, and on the perineum that’s receiving the brunt of that exertion? The fabulous Whapio is here to tell us more. Check it out.

What we talked about:

• The missing stage between 10 centimeters and pushing (plus, how physiology will set you free)
• Managed pushing vs. instinctual physiological pushing
• Interior crowning of the head on the cervix
• Allowing time for the internal rotation of baby’s head
• What this looks like from the outside: “The Quietude”
• How pushing early creates (unhelpful) friction
• The importance of taking that rest
• Pushing from a place of inner alignment (i.e. let your body guide you)
• Following the British model, with two stages for pushing (latent and active)
• The importance of (baby’s) head extension before pushing
• Looking at those who can’t push, and still “ooze” their babies out
• Grinding = increase in fetal distress
• How will you know if it’s time?
• What immediate pushing can do to your pelvic floor
• How are contractions like waves in the ocean?
• What if you get checked and there’s a “cervical lip” that gets “pushed out of the way” and then you’re told to push?
• What about this idea that you need to be on your back to get baby’s head “under the pubic bone”?
• What if care providers insist on managing your pushing stage?

Related resources*:

• Is Pushing During Labour Necessary? BellyBelly
• Are women pushing too hard, and too soon, during labour? Today’s Parent
• Women in Labor Stop Pushing, See Amazing Results, Mothering
• Supporting women’s instinctive pushing behaviour during birth, Midwife Thinking
• Pushing: leave it to the experts, Midwife Thinking
• The Anterior Cervical Lip: how to ruin a perfectly good birth, Midwife Thinking
• Pushing for First Time Moms, Birth with Gloria Lemay podcast
• Pushing methods for the second stage of labour, Cochrane systematic review
• Effect of spontaneous pushing versus Valsalva pushing in the second stage of labour on mother and fetus: a systematic review of randomised trials, British Journal of Obstetrics and Gynaecology
• Fetal Ejection Reflex – What Is It And How Does It Happen? BellyBelly
• Fetus Ejection Reflex and the Art of Midwifery, Womb Ecology (by Michel Odent)
• Care Practice #5: Spontaneous Pushing in Upright or Gravity-Neutral Positions, The Journal of Perinatal Education
• The Evidence on: Birthing Positions, Evidence Based Birth
• Evidence on: Prolonged Second Stage of Labor, Evidence Based Birth
• Shoulder Dystocia: the real story, Midwife Thinking
• When and How to Push: Providing the Most Current Information About Second-Stage Labor to Women During Childbirth Education
• Promoting Physiological Pushing in Labor

Other episodes with Whapio:

• Transformation Through the Holistic Stages of Birth (Part One)
• Transformation Through the Holistic Stages of Birth (Part Two)

Related Birthful episodes:

• Protecting Your Perineum
• What You Need to Know about Birth Positions
• Can Exercise During Pregnancy Make Labor Harder?
• Talking Pelvic Health with a PT

Courtesy of Whapio

About Whapio

Whapio has been an Independent Midwife for the past 30 years. In 2001, she founded The Matrona, where she hosts an online holistic midwifery program, holistic doula programs, and postpartum doula programs to designed to educate birth caregivers, and provide a balance of the academic and intuitive aspects of birth. The Matrona advocates the Return of Birth to the Family and espouses soul-level connections between caregiver and mother and an understanding of altered states of consciousness relevant to childbirth.

Whapio has written and shared ‘The Holistic Stages of Birth‘ with families and caregivers in order to reframe the process of labor in language that best describes the journey of birth. You can read it on her website: thematrona.com (and you are welcome to share it with others!)

The Matrona is also a non-profit organization designed to bring authentic information about birth to marginally resourced women who can then return to their communities and care for mothers and families as Doulas. To that end, each year they offer numerous scholarships and free-of-charge Holistic Doula programs to the larger community.

Whapio also teaches homeopathy and conflict resolution as part of Matrona classes and is an elder in her community.

Find out more at thematrona.com or follow the conversation on Facebook.