Pushing Positions

Specialties Ob/Gyn

Published

How long do you let a patient push in one position?

For those of you who don't have them change positions, if they don't make much progress after 2 hours in one position.. do you suggest they try another position or just get the doctor to assess for a c-section?

I am posting this because I am trying to figure out why at the last birth I was at that ended in a c-section, the nurse only let her push in semi-sitting with legs in stirrups and never suggested squatting or an upright position (even after 2 hours).

Thanks!

obtnt i like your post and totally agree with you. I constantly move my patients and dont usually push them unless they have the urge

0 Votes

obtnt ~ I LOVE YOU!! Every word that you just said, I completely agree with. I know I haven't gone to nursing, or medical school, or even attended more than 2 births.. but I have read so many birth stories (like on childbirth.org) and on a few pregnancy and parenting message boards that I am apart of. I am seeing a huge trend and everything you said, just about says what I am seeing! Docs want to move the pts on out so they are inducing / giving c-sections way too much, just because they want to keep things going.

My FIRST client was to be induced on her due date, which was a thursday, because her doctor was leaving on friday evening and going on vacation for the weekend. I made sure I told my client she has every right to refuse this.. and she went into labour on wednesday, the DAY BEFORE her induction! WOOPEE!!! and she had a great labour and birth. Only took 45 min to get from 4cm to 10cm.. primip too!!

Ok sorry I am blabbing, it's late and I have no one to talk to but myself inside this little post :chuckle

0 Votes
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

it is hard to have an urge to push to work with in the first place---- when 80% or so of my patients have an epidural and no, the dr will not let me turn it down. in theory, i totally agree. but in the world of anesthesized labor where the woman knows not where her legs are, let alone feel to push, good luck folks. can you see how i feel about all this???? (heheheheh):o

0 Votes

i regularly turn down the epidural to get them to push it works wonders

0 Votes

I had more than one doc say, "What do you mean let her labor down? I've never heard of a woman not pushing at 10cm." God, sometimes I can't stand docs!

Mark, they let you around the epidural pump? We can't touch it except to turn it off after delivery or if the doc orders it turned off during pushing.

Gail

0 Votes

yes we can adjust the rate up or down with a doctors order. according to our states board of nursing rns who are properly trained can even redose edidurals with non narcotics and pull the epidural caths, hows that for progress?

0 Votes

Bringing up personal experience again.. my nurse turned my epidural down so I could feel the urge to push and I loved it. When I went to the mother/baby unit, another RN pulled it out of my back.. EW that just sounds so horrible! (shivers and gets the willies)

0 Votes
Specializes in OB.

Another great thing about working nights - I can allow my pts. to labor down, wait for the urge, change positions, and not wake the doc until the last minute ( and they think I'm being SO considerate - LOL).

0 Votes

HEHEHEHE exactly baglady, i try to never call them until the baby is crowning works best for my patients. it is amazing how low the forcep ,vaccum assist and episiotomy rate is for my patients. got one doc i work with that always seems to do an episiotomy,but with my patients he has only got to cut one so far. and gee guess what no tears either,:).

0 Votes
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

we can up or down the epidural rates, when APPROVED (ugh) by anesthesia. (UP, I can see needing their approval, but DOWN?!)...

and we regularly pull the catheters out. This is considered a nursing function where I work. On pushing, I forgot to mention, I prefer to let the person "labor down" if she has a heavy epidural right til the last minute, then have her push. It sure works out great for mom cause she is much less exhausted and the baby usually comes out great, too. often by this time, they are at least AWARE there are contractions and work WITH them.

0 Votes

Man I wish you guys would have been my nurses! With my first baby I had an epidural *sigh* I pushed for 4 1/ 2 hours in the same position. (flat on my back) I couldn't feel a thing. I couldn't have changed positions if I wanted to because my legs were so numb. I was threatened with a c/s and given 20 minutes to finish the job which I did. I know now from my other 2 babies that it didn't have to be that way at all.

Kat

0 Votes
+ Add a Comment