How long do you push?

Wow that seems so short. I pushed 5 1/2 hours with my first. But then I had a CNM.

jee this is surprising usually MW are more in favor of laboring down...

Ginny Doula RN SNM

jee this is surprising usually MW are more in favor of laboring down...

Ginny Doula RN SNM

I was drug free and had an urge to push. And I do mean a strong urge. My dd was also sunny side up. I pushed every where. On the toilet, in the shower, kneeling on the bed. If I had drugs and didn't have the urge she probably would have waited (the mw). And my ctx were still 5-10 mins apart when I delivered my first. I am sure a dr would have given me some pit. I would probably had refused but I think they can get pushy. Since mine and the baby's vitals were good we so no reason to hurry mother nature along.

Funny but I even had the urge when I had an epidural with my last (wanted a tubal w/o going to sleep).

jee this is surprising usually MW are more in favor of laboring down...

Ginny Doula RN SNM

Where are you going to school at?

Beautiful work, Daisy.

Thanks! I'm a recent grad, and my preceptor- a truly wonderful role model in every aspect of nursing care- introduced the concept to me.

My friend was asked (forced?) to push for 7 hours until office hours were over for her OB. She claimed that the baby wasn't descending but the nurses told her she was making "slow progress." Well, perhaps. :rotfl:

After office hours were over, her OB came to examine her and couldn't because she was too swollen (the nurses had already started icing her perineum). Then they CS her. This was the same OB that wasn't going to consider an induction until 43 weeks. :angryfire

SEVEN HOURS???????????????????????? good lord. How on EARTH?

When I originally posted this question, I had a 18 y/o primip who had pushed for almost 3 hours. She also had a diagnosis of pre-eclampsia. This was not actually my patient, but I was helping out a co-worker because I had some time and our unit was particularly slow this day. She ended up going to section, but at the time I wondered if we had let her rest and labor down (in the earlier stages of pushing) maybe the outcome would have been a little different. I actually prefer this method as well, but I'm not about to tell a nurse with 13 years more of L&D experience than me how to run her delivery. So the next day I have this same patient post partum. When I go to check her lochia, my mouth falls open and I am panic stricken by what I see. I have never seen swelling to that degree before. Her poor perineum looked like one huge "blister". At first glance, it looked as if her bladder was protruding from her lady parts. I go and get the doctor since he was in-house for him to assess the patient. He said that since she had pre-eclampsia and pushed for so long, that the fluid was actually third spacing in her perineum. Has anyone ever seen this? If so, was there any specific treatment?

When I originally posted this question, I had a 18 y/o primip who had pushed for almost 3 hours. She also had a diagnosis of pre-eclampsia. This was not actually my patient, but I was helping out a co-worker because I had some time and our unit was particularly slow this day. She ended up going to section, but at the time I wondered if we had let her rest and labor down (in the earlier stages of pushing) maybe the outcome would have been a little different. I actually prefer this method as well, but I'm not about to tell a nurse with 13 years more of L&D experience than me how to run her delivery. So the next day I have this same patient post partum. When I go to check her lochia, my mouth falls open and I am panic stricken by what I see. I have never seen swelling to that degree before. Her poor perineum looked like one huge "blister". At first glance, it looked as if her bladder was protruding from her lady parts. I go and get the doctor since he was in-house for him to assess the patient. He said that since she had pre-eclampsia and pushed for so long, that the fluid was actually third spacing in her perineum. Has anyone ever seen this? If so, was there any specific treatment?

Oh honey, yes, I have seen this. I have seen labia and peri's so swollen, they looked like balloons between the legs. Treatment is to keep ice/cold packs to the site, Motrin 600mg po q6 hours for pain/inflammation and KEEP HER OFF HER TUSH!!! (side-lying as much as possible ) to alleviate dependent edema that occurs when they are sitting too long. Also, if a foley catheter is in place LEAVE IT THERE until the swelling subsides; it's sometimes nearly impossible for mom to void when this swollen. If there is no catheter, be sure you are assessing her voiding/bladder status often and straight-cath or place indwelling cath PRN. Should already be a standing order to cover all of this.

It's a horrible sight, but fortunately, is temporary.

I wish I wish I wish more docs would understand the whole labor down thing. Especially the epiduralized women. Sheesh.......it is so frustrating and such hard work on everyone...

Our docs have gotten good about that (the ones that are more impatient). I jsut usually tell them I'll call when I need someone and they like NOT being there anyway.