Coaching style during pushing

Specialties Ob/Gyn

Published

Wondering what you think about the cheerleader style of encouragement during pushing. You know...the counting to ten during every push and the constant instruction some coaches/care providers/nurses get into. I can see that it may be necessary for a few, but in general i think it's just plain annoying and unnecessary, especially when the patient is doing fine w/o it. I prefer calm reassurance and encouragment and keeping the mood/ atmosphere a bit calmer. Same goes for the breathing with ctx...the breathing is a tool, but I think is often overused and overrated. Isn't this supposed to be a natural process? The way some people coach I sometimes I feel like I am at a football game!

Canoehead thanks for the point about using your fingers at babies head, sounds great, hope I can remember it when in clinicals if I get a chance to put it to work! Last time I got to watch a C-S and it was great. Thanks again for the pointer!

At our hospital RN's and Docs all scream the 1-10 counts.... And yes I am guilty of it too esp with the epidural patients. They are always to numb to feel and they never effectively push. Been to recent conferences and have tried the grunting through method and it seems to be very effective. Anyone else using this

If they're too numb from the epidural, cut the rate in half. :idea: They will be able to feel to push much more effectively in about 30 minutes. And if you can't do that, then why don't you just labor down? If they've got an epidural and are numb as stone, just let the uterus push the baby down. No sense in pushing if there's no urge and the babe and mom are doing fine.

Some of our docs still want them to do the count thing.

We actually had a nurse who stood against the wall, with her arms crossed, facing the pts perineum loudly counting "PUSH, TWO THREE FOUR..." like a drill sargent or something. In some cases the counting helps, but women do best if the can listen to their own bodies and urges and are supported in doing so.

Originally posted by moz

We actually had a nurse who stood against the wall, with her arms crossed, facing the pts perineum loudly counting "PUSH, TWO THREE FOUR..." like a drill sargent or something.

If I had been the patient, I would have told her to get the f*** out of my room and demanded a new nurse. :( :rolleyes:
Specializes in Obstetrics, M/S, Psych.

I agree, Shay...Sarge sounds like one damn ineffective labor nurse. I'd hoped all of that type had retired.

Specializes in OB, Post Partum, Home Health.

We have one MD, that by the way I think the world of, he is a great doc, that while the pt is pushing, he will say "work it girl!" It is sooooooo funny that many times I have to turn my back so the pt doesn't see me laughing!!

I follow the patients wishes and what works best. in general I hate the counting cheering thing unless of course it works. I believe in going with the urge to push and letting the mother do what feels right to her. if the epidural is affecting her pushing i turn it down or off depending on the need of the moment. I really hate when there is 5 or 6 family members in the room yelling push or counting .that just burns me up:)

i agree with canoe head , i usually use my fingers to feel the baby move and when mom does it right i let her know to push just like that each time. this is very helpful with epidural patients.

i hate counting. baby story does for l/d what cap'n crunch does for dental health. i try to follow pt's cues. i had happily short labours and didn't have to endure any irritating counting 'cause i'd tossed those counters outta my room. last week i was in a room w/ so many people screaming and counting and instructing this poor gal who had iv pain med and was having a preemie...it was like halloween!

Ok, I have to admit I counted for laboring patients while in my L&D rotation.

But the RN told me to!! I was just a student and so cannot be held accountable for my actions!!

There. I feel better now.

Hi, my name is Rebecca and I have watched A Baby Story. And guess what.... my high school drama teacher was on it. She was as dramatic as ever. I was soo glad when they gave that heifer an epidural.

Specializes in Obstetrics, M/S, Psych.

Another baby story...

Yep, that's pretty much what it looked like.

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