Pushing before complete

  1. I used to work at a facility that highly discouraged pushing with a rim...it was always best to wait and let mom labor down first. (Concerns about cervical swelling and lacerations). This was for both primips and multips.
    At my new job, I checked my pt and she was 7cm, and the doc said to see if she could push through it. The other nurses think I'm nuts because I refused. It may be the norm at this facility but I don't feel comfortable doing it.
    Does anyone agree?
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    About winterblue

    Joined: Sep '03; Posts: 24; Likes: 54

    15 Comments

  3. by   fergus51
    I wouldn't do it. Did she even feel an urge to push? I generally don't like directed pushing.
  4. by   Spidey's mom
    I agree with Fergus . . sounds nuts to me. Why not let nature take it's course? What is the big hurry? Golf game gonna be delayed or something?

    steph
  5. by   VivaLasViejas
    With my last vaginal birth 16 years ago, I was told to push when I was at 8 cm, and let me tell you, it hurt like a b****. They were in something of a hurry to deliver because there was meconium in the amniotic fluid when they'd ruptured my membranes, plus I was a VBAC (after 2 c-sections!), so there were some good reasons to get the show on the road.......but it sure didn't feel good, like pushing normally does when nature decides it's time. I don't recall that it did any damage, and the baby turned out just fine; it was so late in the labor process that I never did have any medication, and he was so alert he held his head up and looked around the delivery room! But given my druthers, I wouldn't have pushed before the urge hit me......it was just really painful.
  6. by   KellyLynn
    Bad for fetus and can be bad for mom...agree wait to push.
  7. by   Zhlake
    Boy that sounds way early to push.

    I have had very good success both personally and at work with having moms bear down minimally if they are in transition and feel the urge to push. Basically it is just following the natural course of things. Many times in transition moms have a sort of..heavy grunt..at then end of a ctx. Sometimes that minimal pressure helps reduce the cervix. I did this when I was in labor in March. After a few ctx of doing that, I had the urge to push and sure enough I was complete.
  8. by   bam_bam
    Primips no way! Multips, if they have the urge to push we let them gently bear down with contractions. When my sister was having her 5th baby and was 8cm she had a very strong urge to push but they wouldn't let her. She didn't deliver at my facility. I was whispering in her ear to go ahead and bear down but she didn't because they told her that she would tear her cervix and she was scared.

    If there is no urge to push though I would never allow that!
  9. by   BETSRN
    You did the right thing! Pushing with that much cervix is sure to cause problems.7 cm is not usually considered a "rim." Your doc juts wanted to get out.
  10. by   dixienurse2be
    I am just a first year student but I was allowed to sit in on a delivery yesterday during clinicals. This was the mother's first child and she had lacerations due to pushing with a rim. i don't know all of the details or technical stuff because they just grabbed us off of another floor because it was a good opportunity. But I was wondering about this because she did have several lacerations. Glad i saw this post.
  11. by   Daqueengene
    Labor down Labor down Labor down
  12. by   JoniL&DRN
    Quote from bam_bam
    Primips no way! Multips, if they have the urge to push we let them gently bear down with contractions. When my sister was having her 5th baby and was 8cm she had a very strong urge to push but they wouldn't let her. She didn't deliver at my facility. I was whispering in her ear to go ahead and bear down but she didn't because they told her that she would tear her cervix and she was scared.

    If there is no urge to push though I would never allow that!
    This is similar to my personal experience... At 8-9 with urge my OB would encourage grunting not full pushing. Again WITH THE URGE! Are these doc's in a hurry or what? Why don't people trust the female body?
  13. by   AutumnRose
    I'm fairly new to L&D, less than a year. We have a doc that routinely rushes to push, and calls a 6-7 complete. Sometimes the moms deliver....but we end up with stat c/s more than the other docs. Needless to say we all cringe. Thank God the moms and babys end up fine.

    We have another doc who is more laid back and lets mom labor down as long as theres no sign of distress. The birth experience for mom is better. With epidurals I see no reason to rush. Labor Down!!!
  14. by   JenTheRN
    calls a 6-7 complete
    Wow...now that is stretching it (no pun intended). Our docs almost always wait until the mom has the urge to push.

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