When is the right time to push?

k_cole21 · Jun 28, 2005

This is really nice that you say that. I've found that a lot of OB nurses are really ignorant when it comes to the laboring down technique and waiting to push. I did some research on it after having my baby. I was just chilling out, had my epidural and the nurse comes and tells me I'm 10 cm and it's time to push. Everyone in the room including my mom and motherinlaw starts YELLING at me PUSH PUSH PUSH. I am Exausted, and the nurse tells me I *have* to push in 3's (3 counts of 10 during each contraction) and I am holding my breath and pushing as hard as I can and seeing stars***, begging them to let me push at least "in twos" (everybody laughed when I said that). After a few minutes of pushing, doctor gives me an episiotomy and my mom and mil tell me it was because I didn't push fast/hard enough, even though I was giving it my best (kind of hard to do when you're about to pass out from lack of oxygen). Anyway, after the episiotomy the baby slides right out (only 6lb15oz after all). I have this reallly painful episiotomy that does not heal well and is really painful for about 8 weeks and the only thought I have to console myself with is ITS MY FAULT because I didn't push him out fast enough. The whole thing was over in tops 10 minutes. I feel that if I had been allowed to labor down, and if they had let me push more spontaneously instead of making me push to a count a of 10, that I would not have needed the episiotomy. I think the doctor just wanted to get back home to his nice warm bed. I ended up feeling "rushed" through my birth experience and traumatized by everyone in my face yelling and counting AT ME and then getting cut for no good reason. I would love to have a midwife next time I deliver, in fact, I would rather have an unassisted homebirth than get treated like a piece of meat that needs to get delivered and moved in and out as fast as possible.

If all that took 10 mins than laboring down wasn't really an option. Hopefully your doc cut an epis b/c you were tearing not the speed things along. The head must have been low enough.....

NurseforPreggers · Jun 28, 2005

Most of the times that women are not "allowed" to labor down it has absolutely nothing to do with the nurses. Think about it this way ... as much as you don't want to be pushing for hours the nurses just as badly don't want to be doing it either. There is nothing worse than being tied up in a room for hours pushing.

Docs can be very impatient. Especially depending on the time of day or night. And yes I have seen doc's come in cut an epis and pull the baby out with a vacuum with little or no pushing from mom. It is sooooo wrong, but it does happen unfortunately. Everytime I see a situation like this I think to myself, "thats why you will never be my doc or take care of anyone I love".

NursePamela · Jun 28, 2005

So are you saying another reason to wait until a hard and fast ten is for staffing issues? I know for fact that they had to turn my pitocin off at least twice due to staffing issues. I was being induced do to Pre-eclamp. and they openly admitted they had to turn it off.

NurseforPreggers · Jun 29, 2005

So are you saying another reason to wait until a hard and fast ten is for staffing issues? I know for fact that they had to turn my pitocin off at least twice due to staffing issues. I was being induced do to Pre-eclamp. and they openly admitted they had to turn it off.

I'm not sure if you were directing this statement at me or not. I reread the posts and I don't see anyone saying anything about staffing issues, unless you were referring to my comment about the doctors availability. Yes, we generally don't like to have our patients pushing before the doctor will be available for delivery, if that is what you are asking. I wouldn't exactly call that a "staffing issue". Maybe I am missing something.

k_cole21 · Jun 29, 2005

I forgot to mention that if a pt is having a hard time w/ 3 sets of 10, I will have them do 3 sets of 8. It's bebeficial in many cases than to have the pt only make it to 6 on that 3rd push that is so important.

NursePam....are you sure they didn't turn it off for other reasons? There are multiple reasons that pit goes off.

RNnL&D · Jun 29, 2005

So are you saying another reason to wait until a hard and fast ten is for staffing issues? I know for fact that they had to turn my pitocin off at least twice due to staffing issues. I was being induced do to Pre-eclamp. and they openly admitted they had to turn it off.

That was for safety's sake. If a unit is extremely busy, it is unsafe to run Pitocin on patients, without the staff to adequately monitor them.

NursePamela · Jun 29, 2005

Yes, I was referring my staffing issues to NursePreggars. Staffing being doctors or Nurses. They told me directly they had to turn off my pit because it was shift change and then again because someone was delivering twins. Not to mentions they did not even start it until about 7 hours after the doctor ordered it.

So I guess I was saying or questioning not letting the woman push until a doctor or nurse was available. However I will say that having a catcher in this particular "game" is somewhat important.

ljds · Jun 29, 2005

We don't do alot of VE, so when mom feels the need to push, she pushes. In most cases, mama starts grunting, then giving a little push at the height of her contraction, then as the baby moves down, starts to push with more effort. If she is pushing without progress, or complaining of pain with pushes, then we do a VE to see if there is an anterior lip, or if she isn't completely dilated and has a firm, unstretchy cervix. Using mom as a guide, I have never seen a case of a swollen cervix or a cervical tear in my four years here. Occasionally we *do* have a mom who has the urge to push before her cervix is ready. Then we also encourage her to breathe through them, position for comfort, keep her bladder empty, and encourage frequent position changes to help the baby move down and her cervix open up.

If she felt like pushing and she was an 8, perhaps her cervix was very stretchy, and slipped up over the baby's head during her pushes, so the nurse/doc/mw felt comfortable encouraging her to give little pushes.

Lori