Is Mother Directed Pushing Possible in the Hospital?

April 7, 2010

I love Lamaze’s 5th Healthy Birth Practice: Avoid giving birth on your back and follow your body’s urges to push.

Their video is great, but here is an example of what more likely happens in a hospital setting.

Polly is having a wonderful un-medicated hospital birth – things have progressed quickly and the staff has been supportive about her birth preferences.   It has been a calm and peaceful un-medicated birth.

She starts having an urge to push and the nurses check her to confirm she is 10 cm and then call her OB, who is about 15 minutes away.

The feeling in the room has changed.

“Don’t push!” The nurse keeps barking at her as she bustles around getting the room set up.

Polly struggles not to push.

“Don’t push!” the nurse orders as more people fill the room, including an on staff OB.

Polly can’t help but push.

“Don’t push!” the nurse chastises her as she gets the mom into the stranded beetle position.

Oops, I meant something like this –

Polly’s OB arrives.  Now there is a new urgency in the room.

“PUSH! 2,3,4,5,6,7,8,9,10”

Polly starts pushing at their command.

“Push again!”

Polly tries to rest and she is chastised again, “Keep going, one more push!”

“PUSH 2,3,4,5,6,7,8,9,10”

It is as if now that the OB is here it is a huge rush to get the baby out.

Polly keeps following orders and after X minutes her baby is born.

This is so frustrating to see when it happens to my doula clients.  (there is one hospital in my area that is very supportive of mother directed pushing, but at the other hospitals it is an uphill battle).

I teach about Mother Directed Pushing (MDP)  in my Hypnobabies class and I try to help make it happen at births I attend by telling the nurses way before pushing – “Mom wants to push in hands and knees position (or whatever mom wants) – I also remind her she wants to do mother directed pushing.    But somehow when the pushing stage begins, most care providers fall back into their “normal routine” and it takes a lot of work to get them out of that routine.

I try to balance what the nurses are barking at my client with “Follow your body, you are doing great!”  and remind care givers mom is doing MDP.  But the mom has to choose who to listen to.  (These are in situations where mom and baby are doing well.  If there is a problem with the baby then certainly I would let the nurses take charge… I always check, “Is baby doing ok?” )

So YES it is possible, but it takes preparation and support to make it happen. I made this video showing 2 hospital births where it did and give tips for mom, birth partner and doula as to how to help make it happen for you!  I would love nurses to watch it too and give feedback.

Is it possible to do Mother Directed Pushing with an Epidural? Yes!  I have seen it done with moms who can feel what is going on.  Here is an amazing video of a mom doing so!

So here is a set of tips to help make MDP happen.

  • Talk to your care provider during pregnancy to see if they are open to different pushing positions and MDP.
  • Tell your nurse before pushing starts you want to use different pushing positions and MDP.
  • As pushing phase begins, quickly get into alternative pushing position (once you get in the stranded beetle position, it is hard to get out.)   Having a supportive nurse or doula can help so much with this!
  • Follow your body and push when you feel the urge.    If you don’t have a strong overwhelming urge to push, you may want to start by breathing the baby down and out, or change to a new more upright position.
  • If the care providers are coaching you, remind them you are doing MDP and ask them to stop.

Would you get your teeth drilled without drugs?

August 10, 2009

Then why would you give birth without drugs?

This is a common question asked to moms preparing for Natural Childbirth.

Here is a great explination on you tube!  A shift in perspective. 

(If you prefer to read, rather than watch go here.)

Here are the videos referenced in the above video.

Video 1 – Man gets root canal using only hypnosis.

Video 2 – Woman gets teeth pulled and inplant put in, using only hypnosis.

Video 3 – Childbirth using Hypnosis

Jake’s Birth Story: A Hypnobabies VBAC

July 11, 2008

My Hypnobabies VBAC success story

I had been having contractions almost every night while working at
the computer, but any time I laid down they would stop. On Friday,
Nov 16, it was the same thing, contractions every 5 minutes but if I
laid on the couch they would stop. So finally at 11pm I just went to
bed. I got all ready and in bed and after about 10 minutes I had a
nice contraction. I waited and it happened again. I was not very
comfortable in bed so I went and sat in the rocking chair and
listened to my 1st stage birthing scripts. When they kept coming
pretty frequently I finally woke up Dan and asked him if he thought
we should call Jen to come over to watch the girls.

We decided I should at least call her to give her a heads up. This was around
12:30am. I called Jen and was talking to her and she decided she
should come over. I was so excited that this might be the real
thing!!! She got to my house around 1:10am and we started timing my
contractions. They were less than 3 minutes apart, but this being my
first vaginal birth we figured we had time. So we made brownies for
the nurses, called my mom and sisters and finally around 2am, I woke
up Dan to get ready to go to the hospital. We were getting ready to
leave and of course the twins decided to wake up. So I tried to get
them back to bed. I was up there rocking them for about 20-30
minutes and had quite a few contractions:) I think they knew
something was up and they wouldn’t go back to sleep so they got to
come downstairs and watched a show with Aunt Jen. The contractions
were not bad at all and I just relaxed through them.

We got to the hospital around 3:30am and they checked me and I was 2cm dilated.
They hooked me up to the fetal monitor to check his heartbeat and
then I walked around. They checked me again at 4:30am and I was 3 cm
dilated. They pretty much left me alone after that. I walked, took
a nice hot shower and sat on the birthing ball. Dan was great
through it all and there for me. I still was feeling great and
breathing through each contraction.

The midwife came in at 7:30am and said that they were probably sending me home. She said it is
better to go through the early labor at home but wanted to check me
first. My contractions were still about 3 minutes apart at this
time. She was very surprised to see that I was at 7cm:) She said I
looked so relaxed and calm. Things slowed down after that but I
still was feeling great. The contractions were getting a little more
intense but nothing unmanageable. I would want Dan to be next to me
for each one and he would help with the relax cues and his hand on my
shoulder. In between he would tried to lay down and rest but as soon
as he laid down another one would come and he would have to jump
right back up:)

I also remember that I made sure to keep my whole
body relaxed during the contractions. I would face my hands palms up
and make sure my shoulders were relaxed. I continued to walk, took
another hot shower and sat on the birthing ball. I also leaned on
Dan and just went limp a few times. Through this all Dan was great
at keeping the nurses away from me during each contraction and being
there for me to use the cues and help me relax through each
contraction. He was also sending text messages to family to keep
them updated. He did this instead of calling so I would not be
distracted. The nurses and midwife kept commenting on how calm the
room was.

I was finally fully dilated at 1:30pm. I started using
the exhale breathing and was in a squatting position. This felt good
but after a while my knees started to really hurt:) They needed to
check his heartbeat so they asked me to turn around. This position
actually felt a little better. After about an hour they told me that
since it was my first vaginal birth I would probably not be able to
use the exhale pushing to get him under the pelvic bone and my bag of
water just would not break. We were trying lots of positions. So I
had to use the “blue face” pushing but I still listened to my
Hypnobabies pushing cd and was able to keep my body relaxed while
doing this.

Since my bag of water would not break, it was keeping
his head from really engaging. So I got up for a little bit and
tried to use the bathroom. Once I got back into bed I had about 3
more contractions and my bag finally broke. The midwife knew I did
not want any intervention but I think next time I might tell them to
break my water while pushing:) This was around 3:30pm. I had a few
more contractions and finally got his head under the pelvic bone. I
felt his head coming down and out and it was such a great feeling.
He was born at 4:06pm and the whole birth was amazing. It was such a
wonderful feeling to feel him come out. They put him right on my
chest and waited for the cord to stop pulsating before Dan cut it!!
He weighed 9lbs 2 ozs and was 21 inches long. His head was 38cm:):)
It was my perfect vbac Hypnobabies birth:)

Thanks to Hypnobabies, my wonderful husband, Dan, and my wonderful
Hypnobabies coach, my sister Jen:):)


Do Doulas replace Dads?

July 8, 2008

This is a question my husband had when I wanted to hire a doula for Bryson’s birth.  I reassured him they didn’t.  When we met with Alison and talked with her about her role, he felt much better about it.  Then after the birth he wondered why we didn’t have one for each birth? 

He LOVED having a doula!  He was not replaced at all, rather he felt as if he had a huge weight lifted off his shoulders, he could relax and enjoy the birth and let someone else (Alison) worry about the details. 

I have found that sometimes dads are worried about this.  But if you ask any dad who has had a doula at his child’s birth, they are the biggest supporters and say it is great! 

Here is a great chart explaining why doulas do NOT replace dads!

Support for VBACs from Australia…

January 13, 2008

This is an interesting article from the Australian birth community.  It discusses how the cesarean rate is too high and the problems that is causing for women and for the medical world there.  I hope America figures this out sooner than later!

If you are a mom trying to GIP (gestate in peace) you don’t need to read it.  But if you are someone interested in cesareans and VBACs, then it is a great read!

ICAN is a great resource for cesarean and VBAC support!

Enjoy Birth Tip #1 – Get a Birth Doula

December 24, 2007

Having a birth doula can help you have a more enjoyable birth! 

The Advantage of having a Doula.

Studies have shown the following benefits of having a doula present at birth:

  • 45% reduction in c-section rates

  • 25% shorter labor

  • 60% reduction in epidural requests

  • 50% reduction in pitocin use

  • 31% reduction in analgesia use

  • 34% reduction in forceps or vacuum deliveries

Women who have used a doula at birth are more satisfied with their births, feel more confident before and after the birth, show a quicker rate of bonding with their newborn, are less likely to have post-partum depression, and more likely to breastfeed.

Having a doula is a wonderful way to help you have an enjoyable birth.  Doulas can assist moms in any birthing situation, from moms who want an un-medicated birth, moms who plan on epidurals to moms with planned cesarean births.   Each doula has different training and specialties, so interview different doulas to find one that matches your needs!

What do doula’s do exactly?  We provide support to a mother and her family during her birth.  We do this in many different ways… 

Resource for Comfort MeasuresHaving a doula is like having your very own talking birthing guide. Doulas know what can help during birth and how to do it. Your doula can either perform these comfort measures herself, or help your family or friends to support you with comfort measures. Your birth partners will feel more confident knowing that they are doing the right thing.

Constant Encourager: A doula not only encourages the mother to keep going, but she encourages the labor support to keep going as well. The process of labor can sometimes be long.  A doula can keep you and your partner focused during the most intense part of labor.

Helps Explain Options:  A doula is also a source of information about ways to handle your birth. Medical attendants don’t always have time to get into all the options available, and rarely give all the risks and benefits for the options they do give. A doula can help you understand what options are available, and what the pros and cons are. This can help you make better informed decisions.

Pushed by Jennifer Block

December 17, 2007

Pushed:  The Painful Truth about Childbirth and Modern Maternity Care

by, Jennifer Block

Wow, what a book!  When I read books from the library, I put little slips of paper on the pages I want to go back and look at.  You should see my book; there is easily over 20 pieces of paper sticking out of the top.  This tells me I need to buy this book!  I am just sad I didn’t buy it in the first place, as my library copy is now past due and I don’t have time to take notes on all I wanted to.  So this may be a brief review, mostly because if I wrote ALL my thoughts it would become a book itself.  J 

Who is the audience for this book?   Any person interested in birth.   I would love to see this be a text in a college class to help people think about birth before they are pregnant.  It would be wonderful in sociology or a women’s studies class.  Really everyone of childbearing age should read this book!

I loved the way the book started; with a hurricane causing a hospital to change the medical way they normally handled birth due to limited supplies/manpower/energy.  They cancelled the planned inductions for the week; they sent moms home if they were not in active labor.  The staff saw a LOT of normal births, instead of the typically medically managed births.  Because they were not using pitocin “We had no cases of fetal distress during labor and respiratory distress of neonates following delivery…. And an incredibly low cesarean rate.”  Wow, what a concept, let women progress through their birthing time on their bodies own timetable and you have better outcomes for babies and moms?  Revolutionary!  

The book just gets better and better.  It touches on inductions, cesareans, vbacs, unassisted births, home midwives, doulas and much more.  There were 2 scary scenes that I would say pregnant moms trying to GIP (gestate in peace) may want to avoid.  Page 203-207 and Chapter 7.  The rest is safe. 

Frankly this book really made me think about birth and my rights as a woman.  The choices I make during my births and the power I DO have.  It made me also more aware of the way the government/OBs/insurance companies, are trying to take away my choices.  This should be a woman’s issue, but it isn’t embraced by the women’s groups, they see it as a medical issue.  But we need to remember normal birth does not need to be a medical event! 

The book ends with this thought by Jennifer, after commenting on how the goal of having a healthy baby is used to scare women into doing things that are not necessarily evidence based,  “Today women have unprecedented access to the information they need to make the best decisions for themselves-and therefore the best decisions for their babies.  They are in fact in a far better position to make evidence-based decisions than their doctors.  They have a right to make those decisions, and they should make those decisions.  The goal is to have a healthy family.”

I think this is SO true.   Women of the world, take the power back!  Inform yourselves of our choices, empower yourselves, and choose to have a healthy family!   This is where a good INDEPENDENT childbirth class is so great (not hospital based) Because we can share the information on what the choices are, the pros and cons of them, caregiver options, birthing options as well as basic childbirth information all together in one class.  To help families figure out the best choices to help them have the best birth possible. 

This is a MUST read!

Jennifer also has a blog!

New Cesarean Rates are not surprising, but are disappointing.

December 6, 2007

Cesarean rates are at an all time high and no one in the medical community or women’s groups seem to care. 

But there are women who DO care!  I am one of them.  In the next weeks I will be posting some articles I have been working on regarding worries and fears and how these can effect their births.  The thing is MANY women are being scared into unnecessary cesareans.    This then leads to an increase in risks to mothers and their babies. 

I think that education of parents is key to helping to decrease the cesarean rates.  The medical community doesn’t seem to want to rectify the situation, so parents need to make wiser choices in their care providers and in their birthing education to get the healthiest births possible. 

Great ideas for choosing a care provider…

November 27, 2007

How can you find the best care provider for your birth?   Well, a lot of this depends on what kind of birth you want to have.  How can you know what kind of birth you want to have? 

1.  Take an independent childbirth class. (outside of the hospital system)  Here you will learn about all your options for birthing, choices you can make. 

2.  Read good books talking about different options for birthing. 

3.  Read positive birth stories, looking for similarities in the births.  What did those moms do to create a great birth?

Here is a great post on another blog with more ideas, questions to ask, things to think about!  Check it out!

Cool Birth Movie “The First Cry” released in France

November 6, 2007

I learned about this on Rixa’s Blog.  

Le Premier Cri looks (site is in French) like a film where they go to different countries and cultures and film different births.  It looks like it is GREAT!  I can’t wait until it comes out on DVD.  🙂