Second Stage - to push or not to push?

Extract from Calmbirth Booklet

This concept has its origin in the Active Management of Labour given to us by a group of Irish doctors in 1970s. Their belief was that every mother’s labour and birth has to fit within a certain time frame. This belief was carried on and is still very much in evidence in many of the maternity hospitals throughout the western world. A number of Calmbirth mothers have reported that when labouring in the hospital birthing suite their labour was disrupted by a midwife insisting on them inappropriately “pushing” when if fact they did not feel the urge to do so.

The old and all too familiar scene is one of a pushing, panting and a fatigued mother being instructed to take a deep breath and hold it as long as possible whilst bearing down. It was expected that the mother would be working extremely hard, getting very hot and going purple in the face. It is often referred to as purple pushing.

Scientific evidence shown in the 1980's has to a certain extent been disregarded. This evidence showed that the second stage of labor is not dangerous for the baby but actually helps to stimulate the baby’s digestive, eliminatory and respiratory systems. Pushing, in fact, can be dangerous to both the mother and the baby. When a woman is pushing she is holding her breath. Oxygen therefore is not going to her uterus which makes contraction more difficult and painful. It is also not going to her baby. This can lead to a drop in the baby’s heart rate and fetal distress.

Of course, this isn't to say that if a woman has the urge to push, she ignores the feeling. But certainly, she shouldn't feel she has to just because she's been told that this is the way babies are born. Birth is a creative act, and like all creative acts it cannot conform to society's unnatural time constraints. The insistence that pushing is necessary in labor is simply a reflection of our cultural attitude that force and haste are superior to trust and patience.

As long as the mother and baby are monitored and all is well, both should be left to “allow” the birth to happen rather than "make” it happen.