# Is grunting while pushing counterproductive?



## Belle (Feb 6, 2005)

Somebody, I think the OB, said this to me after I started pushing. Is this true? I'd just been vocalizing a lot during the first stage it seemed natural to me to continue to vocalize while pushing. I took a couple more pushes while grunting and it was hard to stop. When I did it I felt worse. They also had me push to a count, which I didn't like, but wasn't in a position to argue with them at this point. I would only push to 5-6 count and take a breath. I think I was repremanded for that, but I don't really remember that well.


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## pamamidwife (May 7, 2003)

it's only counterproductive if you've got better things to do and want this darn woman to blast her baby out already.

geez.


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## Thmom (May 4, 2004)

well Pam, if she doesn't blast the baby out how will the sOB be able to justify the episiotomy?
My personal experience is that when I grunt I am using the diaphram to push as opposed to the pelvic muscles. IMO, breathe holding is counter productive because you have a tendency to use your upper abdominal muscles to help you hold that breathe, rather than use them to push. Not to mention the depriving your body of oxygen thing. I really don't get why they put O2 on a mom and then tell her to hold her breathe?? am I the only one who took basic biology in school?! lol


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## Kirsten (Mar 19, 2002)

Next time try a midwife. Out of hospital. No one will count and you can grunt/vocalize all you want. It is the way to go!


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## ZeldasMom (Sep 25, 2004)

No! Don't let them tell you that! If you prefer not to be coached/counted at/told to hold your breath while pushing you can discuss this in advance with the person(s) who will be attending your birth (physician/midwife) and put this in your birth plan.

When I had DS the nurse told me to be quiet because I was wasting energy and I just ignored her. She did do the counting thing though. Ugh. I agree that when you're pushing you're in no position to argue with them unfortunately. And you don't really want others attending the birth with you getting into it with them when you are pushing since it is such an intense time. It can help to have your doula or husband/partner right up by your head quietly almost whispering to you, supporting you in what you want to do.


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## teachinmaof3 (Sep 15, 2003)

Just a bunch of phooey!

There's no way I could NOT make noise. For me it's an automatic thing that happens for me. With each baby it's been exactly the same noise and it's something that I can't duplicate when I'm not in labor.


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## Eman'smom (Mar 19, 2002)

I was actually told to grunt, make low screaming sounds.

I agree, see someone else next time, fwiw, I had two hospital births (with a wonderful midwife) and nobody counted or anything


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## Artisan (Aug 24, 2002)

No, it's not counterproductive. It's intuitive.

Who are they to boss you around, anyway?


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## seven_lux (Jun 13, 2003)

It might be counterproductive, but I wouldn't want my babies flying out any faster than the 10mins/3 pushes, that they do.

Seriously, I don't know how anyone doesn't scream. I scream the house down. I swear and scream and hurt my own throat doing it.
But I can't NOT. I can no more stop it than I can say "mm...I've decided not to have the baby today" as it comes barrelling down the birth canal!

ob's are silly. and scary


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## stayathomecristi (Jul 7, 2004)

I found grunting very productive with my last baby (VBA3C). I had made it to pushing with two of my other babes and remember screaming the whole time. This time I felt like I was more in control. You have to do what you have to do at the time. If you feel like grunting, do it. If you feel like screaming, do it. If you "go into yourself" and make no noise, then do it. It's YOUR birth! When will health care providers trust a woman's instinct to do what only women can do?

Like other pp's I hated the counting thing and told my support people not to say anything while I was pushing unless there was a problem with the baby and we had to get her out fast. Well, my midwife was quiet, my doula was quiet, my husband was quiet, but the nurses were freaking me out by "encouraging me" to "push". I wanted to say, "just shut up unless we're in trouble". Oy







All that to say that I think it's a good idea to discuss with eveyone ahead of time (put it in your birth plan), but don't be surprised if people walk all over you because they are so programmed to do so. In retrospect I would have discussed with my doula and midwife ahead of time that one of them needs to step in if any of the hospital staff starts with counting or yelling at me to push. When in labor, you're not in much of a position to argue with people.


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## Belle (Feb 6, 2005)

Quote:


Originally Posted by *Kirsten*
Next time try a midwife. Out of hospital. No one will count and you can grunt/vocalize all you want. It is the way to go!









I'm planning on it.









I just wanted to know if this was true or a load of hooey. Thanks for your responses ladies.


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## TCMoulton (Oct 30, 2003)

If it works for you, who is your Dr to tell you otherwise! I personally was the silent laborer, never really made a peep except for to apologize endlessly for various things - made the nurses giggle cause they said they hear a lot of things in labor rooms, just normally not apologies from the laboring mom!
Everyone is different, do what comes naturally to you.
Colleen


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## theelfqueen (Dec 4, 2002)

Quote:


Originally Posted by *seven_lux*
Seriously, I don't know how anyone doesn't scream. I scream the house down. I swear and scream and hurt my own throat doing it.
But I can't NOT. I can no more stop it than I can say "mm...I've decided not to have the baby today" as it comes barrelling down the birth canal!

:LOL and YES!!!!

I don't think it's counterproductive personally but I think it's very humanizing. You are a real person in real pain if you're screaming, you're not part of the big machine that does what it's told and moves to the count.

Sorry, I'm in a pessimistic mood today, I guess.


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## cottonwood (Nov 20, 2001)

How can it possibly be productive to try to suppress your natural urges?









Anyway. Yeah, I made a LOT of noise. Growling, roaring. I guess the doctor would think that if I had been making myself be quiet the baby would have been out in 30 seconds instead of 3 minutes? Or, I'm just one of the lucky ones I guess who does everything wrong (like listen to her body) and the baby comes out quick anyway! Yeah, right.

The thing to remember is that most doctors and even many midwives have never SEEN normal birth. All they've seen is birth in which women are prepped, monitored, bullied, with every move dictated by an expert. They've never seen birth happen in any other way. So how could they possibly know?


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## BlueStateMama (Apr 12, 2004)

Interesting thread...I just had DD a week and a half ago and was MUCH louder during this birth. Grunting, vocalizing, and I kept (Ooops, how awful of me!!







) breathing mid count during the pushing, etc. The nurse kept trying to shush me







: - telling me I'd "have a sore throat" the next day - like that wasn't the least of my worries while pushing out my 8 lb, 12 oz daughter!!!

I didn't push any less effectively than the first time (when I was almost silently focused)...the only waste of energy was having to tell the nurse that I didn't care about a sore throat!!


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## Messac888 (Jan 24, 2005)

UGH, they pulled the same crap on me too, at my ds's hospital birth (hence, the dd's homebirth!!!).

I wrote in my L&D plans to not count, the dumb nurse started counting anyway, I looked at her square in the eye and said, "Shut up and stop counting, I can't focus on having this baby while you're practicing counting your numbers!" She stopped.









I feel it's unhealthy to hold your breath for so long to push on THEIR cue instead of your body's demand. I did lots of little pushed with ds and he was out in 39 minutes. Three big pushes with dd and she was out, however long that took. (My time sense was different in dd's birth than ds's cuz there wasn't a clock sitting right in front of me- and it made it easier to have my baby!)


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## tinyshoes (Mar 6, 2002)

I can't believe I get to use this gem of knowledge from my college days:

In anatomy class for speech & hearing science, I learned all sorts of cool stuff. First off, vocal cords are really two thin membranes that cover the windpipe. When they're toghether, you're holding your breath. When you're talking, they're _almost_ completely together. When they're open, you're breathing.

When talking/vocalizing, they're almost together, breath is rushing past them, and they vibrate. If you vocalized loud, low, with a lot of air, you'd be grunting--and your vocal cords would be almost shut together.

Anywho, when learning about all this anaotmy, the prof. explained _WHY_ we humans even have vocal cords. (Because suprisingly, the answer is *not* 'so we can talk.' That came later in our development as a species.)

1. To keep food out of the lungs (humans are the only animal that can choke the way we do--other creatures _can't_ breathe & swallow at the same time)
2. To increase intra-abdominal pressure for defecation.
3. To increase intra-abdominal pressure for childbearing.

I'm sure those aren't in any particular order, LOL!

Grunting while pushing out a baby seems like an expert way to finesse the intra-abdominal pressure (vs. a crude ON/OFF switch as recommended by these OBs, PUSH or NOT.)

I wonder if these NO GRUNTING OBs ever make a noise when they take a [email protected]&%.


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## lynsage (Jul 13, 2004)

Quote:


Originally Posted by *tinyshoes*
I wonder if these NO GRUNTING OBs ever make a noise when they take a [email protected]&%.









:

the only thing my midwife said about my labor grunts was "Sounds like pushing to me!", with a big smile on her face. as it should be.

"that's counterproductive" is sOB-speak for "that bothers me because i have a tiny brain that is so jam-packed full of misogyny and bull poopoo that it can't handle very much useful information".


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## mountain (Dec 12, 2001)

Hallelujah, Melissa! I found low, primal sounds helped me a lot...my midwife advised me to not let it get high and shrieky, because then it makes you feel like you're losing control--Hell, you are losing control but it's better for your psyche not to know that









Ah, birth was so much ebbing and flowing, I totally rode the waves like a surfer and let it all wash through me, over me--noise was part of it, whether it be my groans or the music playing in the other room...

I woulda been pissed at someone counting in my face,too.


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## Kirsten (Mar 19, 2002)

Quote:


Originally Posted by *mountain*
I found low, primal sounds helped me a lot...my midwife advised me to not let it get high and shrieky, because then it makes you feel like you're losing control.

I totally agree with this!!!! The low, primal sounds just come out if you are relaxed - and it really helps! I coached a friend and she was very relaxed and then started making those noises. She got a horrified look on her face and said "make me STOP!" I tried not to laugh as I told her they were good noises; she wanted to be making them; it helped and meant she was getting close to seeing the baby (I think she was in transition). The reason she wanted to stop was that the room was full of people - her stepmom, her mother-in-law, her aunt, her cousin. I would never have such a show at my births; they are private and there is no way I could relax and focus on the birth with an audience. JMHO.

Primal sounds are not a noise you try to make; it just happens. I do agree completely that yelling, shrieking, etc. is counterproductive as it gives the impression (to yourself) that you are in trouble, in pain, out of control.


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## Thmom (May 4, 2004)

Quote:


Originally Posted by *tinyshoes*
Anywho, when learning about all this anaotmy, the prof. explained _WHY_ we humans even have vocal cords. (Because suprisingly, the answer is *not* 'so we can talk.' That came later in our development as a species.)

1. To keep food out of the lungs (humans are the only animal that can choke the way we do--other creatures _can't_ breathe & swallow at the same time)
2. To increase intra-abdominal pressure for defecation.
3. To increase intra-abdominal pressure for childbearing.

I'm sure those aren't in any particular order, LOL!

Grunting while pushing out a baby seems like an expert way to finesse the intra-abdominal pressure (vs. a crude ON/OFF switch as recommended by these OBs, PUSH or NOT.)

I wonder if these NO GRUNTING OBs ever make a noise when they take a [email protected]&%.

Do you have a study or something you can link me to for this information? Not that I doubt you, in fact I've always thought that grunting helped with pushing, at least when I do both I can feel a difference in muscle usage... anyway.... I'd like something a little more "professional" than "this chick on Mothering says..." lol to give to clients


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## tinyshoes (Mar 6, 2002)

I don't have a study, but I did some Google-ing to find some resources for you. I couldn't find anything that lumped all the anatomy & info together--the way my prof lumped it and I quoted it.

Human Respiration touches on the concept I mentioned. Scroll down to the *Conducting Zone Organs* section, under *3. Larynx* (your voice box, which contains the vocal cords, aka glottis):

Quote:

vocal folds can perform a sphincter function: glottis closes and inhaled air is retained when abdominal muscles contract; this raises intra-abdominal pressure; associated with emptying bladder, rectum or also used to equalize pressure on ear drums (Valsalva's maneuver).
(Please note the Valsalva maneuver mentioned in the above quote is _associated_ with the result of a closed glottis; you can close your glottis to hold your breath *AND* you can close your glottis to perform the Valsalva maneuver, which is holding one's breath to blow nose/open ear drums. Often the "hold your breath and push!!!!! 1-2-3-4-5-6-7-8-9-10!" pushing encouraged by OBs is called Valsalva pushing. )

So, I was referring to this sphincter function of the vocal cords (glottis.)

A bit about the hazards of humans and choking is discussed in HUMAN EVOLUTION AND LANGUAGE, specifically this point under _*Conditions for language emergence*_:

Quote:

On the one hand, this lowering increases the pathway shared by food going down to the oesophagus and air going down to the trachea, increasing the chance of choking. On the other hand, the lowering enlarges the pharyngeal cavity in the throat, facilitating the production of a wider range of sounds.
This author argues that we did lower our vocal tract (larynx) in order to produce more language, whereas my prof said otherwise. Ah, the thrills of educated disagreement in academia.

Lastly, THE PREVERTEBRAL REGION, under T*HE LARYNX*, mentions these two points, the swallowing and the intra-abdominal pressure-increasing...I'm highlighting the pertinant points in purple:

Quote:

SPHINCTER FUNCTION: Adduction of the vocal cords is performed in increasing intraabdominal pressure. It also occurs in the "coughing" reflex to increase the force of expiration and remove the stimuli.
(so adduction--bringing together the vocal cords, increases the pressure)
and

Quote:

In SWALLOWING : The aryepiglottic, thyroarytenoid and thyroepiglottic muscles:

* close the vestibule,
* tilt the arytenoid cartilages anteriorly
* and assist in depressing the epiglottis as the larynx is elevated during swallowing.
* This closes the superior laryngeal aperture and divert the swallowed food to the piriform recesses.
(the superior laryngeal aperture = the hole to your windpipe)

Gee whiz.......is anyone else noticing how a little jargon goes a _long_ way? If we knew how 'hard' it is to talk, breathe, and swallow, we'd probably all be tube-fed, just like we know how 'hard' it is to have a baby naturally.


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## Thmom (May 4, 2004)

Quote:


Originally Posted by *tinyshoes*
Gee whiz.......is anyone else noticing how a little jargon goes a _long_ way? If we knew how 'hard' it is to talk, breathe, and swallow, we'd probably all be tube-fed, just like we know how 'hard' it is to have a baby naturally.

LOL ain't that the truth!!

I think you need to write an article about this... It'd be great to have an easy to read explanation of this that uses but explains the terminiolgy and puts it all together in a way that us laypeople can easily understand


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## cottonwood (Nov 20, 2001)

Quote:

Primal sounds are not a noise you try to make; it just happens. I do agree completely that yelling, shrieking, etc. is counterproductive as it gives the impression (to yourself) that you are in trouble, in pain, out of control.
Not necessarily. During my first birth I was instinctively making more high-pitched sounds, and my midwife was adamant that I stop. For me to try to suppress that urge, in other words to try to be in control of what my body was doing, trying to make it do something other than what it wanted to do, took a lot of energy that would have been better spent elsewhere, and put me too much in my head. It was exhausting, and incredibly demoralizing to be having so much trouble doing it the "right" way. I told my next midwife that she was not allowed to comment on the noises that I was making, that she would just have to trust that I was vocalizing the way I needed to. I ended up making a lot of high-pitched sounds, heck I was practically yodeling. And doing a lot of roaring. Yes, I had a sore throat the next day :LOL but that birth was comparatively easy and very empowering. (As were my third and fourth births, in which I allowed myself to make whatever noises I damn well pleased.) And I know that my vocalizing had something to do with that, well, maybe not the vocalizing per se, but the letting go, and just giving myself over to it without trying to make myself do it a certain way.

There's a difference between being "out of control" and being "not in control", after all. In my first birth where I was trying so hard to remain in control and failing so miserably. I *did* feel out of control, I was bordering on hysterical, actually. But my births where I purposely let go of control (which in my case meant making a lot of high-pitched sounds) there was zero hysteria -- I felt very strong and like things were going exactly the way they needed to. So I think there's a bit of a misconception about which noises are "correct" -- IMO the only wrong noise, the only wrong *anything* in birth for that matter, is that which is contrary to what your body feels the urge to do.


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## wasabi (Oct 12, 2004)

I actually made a ton of noise while pushing this time. I grunted, I groaned, I talked to the baby. Later DH and my doula both said they thought about telling me to "save my energy etc" and I was so glad they didn't. This was my first uncoached pushing experience and in some ways I felt a bit lost and that I was finding my way. If people had been telling me not to do what felt right to me it would have really bothered me. No one was counting. No one said anything other than encouragement that I was moving her and that I would be done soon.


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