# baby's heartrate dropping during the pushing phase?



## Hollin (Jun 26, 2005)

I've been thinking about things I would have liked to have different from ds1's birth and one of the main ones is that I think having to push him out really fast caused me to tear worse than I would have if I could have avoided the dreaded "purple pushing". The reason I didn't feel like I could take my time is that his heartrate was dropping pretty low toward the end of labor and got even more erratic as I started to push. We were able to control it somewhat by giving me oxygen and lying on my left side, but I think the dr was eager to get him out (as was I, to be honest). My question is what should I do if it happens again? Is it normal to have weird heartrates during pushing and is pushing as fast as you can a good idea in this case? I was only getting intermittent fetal monitoring but switched to continuous when we got some low readings.


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## heatherweh (Nov 29, 2007)

Good question, I'll be checking back too to see what answers you get. DS had the same problem during the pushing phase. They used an internal monitor at that point to read what was going on better. I would love to avoid that too this time around. I blame some of it on the interventions used up until that point, so the cervadil, pitocin, purple pushing in lithtomy. I think oxygen and changing positions are acceptable means of controlling the situation from what I've read and *should* be common to both midwives and doctors.


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## boscopup (Jul 15, 2005)

With #2, the heartrate went down to 70 during pushing. My midwife just got the O2 out and had me breathe with the tube near my nose (no mask). She checked again a few minutes later and the heartrate was back up to where it should be. Didn't have any more heartrate problems after that though. We continued to let my body do the work as we'd been doing... didn't hurry it up any at all. I just kept sniffing the O2 as needed (my body was telling me I needed it).


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## cileag (Aug 16, 2008)

As an L and D nurse I can give you some general rules of thumb that the mds/midwives/nurses would be concerned about. I find that for many babies, heart tones will drop during a contraction as the cord/head are being squeezed through the birth canal. Depending on how deep the deceleration is, this not particularly troubling and somewhat expected. I'd say 70s is pretty low FWIW and I'd be concerned. More troubling would be if the baby's heart rate stays up at baseline during the contraction, but dips after the contraction. This can be a sign that baby is tiring and his reserves for the labor are decreasing. If this happens frequently and in succession, I too would encourage some pretty heavy pushing.

Much of the time it's due to where the cord is located, and since this is a different baby and with different cord placement, hopefully it'll be better this time. Does that answer some of your questions?

Fetal heart tone interpretation can get pretty complicated and so, as always, that's why you need a provider whom you trust.


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## MegBoz (Jul 8, 2008)

Same thing happened to me! DS' HR went to 70s/80s while I pushed, but recovered after each ctrx. First, MW asked me to get down own my left side (I had been pushing on my hands & knees.) They also gave me oxygen & that helped a lot. It was fine, so I didn't have to rush pushing. (Took about 40-45 min to push him out.)

Cord was wrapped around his neck 2X, so I thought that may have been part of the reason for his decels.


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## Jilian (Jun 16, 2003)

Same thing happened to me with DS1. He was born in the hospital and I pushed for 2hrs 20 mins. I think it was a combo of pushing for so long and being on my back for the end of the pushing that caused his HR to drop. Same thing happened to me, I got him out fast at the end and tore horrible. DS2 was born at home and I was upright without coached pushing and there were no heart decels at all. I only pushed for 40 mins that time. Being upright helped to bring him down and I didn't tire myself by being forced to push for a full ten seconds while holding my breath (like the nurses had me doing in the hospital).


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## Hollin (Jun 26, 2005)

Thanks for the responses everyone. I learned a lot and hopefully it just won't be an issue this time. I only pushed for 30 minutes or so, but his heartrate problems had started before I began pushing. It was a very fast, intense labor so I wonder if that had something to do with it. No time for us to recover between contrax as they came right on top of each other. I feel better going into it knowing more this time.


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