# once dilated to 10cm...PUSH???



## swissmiss2584 (Dec 29, 2007)

Is it really necessary for a laboring woman who is dilated to 10cm to start pushing right away? Even if she doesn't have the urge to push or the baby hasn't descended yet? Is it an emergency to push right away? Is there an issue?

I think many women get c-section because they are 10cm but are not "ready" to push. Especially if they have an epi and can't feel. Couldn't they just wait and push?

Do you think they are given sections because they can't properly push their baby out just because they can't feel their butts? I believe that could be an underlining cause of sections.

There are so many ways to ask what I am trying to understand.







:


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## alegna (Jan 14, 2003)

Absolutely no reason to hurry up and push.

-Angela


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## MommyinMN (Oct 18, 2007)

With my first once I got to 10cm I didn't feel an urge to push for almost 2 hours. Thankfully I had an OB that just let me rest and push when I was ready. I had an epidural and was still mostly numb when the urge to push happened yet I still only pushed for 20ish mins and I skipped a couple of contractions that I didn't feel like pushing through.

I don't think that pushing before you feel an urge is effective, just a waste of energy that could be used later.


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## Mosaic (Jun 20, 2005)

Nope, no need. In fact, oftentimes your uterus needs a minute to figure out there's still a baby in there because there's no longer a butt up in your ribs! You can push when you're ready, or you can "breathe the baby down" if you don't feel the urge, and in theory that helps prevent tearing.


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## Mama~Love (Dec 8, 2003)

Like the others said, there's no reason to push as soon as you are at 10cm. Wait for your body to tell you it's time.


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## swissmiss2584 (Dec 29, 2007)

The main reason I was asking was because I see on birthing shows, OB tell the mothers to push right away and then they need a c-section. I was just wondering why they wanted them to push right away. I didn't think that there was a real reason to do that.


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## spu (Dec 6, 2002)

you are so right!!! In fact, I've read that this is a true and factual 'stage' of labor that sometimes occurs after reaching 10 cm, and before the urge presents itself. It's a resting phase that allows for a number of things to continue to happen, such as further descent of the baby, rotation of the baby, and allowing mom to get more energy from a rest. All of these factors come into play to help establish that urge.

On the flip side, I've read that sometimes a mom will not feel the urge, but to me, if the urge isn't felt, then something isn't ready yet and things are still progressing to get to that point. Doesn't mean failure to progress... progress is happening even after the 10cm mark.

There's a book called Active Birth : The New Approach to Giving Birth Naturally which helped me understand more about what's happening aside from dilation and pushing.

good thinking!
susan


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## barefootpoetry (Jul 19, 2007)

That's what happened to me.







Epidural, on my back, got to 10, was told to start pushing. I said no, I didn't feel ready - I really didn't - and they got up in my face and ORDERED me to. Pushed for four hours, wound up with a cervical laceration and a C-section.

A friend of mine who homebirthed said she actually TOOK A NAP when she reached 10 cm. The MW came in about an hour or two later and whispered, "Can I check you again?" because she'd never seen someone fall asleep once complete before.







Calm before the storm I guess!


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## spu (Dec 6, 2002)

as dramatic as they are, try to avoid the tv-style birthing shows, and rent some good birth videos instead. You'll learn (and see!) a lot more.


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## meowee (Jul 8, 2004)

The time I had an epidural the baby came out on her own! Once they realized she was coming out they started saying "push!!!" but there was no need to. She would have come out all the way on her own.

I don't think there is any need to push the second you get to 10cm unless the baby is feared to be in distress.

I saw a documentary about a paralyzed woman whose baby also came out on his own... if the baby is decently positioned, the uterus will do the work for you. In the early 20th century hospitals used to knock women out cold during labor, and the babies would still come out.


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## DBZ (Aug 9, 2005)

You wouldn't know you were at 10 cm unless someone did a VE. With my last labor I had no idea I was even dialating until I got the urge to push. And then I didn't push. The baby came on her own.


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## yeahwhat (Feb 10, 2007)

With my first, I had an epidural. My dr. checked, said I was 10cm and asked if I needed to push. When I said no, she decided to let him "labour down" a while and came back 45-60 minutes later. So no, even in hospital, attended by a dr., there is no need to push at 10cm.

With my other 4 unmedicated, midwife attended births, there was only one that I wanted to push at 10cm and didn't have a resting stage between transition and feeling the baby descending and thinking about pushing.


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## mommathea (Apr 7, 2008)

Quote:


Originally Posted by *swissmiss2584* 
The main reason I was asking was because I see on birthing shows, OB tell the mothers to push right away and then they need a c-section. I was just wondering why they wanted them to push right away. I didn't think that there was a real reason to do that.

Yea, that's because they have an epidural and can't feel when her body is ready to push. And the sooner the baby is born the sooner the ob is done with their job.

I firmly believe the only time a woman should be 'coached' to push is is there is real distress and should come out to avoid problems.


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## 2+twins (Apr 20, 2004)

I'll take it a step further and say there's not usually a need to even "know" that you're 10cm. When your body is good and ready, the baby will come out in most cases (and of course there are some less optimal fetal positions which would change this scenario, I do realize). My last 3 births were proof of that for me. I never knew how dilated I was. I just kinda figured it must be time b/c out they came w/o any conscious pushing effort from me!


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## swissmiss2584 (Dec 29, 2007)

Quote:


Originally Posted by *spu* 
as dramatic as they are, try to avoid the tv-style birthing shows, and rent some good birth videos instead. You'll learn (and see!) a lot more.

Actually, some of the birthing shows are showing more birth center and home births. I started watching those and delete the epi ones. I also have a video my midwife made called, "Birth". It's used in midwife studies and I believe some OB studies/teachings and childbirth classes. It's old but very informative.


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## Nan'sMom (May 23, 2005)

I know a couple of people who this happened to. The OB told them the baby just wasn't coming out and they had c-sections. easy way to avoid this is to refuse vaginal exams. They generally don't tell anything useful, I've heard they are uncomfortable (I don't get them in labor or pregnancy), they can cause labor to stall and they can introduce infection.


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *swissmiss2584* 
The main reason I was asking was because I see on birthing shows, OB tell the mothers to push right away and then they need a c-section. I was just wondering why they wanted them to push right away.

Why? Because they no nothing about physiologically normal birth.


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## starshine1001 (Feb 16, 2008)

With my first (hospital, OB birth), I got to 10 and was told to push. I felt no real urge to push, I just did because I was told to. 45 min. later with little progress landed me with an episiotomy which tore past to a bad 3rd degree and a Dr's hand inside of my pulling my babe out. Not to mention that he pulled out the placenta seconds after which made me hemmorhage and left peices inside that became infected 9 days later...

With my second (birthing home, midwife birth), the last time I was checked I was 9cm. A few hours later, I was still laboring when my midwife suggested that I get up and try to use the bathroom, then she'd check me again. As soon as I stood up, he was coming. He was 10 lbs, 1 oz with a nuchal hand, so who knows how dilated I was?? 10 cm?? 12 cm?? My body pushed without me, and he was born in about 4 contractions. Nobody ever told me to push, or held my legs up and yelled in my face. It was wonderful!!! I felt totally in control, but out of control at the same time. I paid attention to my body and worked with it. That's all a mama needs to do...listen to her body, not an OB, especially a male who has never been even close to what she's experiencing.


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## BrooklynDoula (Oct 23, 2002)

IME the vast majority of women laboring in hospitals are coahced to push. They are also more likely to have tears and damage afterwards. In home births (and some hospital MW or OBs) there is not coached pushing and the babies are still born, still healthy, and mom is more often intact. There are always exceptions to any trend, no doubt, but coached pushing is overwhelmingly common in hospital births and almost always unnecessary.


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## soso-lynn (Dec 11, 2007)

I think vaginal exams in labour should not be done routinely. The only use they serve is to set timelines for further interventions. I find it very hard to believe that, given all of the variations in all other measurable parts of the human body, every woman would dilate to exactly 10cm.

I never got checked while in labour but I assume that I was fully dilated for a while before pushing. There was no real break as it was all very fast, but the whole time was a little bit of descent and involuntary pushing so I don't see how there is supposed to be a clear distinction between dilating and pushing. The model of 3 stages of labour is just that, a model, an ideal-type. It serves the purpose of better understanding labour and having words to talk about it, not force some pattern on a labouring body.


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## spu (Dec 6, 2002)

I had no coached pushing this time around, just lots of reassurance.

With DS#3, I couldn't stand the coaching method the nurse was using, and I swore I'd never have her again if I got pg. I actually complained about her to the practice. With no coaching, you're free to do as your body tells you - and there's no guessing - it just feels right.


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## the elyse (Apr 15, 2006)

i did what my body told me to, and i pushed for 3.5 hours!







i don't know if i was 10cm or not, but i felt the urge to do those little grunts with every contraction for a while, and then later into it, i had to push harder and longer. slow process, but definitely what my body needed. coached pushing is silly.


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## llamalluv (Aug 24, 2007)

Quote:


Originally Posted by *meowee* 
The time I had an epidural the baby came out on her own! Once they realized she was coming out they started saying "push!!!" but there was no need to. She would have come out all the way on her own.


That happened to my mother when she had my baby sister! The doc kept telling her "Stop pushing! Don't push!" and my mother was grunting "I'm not pushing!" and she almost fell on the floor!







No "pushing" at all! (But she was tiny - about 7 pounds, and us other three were all 8 pounds to 9.5 pounders)


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## zoshamosha (Apr 15, 2006)

At the hospital where I delivered my babies, the CNM's and nurses basically leave you alone and tell you to call them when you feel you need to push. They check in occasionally, but are not invasive. Pretty awesome


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## sapphire_chan (May 2, 2005)

Anyone else think "No!!!" every time you read the thread title?


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## Sioko (Feb 3, 2007)

I've never been "told" to push. I always get told not to. With both DD's I was in hospital, had refused and thusly didn't get epi or pain meds, and when my body was ready it got right down to pushing and I had no choice but to help it. It was always right after they checked and said I was 7cm, then they'd leave for a minute or two and I'd start arguing with my mom, "I'm pushing!" "Don't push! You're only at 7!" "I can't stop!" Then the nurses, "Don't push!" as they rush to check me again. I push anyway."She's complete." "Don't push!" Doctor finally comes in. "Ok push." I'm halfway crowning by now anyway. I've only ever needed to push for about 5min. I do what my body says, not them. Even in a hospital I still have my free will.


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## Lauren82 (Feb 26, 2007)

I hate coached pushing. With my last dd, I told the midwives I would not be happy if anyone tried to tell me how and when to push.


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## Belia (Dec 22, 2007)

Maybe a dumb question.... can you ever lose any dialation if you wait too long to push? Like, you're at 10.... waiting for the pushing urge... you think you're just resting... and you're checked again for some reason and you're down to a 7?


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## janasmama (Feb 8, 2005)

this might be a little off topic but it is about pushing...an example of coaching.

In the hospital my sister had IV drugs and when she was ready (or at least told to push) the ob was telling her to push, my mother was telling her to push and so was her husband. At this point my one and only birth was a homebirth so I felt so akward there because I had never seen anything like it. I was the only one whispering quietly that she was doing very good.

Finally, my sister firmly said, "Can just one person tell me to push." Complete silence fell over the room until her husband finally said, "okay, who do you want to tell you to push." I thought that was kind of a funny question since I guess it should have been the ob if anyone was going to do it but she just pointed to the ob and me. Of course I never told her to push...I just think that she like my few and soft words of encouragement and was signaling for me to continue with it.

Anyways...I just thought that was a funny example of coaching.


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## spu (Dec 6, 2002)

Quote:


Originally Posted by *Belia* 
Maybe a dumb question.... can you ever lose any dialation if you wait too long to push? Like, you're at 10.... waiting for the pushing urge... you think you're just resting... and you're checked again for some reason and you're down to a 7?

absolutely. If you look at animals in the wild, the 'fight or flight' experience is a true phenomenon that happens naturally to every living creature. An animal could be in the birthing process, and suddenly feel threatened, and in order to save it and it's offspring's life, the birth process halts or regresses. The same principle applies to humans.

There are many reasons why labor 'progress' could go 'backwards' for lack of better wording, but if it does, there could be a sound reason why this might be happening. Often times, it's caused by too many interruptions, or a general feeling of 'unsafeness' or 'lack of support'. If the baby is checking out fine, and mom and baby are tolerating everything well, there should be no need for alarm or alternative interventions.

If you are in the hospital, and not progressing as fast as you (or the staff) likes, ask to be left completely alone - even hang a sign on the door, and turn out the lights, get comfy, or if allowed to - leave the premises and go for a walk outside, or to the cafeteria or coffee shop - anything you would like to do that would take your mind off the 'worry' and stop the nurses from looking at the clock.

If you have a doula or mw, they should be respectful of this, and even encourage ways to ease your mind and help you turn inward and 'let go'.


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *janasmama* 
Of course I never told her to push...I just think that she like my few and soft words of encouragement and was signaling for me to continue with it.









I bet you doing that made a huge difference.


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## cottonwood (Nov 20, 2001)

Quote:


Originally Posted by *sapphire_chan* 








Anyone else think "No!!!" every time you read the thread title?









Yes, me. Actually, my response was: NO! No no no no no no _no._










OP, do a search for "pushing" in this forum. There have been many great discussions about this.


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## JessicaS (Nov 18, 2001)

Quote:


Originally Posted by *sapphire_chan* 








Anyone else think "No!!!" every time you read the thread title?










Yes


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