Women and babies are not made with a pop out button like some Thanksgiving turkeys indicating being done. That pesky due date becomes such great topic of debate. It can lead to unnecessary interventions (such as induction, provider change because of regulations or cesarean), emotional unease (I am broken, this baby is never coming, I am LATE one minute past 40 weeks), physical distress by way of decreased pregnancy change tolerance, and mess with a woman’s work schedule (when to start maternity leave or return to work date).

Prior to home pregnancy tests and ultrasound dating, the due date was much more of a due month. Now it seems everyone has bought into this mysterious due date being something very hard fact and unfailing.

Henci Goer wrote a tremendously helpful article called “When is that baby due? ” several years back that sheds light on this very issue. She states: “When it comes to determining your due date, “things,” as the Gilbert and Sullivan ditty goes, “are seldom what they seem.” The methods of calculation are far from exact, common assumptions about the average length of pregnancy are wrong and calling it a “due date” is misleading. Understanding these uncertainties may help to curb your natural impatience to know exactly when labor will begin.”

The most common way women are finding out the due date of their baby is by using an online calculator such as this:

However, this even from the federal website does not take into consideration ovulation, only length of cycle (which is an improvement over straight up LMP dating).

So how do women handle this notion of a due date? I asked the question and here are some responses.

• KZ -    “Last time, I told everyone my due date, and when E had other plans, I got the, “Have you had that baby, YET?? How long are they gonna make you go?” *cringe* This time, I’m wising up and saying Spring. That’s it. Spring.”
• SL – “I used a “due season”. I told my three year old that the leaves would change on the tree and we would probably have Thanksgiving dinner and she would be here sometime after that. ”
• KMC-M -”I love the Ish… december-ish”
• CLM -”I always give very generic answers to avoid the annoying “aren’t you due yet???” comments. I’ve also written on Christmas cards … “baby #3, due Spring 20??”. Once I was due at the very end of July. My well meaning neighbor was asking … “are you STILL pregnant?” on July 4th. Ugh.”
• LE – “Whenever someone asked my due date I always said, “he’ll come when he’s ready” or “when God decides he’s ready”
• SC – “Mid to late month was the closest I’d get.”

Seems these particular women either have previously gotten bitten by the pesky due date or learned in the first pregnancy not to put too much stock in an arbitrarily determined date. I say good for them!

As a midwife assistant, I now participate in the baby assessments. Some of these post birth assessments gestationally date baby. Often the dates are different than the due date assumption. Some earlier and some later.  This happens even with women who knew exactly when the last menstrual period, ovulation, and conception occurred along with cycle length.

Only the baby (and God according to my belief) knows the due date aka when he or she will press start.

Early is not one day prior to 40 weeks EDD just as late is not 40 weeks and 1 day over EDD. Full term pregnancy is defined as 37 weeks-42 weeks gestation.

I think it is high time “we” layoff pressuring mamas and their babies. “We” must stop trying to evict them earlier than they desire without a true medical reason. One day to any adult is nothing, but even a day to an unborn baby coming earthside can mean the difference between alive and thriving.

This is a personal post written 10 years to the day of my third son being born. I was also birthed that day into my fullness of voice as a woman and as a full throated advocate for mothers and babies.  You see my son was a CBAC (cesarean birth after cesarean) after a failed natural VBAC (vaginal birth after cesarean).

I had a VBAC with my second son, though by other peoples standards might not be said to be wonderful because at the very end of a totally natural, spontaneous labor after arriving at the hospital at 9cm’s with waters having broken on the way in the car,  forceps were used by an impatient on call doc after merely an hour of pushing. I was thrilled though it was ultimately less than ideal with a baby overnight in the NICU. I was not broken. An impatient doc who gave me an awful episiotomy could not take it away from me. But I digress. We can talk heinous episiotomy at another time.

Of course when I became pregnant with my third some 14 months later I assumed of course I would have another VBAC this time with no forceps. Of course I didn’t have to think about another cesarean I already disproved the need. There is a piece  of information that I was missing though………

My pregnancy goes well. I am terrifically healthy though more fluffy than I should have been. You see  my dear husband was laid off during pregnancy and well, I clearly didn’t exercise and eat properly the second half of the pregnancy.  A very dear friend and her children were flying in from out of state near my due date.  She arrived and I was contracting already. I must have been waiting for her to arrive to round out the support team.  She has clinical skills so I ask her to check me and allow her to sweep my membranes (okay stop groaning at me I was already in the beginnings of early labor). I was a few centimeters dilated and well effaced. She wasn’t sure of baby position though.

The membrane sweeping helped move labor along. I was 5 centimeters before very much time once contractions became nicely regular. My husband had gotten a job two weeks prior and was scheduled for work so off he went though I knew I would be calling him before too long. Sure enough contractions picked up very nicely and I could no longer tend to any of the children.  I decided to call my husband home.

Around this time I was about 6 cm’s dilated… good news right? WRONG! I also began having severe back labor. I had this with my first and he had an acynclitic head ending in cesarean after 4 hours of pushing. After my husband got home it was so much worse. You see I am a natural birther but this caused a panic stricken heart. I really freaked out. Not from the pain, but thinking OH no not another cesarean. How could this be happening? I was screaming inside my head. Sheer terror actually. I had not prepared at all for a malpositioned baby – I mean I had gotten him to turn vertex at 37 weeks from frank breech on my own. OP how could this be? In my panic I insisted that we go to the hospital though my dear friend and husband thought we should stay home longer. I was about 7 cm’s at this time. My friend now suspected an OP baby but didn’t tell me. Why did they not insist we stay home? I mean I was in no condition to drive myself the 15 minutes to the hospital. I don’t know.

We arrive at the hospital, I am indeed about 7 cm’s and yes baby is OP. No one worries though that I am a VBAC again. Basic monitoring, no saline lock, all is well in l&d land (so it would seem). In my head I am still in sheer terror though from the outside apparently it was not visible. That is still tough for me to comprehend. I was screaming through my eyeballs but I made no noise at all from what I am told.

I tried many positions to get him to turn, and probably would have but……..

At some point during a vaginal exam, my water was broken without my consent. This my dear readers is what caused the downhill slide to a repeat unexpected cesarean. I have since learned I have an android pelvis and without intact waters rotating a poorly positioned baby is near impossible if possible at all.  Back to the story.

I cannot say how much time went on for sure, a couple of hours I believe. Somehow in this room filled with two nurses, my dear friend and husband, a complete breakdown of emotional care took place. I felt totally and utterly unsafe, scared, terrified, and without hope. My husband too was overwhelmed and felt displaced in the situation though he admits he allowed it to occur. I did blame him and to some degree my dear friend in the beginning, but I do not now. I didn’t prepare well. I assumed. I didn’t define the roles of support between my husband and dear friend. I was a Pollyanna.

I was now complete and still trying everything possible to get baby to rotate. Nothing worked. I was desperate. By the way, I was unmedicated and only on intermittent monitoring for most of the time. So cannot blame the epidural or being strapped down.

I pushed for over three and a half hours in varying positions. During pushing (I am pretty sure of timing) an internal monitor was put on my son and a scalp sample was taken to check his stress level. Oh, the SAME on call doc that was impatient and used forceps on me during the last birth was my attending. That very much did not make for a safer, happier birth space.  At the end of the hours of pushing, she again pulled out forceps to see if she could rotate him or help me deliver him, but my dear friend discouraged it highly since he was still higher up (forgive me the station escapes me without my records in front of me).   I was then told the scalp sample came back showing my baby was becoming acidodic, which means he was getting very stressed. His FHT’s were fluctuating quite a bit as well.

At this point I could hardly keep my eyes open. I was in despair, heart broken, and becoming very angry. The doctor presented me with a cesarean consent form. I refused to sign it. I said I wouldn’t sign it but my husband had a power of attorney. I made him do it. I could not do it. I could not agree to another cesarean. Somehow having my husband sign it helped me face it better. Perhaps because then it was out of my control.

So another cesarean for a “stuck” and this time fetal distressed baby. So I was told. I was taken to the OR where the anesthesiologist would eventually place the epidural. I begged and begged and begged for a dose of terbutalin to slow the contractions as I still had the uncontrollable urge to push.  He essentially told me I was being a baby. To man up. He would get my epidural in soon enough. He was mean. He was verbally hostile. In between intense contractions, I actually thought over and over as I sat on the metal table with feet dangling of how I could take a swing at him without falling and hurting my son. I wanted to make this anesthesiologist feel pain. Punching him in his condescending, smug face would have been extraordinarily satisfying. I was so angry at how I was being treated. I will never know if he was punishing me for being a natural birther or a failed VBAC mother.  Maybe both.  He still is in practice and no I cannot be in the room if a client of mine gets an epidural with him as the anesthesiologist. My response is still visceral to his mere presence.

It seemed like a very long interval of time before the I.V was put in, the epidural was placed, the OR team was fully assembled and my husband was at my side. After reading my records it was a long interval. My husband signed the consent form and my son was not surgically born until more than 45 minutes later. Was he REALLY fetal distressed with that long of a wait in between? 45 minutes when the OR was open and available? I was IN there with the anesthesiologist the whole time. That is not an emergency or even emergent. Plainly he wasn’t coming. Yes he was OP.

I was laying on the table, armed strapped down, husband standing next to me watching the cesarean take place. I have no memory of what the epidural felt like. My eyes were closed out of exhaustion, grief and anger. My son was delivered at 535am.  His APGAR’s were decent not that of a highly distressed baby. I wonder if during the long wait and the rest period, he normalized. I may have been crying but not for the good reasons. My son was waved by my face. I do not remember seeing him. My husband was heading to the nursery with him. I screamed after him at the nurse, “If you give my baby formula, I will sue you.” It seems the woman who wouldn’t send back a wrong order at a restaurant was forever changed. Like a light switch my voice was established.

While I was being repaired. I decide to talk to the doctor (at this point I had no idea she broke my water without consent and had falsified my medical records in a few areas), so I tell her I want another baby. I then asked her if my uterus was good for another VBAC. She said sure you can have another VBAC if you want. No problem. My uterus looked beautiful. Wow, I should have felt wonderful that I am such an amazing healer from previous surgery.  I didn’t. Sigh. I wanted to die except my baby would want to nurse. Oh yes, my baby J.

Once out of recovery and into my room my husband came and gave me report on J. He was being observed, seemed very well. No they didn’t feed him anything. M had to go home and check on our other children who were just 4 and 23 months.  He swapped off with my dear friend who had gone to check on her children. I still hadn’t held my baby. I had no idea what he looked like. I was distraught but no one knew it. I would make a heckuva poker player I think.

Five hours post op and I want my baby. I want him NOW. He must be hungry. He must be wondering where I was.  The thoughts ran through my head. I called my nurse and asked her to bring me my son or take me to the nursery to feed him. She said no to both requests stating various reasons. This did not suit the new me at all. I asked her again. She again said no.  This did go on for a few minutes where we were actually raising our voices back and forth. Finally I noticed the wheel chair by the door, I looked the nurse in the eye (who by the way was no more than 6 inches from my face), and I said “Fine you want me to get up and walk across the room to the wheel chair then you will take me?” She said, “Yes” in a non-believing tone. HM she didn’t know me at all. THAT my dear readers was a dare in her voice. I called her bluff. I took a deep breath, held my belly, stood up and walked right over to the wheel chair on my own.  Needless to say she took me to the nursery to see my son.

My voice was completely in full bloom. Never to go back.

As she wheeled me around my son’s bassinet I grabbed his chart much to everyone’s dismay and horror. Why were they worried, well they had performed several tests, admitted him to the nursery for a minimum of 24 hours, started I.V. antibiotics and put in a central line ALL without consent. All done under implied consent which does not exist once the cord is severed and baby is his own patient. I thoroughly read his chart (no reasons given for the battery of tests), made certain they hadn’t him or given him I.V. fluids to curb his hunger, then I held my precious, sad little boy. Almost 8 pounds. Gorgeous. Very hungry. He nursed beautifully. I was elated and even more stricken. I stayed with him until he fell asleep then instructed them to call me at ANY sign of hunger.

I went back to my room and within another hour I was walking myself back and forth alone to the nursery. They had to ask me to come back for vitals to be taken and implored me to rest. He was MY baby not theirs. Mine to care for, nurse, be with….. Sigh.

When evening rounds took place the I asked the pediatrician to come to my room so we could discuss getting my son out of the nursery and into my room. He went through his whole chart with me and told me exactly what needed to happen for him to be released at 7 a.m.  Yes I noted it all.  He wrote it in the chart everything he told me.

During one of my evening trips to the nursery, the truly decent and kind night nurse informed me that my son never needed to be admitted to the nursery and she was better equipped to take care of in need babies. My son was fine. She said sure he needed to be observed for an hour or two but never should the tests been done or a central line placed for that matter. She encouraged me to stay as long as I wanted but it was good for me to go and sleep to heal best too.

In the morning I was there before the floor pediatrician was doing rounds. You probably guessed it, my son was in my room by 8 a.m. I can be very persuasive. The funny part about the scenario was that immediately when the doctor walked away the nurse implored me to help her get all the leads off and my son unhooked from everything quickly. Why? Because she had never seen a doctor release a baby like that and feared the doc would change her mind.

I finally had my son with me. Finally. I was hurting physically. I didn’t rest enough. I was his mother after all, that is what we do. Had I not done exactly what I had he would have still been in the nursery and breastfeeding could have been a disaster. More ibuprofen please. I do not even remember my husband bringing the other boys to the hospital. I do not remember anything but advocating for me and my son.

By 48 hours post cesarean I was desperate to go home. As I put it not so delicately to the doctor who didn’t want to release me so early after surgery, “I can sit on my own damn couch and I have better cable than you do here.” Seriously the full throated voice was speaking. Yes, she released me though against medical advice. I assured her I knew what infection looked like and I would be back if I needed to be.

My husband was there shortly thereafter with car seat and our other sons in tow. I was traumatized and shell shocked BUT I had well spoken up for the two of us when all was said and done.

Just like the Grinch who’s heart grew in size, I powerfully came into my own as a woman, as a mother and as an advocate.  For this and this alone I am tearfully grateful for my CBAC and though much was lost so very much more was gained.

In westernized countries, television and the internet have almost completely replaced the generational teaching and learning found in the “circles” of the past. Women would gather over sewing, quilting, canning, and life events including pregnancy and childbirth. They offered support, told their stories, spoke of family life, shared their everyday knowledge, wisdom and expertise while the children played at their feet.

At first glance it seems that through these technologies women are able to gain vast amounts of incredible knowledge regarding childbirth.  There are very popular websites, message boards and forums to meet and greet other women who are expecting the very same month.  Any topic is available to explore. Excellent places for a sense of community and belonging. The information is so prevalent that some women even eschew childbirth classes because they feel well enough prepared from all the exposure. Fantastic to be sure, at first glance.

Upon a deeper look  with a critical eye at the most popular shows and on-line communities, it becomes pretty obvious that overwhelmingly the messages and scenes actually have little to do with real encouragement and instilling confidence in a woman’s design and inherent ability to birth.

Let’s start with the satellite/cable television shows on the learning and health channels. Stop for a moment and think of what occurred during the last episode you viewed.  Did you see a spontaneous labor from entry to hospital to birth without augmentation, epidural, or any other intervention except for intermittent monitoring and perhaps a saline lock (IV port) placed? Was it an induction with an epidural? Was it a cesarean or a vaginal delivery? Did she have adequate support? Was her background given in any detail? Who made the decisions? What about informed consent? Was the laboring woman paid attention too or were the machines heeded more? What sort of comfort measures did she employ? Was she ever out of bed? Who delivered the baby?  What response to her baby did the mother have? Who saw her baby first? With that clear memory in mind, how did you feel after viewing it? What thoughts came to your mind? Now consider that essentially all of the births shown take place in a hospital. In fact any birth that does not, is often touted as extreme or some other like descriptive.

Let’s move on for a moment.

Now let’s take a look at the most popular pregnancy websites, message boards and forums where women connect with one another.  The “conversations” and threads are filled with all things related to the impending birth. Chatter about baby showers, maternity leave, body changes, vaccinations, previous experiences, breastfeeding, nursery preparations and so much more. Really anything under the prenatal sun. Inspecting further though, there seems to be an inordinate amount of discussion regarding the need for scheduled inductions and cesareans and very little conversation or even support for natural or spontaneous labor and birth.

With intervention appearing to be the ruling majority within the technological communities and filling the television, how is a pregnant woman feeding her eyes, heart, and mind on this type of diet supposed to feel confident, uplifted and excited about her upcoming birth? I am uncertain that she can with the seeds of inadequacy, fear, brokenness, helplessness, and lack of options being sewn into her being at such an alarming ratio.  Sometimes yes interventions are needed, however, in practice it isn’t a need for many women and babies.

These shows and internet locales are like junk food. Like all junk food they are not to be an integral part of a healthy prenatal “diet” that will be encouraging, expand useful knowledge, grow confidence, spark self-advocacy, promote self-awareness, ignite excitement, and offer joy to the expecting mother.

How can an expecting mother improve her “diet” regardless of the type of birth she is planning? What are the better places to “shop”?

• Turning off the TV
• Check out and attend local groups and support meetings. Educational sessions and workshops are often free of charge. For example: Doula Groups, ICAN, Midwifery Groups, Birth Network, Birth Circles, and similar.
• Try some different message boards, forums and sites. See Blog Roll and Resources listed on this site.
• Seek out positive free videos to watch on You Tube.  http://prepforbirth.com/2009/07/30/birth-videos/
• Talk to women who have birthed in the hospital, birth center and at home. Get a variety of positive stories.
• Try some different reading on for size. http://prepforbirth.com/books-videos-and-more/
• Rent or borrow movies from Netflix, a doula or childbirth educator, such as, Business of Being Born, Pregnant in America, or Orgasmic Birth to name a few.
• Take the challenge to learn about and be open to the variety of birthing techniques, locations, options and provider types that women are utilizing.

Bottom line, the most prevalent “food group” in a diet is going to positively or negatively affect the parts and the whole of the journey to having a babe in arms.  No matter what the mother and baby live with the outcomes from the birth. Enriching the prenatal “diet” is not a guarantee of outcome or path to the birth. It does however give much more possibility and opportunity for both mother and baby to have a better birth and start together.

It never ceases to amaze me why women are induced for labor.   I have compiled a list of commonly heard “reason” for an induction occurring.  Interestingly none among them is true.  The true reasons for induction is a very short list (shown at the end of the post) and only a small percentage of women will fall into those categories.  So all you pregnant mamas out there, induction beware because you may have something listed below said to you.

Compilation of “reasons” for induction:

• My doctor says I have a small vagina.
• My husband can’t miss any school or he gets kicked out (heard from both Police Academy AND Fire Academy wives).
• I have already met my deductible for my insurance this year. Don’t want to have to start over again.
• I want the tax deduction this year.
• Because my doctor is going out of town.
• Anesthesia allergy:  She ended up with an epidural, and then a c-section.
• You are an older mother and your baby will die if you are not delivered by 39 weeks.
• You are very small and there is no way you can birth a baby past 40 weeks or 7 lbs.
• Your feet are very small.
• Your amniotic level is really low. Only an 8 AFI at 41 weeks.
• doc: “your first labor was pretty fast so let’s go ahead and induce you so you don’t end up having the baby on the highway on your way in”
• I was told induction was recommended at 41 weeks because the placenta starts to deteriorate and stops working. Tell it to my 41 +4 day baby. I guess she was living on borrowed time those 4 extra days.
• Doc to mom “I am going on vacation and you want me there for sure for your delivery!” Mom is 39 weeks.
• To avoid a cesarean.
• To avoid an epidural.
• The pitocin is JUST like you make so it makes no difference.
• It is completely safe.
• You have a 50 minute drive to the hospital – it’ll save you the stress of worrying about making it in time. (First time mom)
• My family is coming from out of town and I want to know when to tell them to be here.
• I’m GBS positive and they want to make sure they get all of my antibiotics administered before I deliver…
• It is a holiday weekend.
• Baby is getting too big!
• Because my husband works 30 minutes away and if I have a fast labor he might not make it in time!
• Because I’m going to have a ‘huge’ 8 lb. baby.
• Because I’m a teacher and I want as much time as possible with the baby so I’ll get induced earlier in the summer….
• Because after 37 weeks, there is no benefit to staying in–the baby doesn’t do anything except gain weight (that one from a doctor!)
• Low-fluid levels.
• Way too far past your expiration, I mean “estimated due date.”
• Too big for gestation.
• Too SMALL for gestation.
• Because you are so tired.
• Because you look miserable.
• Vacation times not congruent with labor patterns.
• So you can pick your baby’s birthday.
• So you can plan ahead.
• Because it is more convenient.
• Since you are planning the epidural anyway.
• Because it is easier.
• Because there is no risk.

Mother beware!  There are only truly a small amount of reasons evidence shows for an induction to take place.

• Uterine infection
• True pre-eclampsia
• Prolonged rupture of membranes (longer than 48-72 hours)
• True labor dystocia
• Post dates past 42 weeks*
• diabetes (gestational included) if compromising fetal or maternal health

Without the true need for induction the likelihood of cesarean nearly doubles.  Some of the risks or consequences of any induction include:  more need for an epidural, overly strong contractions, failure of induction, distressed baby, distressed mother, placental abruption, continuous monitoring, lack of mobility, the feeling of illness, longer labor, very fast labor, traumatic labor and delivery, and IV fluids.

In the event the word induction is brought up, the mother needs to be aware of the common yet myth filled reasons behind it and that it is alright to say no.  The mother ultimately is responsible for the outcomes.  She and her baby have to live with the results.  Waiting for baby to press start in the absence of medical need for induction, is nearly always the best way to go for mom and baby.

*If a woman knows exactly when she conceived and estimated due date is not solely based on ultrasound and guessing, fits the “average” menstrual and ovulation cycle length, and if she does not have a family history of post 42 weels and beyond pregnancies this can be reasonable.

A couple of weeks ago I went on a quest to find out just what pushing was like for other women.  As an educator and doula it is probably one of the more challenging concepts to address.  Why?  Well some of the imagery can be quite vulgar.  “Push like you are pooping.” Do women REALLY want the image of pooping out their babies?! “The urge will overwhelm you and you cannot help it.” That also is not quite right some women never get the urge until the baby is very low and engages the nerves and some women will have the urge when baby is high and dilation isn’t complete (I did not say premature because I believe when the urge comes pushing “gruntily” with the peaks is alright as perhaps that will facilitate complete dilation and rotation of babe).  Some women feel great rectal pressure, some feel it in their abdominal muscles, and some don’t feel much at all going into it. Hey I do not believe we need to be fixed in this area.  I think whatever a woman’s body does is right for her body.

Below are many quotes that I frankly trolled for to edify women everywhere on the spectrum of what pushing is like. I could bore you to tears with the physiologic nature of the process but that isn’t what you really want to know now is it?! If you have questions on the new perineal massage, please refer to my previous entry http://prepforbirth.com/2009/08/25/new-episiotomy.html.

Quotes from real women

“My babies #1-4 practically fell out. #5 I was in what looked like early labor for 4 days. Midwife assistant came over, checked me, I was at 7 cm but ‘not in active labor’. I got into it quickly! Long story short I pushed, painfully, for 3.5 hours, baby had 11″ cord with a true knot. She needed to be pinked up but is almost 3 and is doing well.”

“When I was coached to push (w/ no 3..first natural birth) I was in agony. When I was left alone and did not push (w/ no 4), life was good.”

“I feel like if I can just get to the pushing phase, it will be a breeze from there.” (and it was. The whole “surrender/dilate” phase is much more challenging to me than the whole “take control/pushing” phase.)”

“Pushing was fantastic with my 2nd baby and awful with my 3rd! It was really surprising because after my 2nd birth I thought “Okay so pushing is the really fun and satisfying part! That’s when it gets EASY.” Then my third birth totally shocked me. Pushing was the most painful and difficult part of the birth. I had stayed so calm and collected… until then. Every pregnancy and birth is so different!”

“I love the way it feels to have a baby move through me and into my waiting hands.”

“I *loved* pushing. I didn’t do it for very long (two contractions), but it was so great to finally get there. I was told to purple push (not in those terms – the nurse told me to hold my breath), and intellectually I knew I shouldn’t, but I tried it and it really did feel like I was more productive that way. I felt like a warrior. It was awesome.”

“Before anyone hates me for only pushing through two contractions, you should know that I’d been in labor for three days – so it all comes out in the wash ”

“Pushing with my 2nd was horrible. 3+ hours of the worst pain I had experienced at that point in my life. Turns out her little fist was up by her cheek (um ouch) and her head did not mold much. My 3rd I did not push because she was precipitous and we were trying to get to the hospital. I felt like all the energy in the world was gathering and swirling at my fundus and then suddenly flowed through me carrying her with it. It was the best physical experience of my life.”

“I have heard some say that pushing feels good.. um, I personally have not experienced that and I have had clients remark the same … :p”

“Hmm…Definitely the best part of labor and delivery. For me though – never had any “urge” to push but still had baby out in 20 mins…I think I was feeling determined being a VBAC mom…still, would have been easier if I felt the need to and not just contractions. “

“Heard lots of clients say it feels good after hours of labor”

“Ahhh, I’m not so fond of the pushing. Did it for 2 1/2 hours with my daughter (LOA) and though it was only about 20 minutes with my boys, they were both OP. That was, shall we say, unpleasant. I cannot relate to those who’ve told me it was such a relief!”

“My labor was surprisingly short, only 6 hours and she’s my first baby so far. I woke up in active labor and at 4 cm and I wanted to push THE WHOLE TIME! It was horrible having the nurse say I couldn’t push yet when I wanted to so badly, but once I did get to push, oh my goodness, it felt incredible. So much control and power, it felt so good to finally work to end. 3 big pushes and there she was. ”

“Sheer, immeasurable power. Unbelievable!”

“Babies actually come out of your butt. Don’t let anyone tell you otherwise.” One of my clients recently said that. ”

“Birth is shockingly rectal” – Gretchen Humphries. She was totally right.”

“Pushing with my first felt like I was satisfying an urge, an uncontrollable urge. It felt almost desperate I couldn’t stop it. (kinda like having that rectal urge when you REALLY have to poop). Pushing with my second was no big deal, I followed my urges again and pushed 3x and out she came in her 10# glory. It was extremely satisfying and powerful I felt like I had just finished exercising. Amazing!”

“The ring of fire OH MY it is indeed! Though as soon as the burn started the whole are went numb almost like too hot or too cold numb and the power of the urge to push my son out was almost beyond description.  Pushing was never easy for me as I have an unusual pelvic shape.  But my last son WOW no molding and quite a large head to birth him was incredible really.  No tearing, just some abrasion.  Recovery was a snap.”

“I had at the point of delivery what was the best orgasm of my life!”

“Pushing was totally primal.  I had an incredible urge and it took over.”

Questions and Answers

1. I have had a previous episiotomy, do I need another one automatically? No you don’t.  Depending on how your scar has set and the position you push in the scar can re-open or it adhesions in the scar will need to be broken up.  I would suggest perineal massage prenatally if there are any adhesions to break them up and soften the area prior and to choose a pushing position that doesn’t put all the tension on that exact area.
2. Is is wrong to push when I am not fully dilated? Not necessarily.  Now I think grunty smaller pushes with those contractions can be effective to complete dilation if you are in transition.  Prior to that change the position you are laboring in to change where baby is placing pressure.  Knee chest can be very effective to abate very early pushing desire.
3. What if I poop during pushing? Some women will pass some stool and some won’t. You may here that when pushing the right way you may pass some.  Hey open bottom is vital to pushing, so hey it is a normal but not always occurence.  A fantastic nurse, MW or doc will not actually wipe it away but simply cover as to not cause constriction of the sphincter muscles which can disturb pushing progess. If it is possible to discard the stool without disrupting you, it will be done very quietly and discreetly.
   
4. I am very modest, do I have to have all my “glory” showing? Absolutely not.  You can maintain good modesty all the way up to delivery.  Even then you do not need to be fully exposed.  Truthfully a home birth or birth center birth with a midwife if likely going to help you have your modesty concerns respected and honored. Really no one needs to put hands in you during pushing, or needs to stretch anything, or needs to see everything either.  A midwife is trained to see by taking a quick peek or simply to know when she needs to have hands ready to receive baby and to offer external positive pressure if mom wants.

Check back later more Q and A to come as more questions are sent to me.