VAGINAL PUSHING VS. DIRECTED (PURPLE) PUSHING
“Hold your breath, 1,2…9,10 (ok) and again, PUSH, like you’re pooping.” Have you ever heard this, or felt like this is what was happening? Many women have, yet other women feel as though they are not doing any of the work and their bodies are doing everything.
What happens in the second stage labor?
During the second stage, your uterus muscles contract, pushing down the baby and opening up your cervix for delivery. When baby is ready to be birthed the nature of contractions change. The matrix of muscles surrounding your uterus begins to push the baby down, rather than squeeze the baby to open the cervix. The urge to push is usually involuntary and powerful; each contraction will bring strong downward pushes of the uterine and abdominal muscles (Ina Mae Gaskin, Spiritual Midwifery.,2002.)This continues until the baby is delivered. Sometimes the urge comes before you are 10 cm dilated, don’t push. This feeling comes from how low the baby is in your pelvis. Jan S. Mallack says “ We find that reliving the urge with baby pushes or grunts will often encourage the rest of the cervix to dilate.” You may not feel this urge to push yet, this could be because your baby’s head may not be down low enough to stimulate the bursts of oxytocin (Ferguson Reflex) that produces the urge to push. To help this urge to come you can wait there is no rush, labor continues to bring baby down. Second try an upright position as gravity works in your favor to bring baby down.
An option for the second stage of labor, in which you naturally bear down or strain for 5-7 seconds at a time and take several breaths between efforts. This type of pushing makes more oxygen available to your baby, than if you hold your breath and bear down for as long as possible [purple pushing] (Simkin, Whalley, Keppler, Durham, Bolding.,2010(259)
Spontaneous pushing, is several strong, involuntary surges to push during contractions. Often felt as impossible to control. Simkin et al says to use these for as long as you feel the urge to push about 5-7 seconds and breathe slowly while resting.
This method is often used when no epidural is in place and labor is normal.
DIRECTED (PURPLE) PUSHING
An option for the second stage of labor, in which your care giver tells you how long and how hard to push. This method is used if you cannot feel your contractions and delayed pushing isn’t an option, or if spontaneous pushing isn’t effective. (Simkin et al.,2010(259)
This type of pushing is most common when you have an epidural in place and cannot feel the spontaneous urge to push. It is also used when there is no urge to push. Lastly, if directed pushing is routine for your hospital or care giver.
Remember with information and education you are in control of your own decisions. If there is not a medical reason why you cannot wait for this reflex, then you reserve the right to wait. Often times Doctors or nurses are in a rush to deliver you, (shift change, break, other arrangements, or middle of the night etc.). You do not need to feel obligated to placate your care givers. It’s your body, your birth, your baby and ultimately your choice.
- Pushing and Beyond | Tips for the 2nd Stage of Labor (thejoyofthis.com)