In response to a question about a birthing mom who refused to push
[Issue 2:9]:
If a c-section was actually done, was it done with or without attempts at
ventouse delivery if the mother wouldn't push? I suspect the mother was
asked to push too early and that waiting for descent and appearance on the
perineum (so the mother could see how close she was) would have been a
better way of managing this labour.
More feedback please!
-Phil Watters
====
You might have suggested she sit on the toilet and push if she was fearing
passing stool. Oops, I just remembered that she had an epidural. Then
offering her a bed pan AND some privacy might have helped her if no one was
willing to wait for her uterus to push the baby out.
-Anon.
====
I had this happen to me twice. The first time the woman was 6 cm dilated,
mulitparous but not progressing, with a very 'loaded' bowel. I gave her an
enema (a rare thing for me), she had a BM and five minutes later ruptured
membranes and delivered. A few weeks ago I was caring for a woman who was
fully dilated with a full bowel. I was loath to give her an enema at that
point, but did get her up onto a commode (hospital birth) to push. She had
a small BM, then got back on the bed and delivered. In the second instance
I think it was a combination of the bowel movement and the position change
that moved the baby down.
-Kirsten Blacker
====
I can speak to this issue personally (as I'm sure many other mothers who
have been through labor can!). With my first child who was born in the
hospital, I did not have that "urge" to push although the midwife was
instructing me to do so. I did not know "how" to push correctly at first,
and therefore for several pushes did not make much progress. I don't recall
if someone instructed me or if I finally caught on to the "correct" way to
push, but once I started pushing as if I was trying to poop, if you will,
my baby made great progress and was out in just a couple more pushes.
Whether more than my baby came out or not, I do not know!
With my second birth, which was at home, I knew the right way to push (the
intense bearing down as if you were trying to expel whatever you could from
your lower abdomen), and was more than happy to push out my baby and
anything else just to end the pain of the contractions. In fact, as my
husband who was one of the helping hands will probably never forget, that
time more than my baby did come out!
For me, birthing without drugs is both the most wonderful and painful
experience I can imagine. During transition, I will do absolutely anything
to get the baby out, including pooping!
The epidural your mother received deadened her sensation to the
contractions (i.e., pain for most of us) AND, I believe, heightened her
sense of self-consciousness. Without that epidural, she too may have been
more than happy to push correctly regardless of what embarrassment it might
cause.
So my suggestions are 1) skip the drugs in order to let your body do the
work it's intended to do, and 2) as the midwife, coach people in pushing as
if they are trying to poop the largest poop imaginable and assure them that
midwives and doctors have seen it all!
-Dianne Oliver
Reprinted from Midwifery Today E-News (Vol 2 Issue 10 March 10, 2000)
To subscribe to the E-News write: enews@midwiferytoday.com
For all other matters contact Midwifery Today:
PO Box 2672-940, Eugene OR 97402
541-344-7438, midwifery@aol.com, Midwifery Today
|
|