At Victoria Jubilee Hospital in Jamaica ... no one pushed
actively for more than half an hour ... women come across
the hall to the birthing room when they feel a strong and
absolutely irresistible urge to push. Prior to that, they
are not "checked" for effacement or dilation, but rather are
simply allowed to labor undisturbed. Their only cues to
their progress in labor are their own physiologic sensations
and their intuition. Once she is in the birthing room, the
woman climbs onto the cot and a midwife checks her dilation.
Very rarely does a mother come into the birthing room too
soon-women are almost always completely dilated and ready to
go, often with the baby's head on or near the perineum.
...[They] subsequently finish the job in thirty minutes or
less! Thus the question begs to be asked: How many gloved
hands have reached up inside of women followed by the
declaration "You're complete! You can push now!" followed by
hours of exhausting effort, frustration, and intervention?
...even when a woman is feeling a little "pushy," she may be
fully dilated but not really ready to actively push. I
honestly believe that in our well-meaning attempt to tell a
woman when we think she is at the pushing stage of her
labor, we encourage her to push way too soon. The
consequence is that when a woman begins pushing before a
strong and irresistible urge is present (because her midwife
tells her "it's time!"), she uses her energy to accomplish a
task that her body would do more effectively on its own if
she was listening to her body's cues rather than her birth
attendant. Maternal exhaustion, a swollen cervix, fetal
distress, and sometimes a transport for vacuum extraction or
a cesarean section often follow. This is too high a price to
pay!
Reprinted from Midwifery Today E-News (Vol 2 Issue 23 June 9, 2000)
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