Re: [ozmidwifery] 'Allowing' to push

[Julie Garratt]

Hi all,        A women very keen to have a "natural birth" with her first baby, brillante labour, full dilation but the babes head not fully engaged was told to push way before she felt the need to. The outcome was lots of poo (very unpleasant for her and off-putting!) but maybe the reason that the head was high and the Doctor coming in and feeling what she described as a "fat lip!" and off we all went to theatre ): By the time we arrived she was very!!! ready to push but this was ignored as the intervention cascade was in full flood and despite a good FHR a section was preformed.  Wisdom here please! what am I missing? Julie. ----- Original Message ----- From: Jo & Dean Bainbridge To: [EMAIL PROTECTED] Sent: Saturday, March 15, 2003 8:05 PM Subject: [ozmidwifery] 'Allowing' to push Mary said:As for "allowing"  What does that mean?  The woman will push when she has to and no amount of "not allowing" will stop her.    The major concern is for those mothers who are told to push when they don't need to.  There really is no way a woman can be told not to push; but the damage that can because when forced to push is hugely ignored.  When I had my second baby (first vbac) the hospital midwife said to my Independent midwife "don't you teach your women to push!"   Hmm kinda says alot Jo Bainbridge founding member CARES SA www.cares-sa.org.au [EMAIL PROTECTED] phone: 08 8388 6918 birth with trust, faith & love... ----- Original Message ----- From: Mary Murphy To: [EMAIL PROTECTED] Sent: Saturday, March 15, 2003 7:56 PM Subject: Re: [ozmidwifery] research @ uni Jen, What a wonderful research question!  As a homebirth midwife I do not routinely do V.E's to confirm full dialtion before "allowing" a woman to push.  Many primiparous women do not have V.E's at home and progress without harm, to the birth of their babies.  The only time I do a V.E in that situation  is when the women is saying that it "really hurts" when she pushes. That is often a signal and  means that she isn't yet in 2nd stage or that there is a hand lying alongside the head (not proven until birthing). It shouldn't hurt so badly when in  normal 2nd stage. If I suspect a woman is not really in 2nd stge, I ask her to try and breathe through the contractions to the best of her ability until the head descends some more.  Occasionally there is an "anterior lip".   As for "allowing"  What does that mean?  The woman will push when she has to and no amount of "not allowing" will stop her.  Multiparous women at home never have a V.E to 'Prove' full dilation.  Why would you?  Also there is that lovely "red/purple line" that appears.  I think that is a really good guide to full dilation, but I don't always see it.  In the research question, are you going to differentiate between Primips or multips?  I would suggest just using primips.  If it is entrenched behaviour or routine, you might not get the numbers in hospitals so think about involving a homebirth or birthcentre practice.  Also, if you haven't already, do your literature search in homebirth/midwives magazines.  Midwifery today etc.  Love to hear how you are going with it and what you decide.  MM