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Hi Emily,
I don't think there is much evidence to support not doing VE's
in labour at the moment. But I guess as most midwives will tell you that
with experience you can learn to judge where the woman is at without invasive
VE's all the time (of course there are always a few surprises!!) I find
that the pigmentation which travels up their bottom crease as they dilate is a
good indicator, as well as listening to their sounds, the things they say and
their behaviour. If they were pushing and there were no signs of descent
after a time then I probably would do a VE. I think the worst part of doing one to confirm that a woman is fully (apart from the discomfort to the
woman) is that then the whole time factors comes into play. eg. in some
hospitals they only "allow" 45 mins for a primip to push and 30 mins for a multi. So by avoiding VE's or putting them off you can buy some time for
the woman.
Cheers
Michelle
>>> [EMAIL PROTECTED] 08/26/05 03:07pm >>> great! thats what i was hoping. i would have hated to find out that i needed to tell mums to ignore their feelings. do you know if theres any evidence to back this up b/c where im at at the moment they always do a VE before 'allowing' mum to push haha how sad love emily --- Michelle Windsor <[EMAIL PROTECTED]> wrote: > I guess the big fear associated with pushing before > the woman is fully is that the cervix will either > swell up (and then take longer to dilate) or tear. > About the only time I've seen swelling of the cervix > is when women are directed to push by staff who have > been mistaken in their VE (ie not fully dilated). > I've never seen a problem with multi's who > involuntarily push before being fully dilated. My > sister had an ARM at 4 cm (induced) and began > pushing almost straight after and 15 mins later had > a baby! Where I work we rarely do VE's so I'm sure > that lots of our mums are pushing prior to being > fully and so far we haven't had any problems. > > Cheers > Michelle > > Emily <[EMAIL PROTECTED]> wrote: > i have been wondering lately about the other side of > things. i was with a woman last week who was feeling > strong urges to push and was pushing involuntarily > at > the peak of each contraction from about 4cm. she > only > had two VEs - 4cm and 6cm. about half an hour after > the 6cm one everyone was still talking her through > breathing through the contractions and trying not to > push. she had been doing a lot of poo so i checked > her > to clean her up again and there i see half a little > head sitting on her peri. the poor poor lady still > trying not to push through that. > i feel awful that she never got to go with her > urges. > so what is the alternative? should women go with > what > their body tells them to do if that means pushing > way > before they're fully? she sustained quite a bad > posterior vaginal wall tear as well - would this be > related at all to pushing before full dilation? > > love to hear your opinions because i really did feel > bad for this poor lady having to fight her urges. > she > had so much faith in everyone.. > > ((anyway after all that she was very satisfied with > her birth, had 8 of her family including her > grandfather with her and a lovely baby girl.)) > love emily > > > --- jo wrote: > > > Interesting....I work with our local homebirth > > midwife as a doula and we had > > a client a few weeks back who never had the urge > to > > push, baby was finally > > born about 51/2 hours after full dilation. The > urge > > never came to her, she > > actively pushed towards the end - not directed by > > anyone...although not > > naturally occurring pushes. > > > > Jo Hunter > > > > -----Original Message----- > > From: [EMAIL PROTECTED] > > [mailto:[EMAIL PROTECTED] On > > Behalf Of Päivi > > Sent: Thursday, 25 August 2005 7:31 AM > > To: [email protected] > > Subject: [ozmidwifery] if mother wants to be > > directed for pushing > > > > Hi again, > > > > Like I told you earlier, I have just started a > > childbirth education program. > > > > One of my students just gave birth and had a quick > > and straight forward > > unmedicated 1st stage, but ended up pushing for > > 1.45minutes. She said she > > had no idea, what she had to do and told very > > clearly to the midwife to > > direct her for pushing. I had promised to be her > > doula if she felt she > > needed me, but since it all went so quickly, she > > never called me. I was just > > > > wondering how I would have reacted to the > situation > > if I was there, since > > during the training we emphasized spontanious > > pushing, waiting for the urge > > to push and following your own feelings. I noticed > > there was discussion > > about pushing here a week ago and I read the > > wonderful artickle by Gloria > > Lemay too. But what if the mom wants to be > directed? > > Do you ever direct a > > woman in 2nd stage and if so, how? > > The bag of waters was broken in the end of > > transition and water was green. > > She was also given syntocin 40 minutes after she > > started pushing, because > > the contractions were getting less powerful... She > > said she never felt a > > real urge to push. She was pushing on all-fours > and > > on the low "birthing > > stool". The baby was average size. Do you find, > that > > not all women get the > > powerful urge to push, or is it just a matter of > > waiting enaugh? > > In my own two births I never found the pushing > very > > painful, but was not > > given syntocin either. Does the syntocin make the > > 2nd stage more painful? > > Many questions again... would like to hear about > > your experience. > > > > Paivi > > Childbirth educator > > > > -- > > This mailing list is sponsored by ACE Graphics. > > Visit to subscribe > > or unsubscribe. > > > > > > -- > > This mailing list is sponsored by ACE Graphics. > > Visit to subscribe > > or unsubscribe. > > > > > __________________________________________________ > Do You Yahoo!? > Tired of spam? Yahoo! Mail has the best spam > protection around > http://mail.yahoo.com > -- > This mailing list is sponsored by ACE Graphics. > Visit to subscribe or unsubscribe. > > > --------------------------------- > Do you Yahoo!? > Messenger 7.0: Make free PC-to-PC calls to your > friends overseas. 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