When they ask you to push your baby out, you have two options either to push immediately or feel the urge and then put the effort. At most hospitals, the delivery happens somewhere between the doctor saying ”Push Push Push!” and your body getting bruised as you force your baby out.
Normal delivery in most cases doesn’t turn out to be natural. Yes, you do sweat, experience pain and get exhausted. By the time your baby emerges out you may wear yourself down or experience a perineum tear.
Studies have shown that coached pushing can generate negative effects as compared to when the mother herself feels the urge to push—also called delayed pushing. It was observed that delayed pushing during the second stage of labor (after 10 centimeters dilation of the cervix), the baby had a higher supply of oxygen through blood as compared to coached pushing.1
The risks of perineum tears are also reduced—research proved that delayed pushing is beneficial for the baby.2 But, why pushing in the first place?
Why Do Doctors Urge The Mother To Push
Until the 1920s, women were not told to push during labor. However, due to a notion that the second stage of delivery was critical, the doctors presumed that the baby should come out quickly. This was so prevalent that the mothers were instructed to push as soon as they feel the contractions, at the first stage of labor.
However, by 1950s, it was found that during the contractions in the first stage, the mother need not push rather relax. Though women got their share of rest for the first stage, the second stage of labor still involved heavy efforts from the mother to push the baby out.
Later on, after 30 years, the significance of the second stage was discovered—it was found that it helped the baby’s digestive, excretory and respiratory system to clear out of fluids and get functional. Unfortunately, it isn’t yet realized rather recognized that when the mother holds her breath while force-pushing every minute, it creates stress for the baby in the absence of oxygen—this leads to increase in their heart rate of the baby. Oxygen must also flow to the uterus and pelvic muscles, which is deprived, making the labor and contractions more painful and tough.
Forced pushing can also put more pressure on the pelvic muscles and the vagina, leading to unnatural stretching and perineum tearing.
How Far Is ‘Not-Pushing’ Really Effective
The Medway Maritime Hospital in Kent, United Kindom came up with slight amendments in the maternity care after observing increased cases of perineum tears during delivery. They stopped instructing women to push altogether during labor. The change was implemented after the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives raised their concern and demanded an action against the rise of perineal tearing, which affected 14000 women in just a year.
About 4000 births were observed in a year after the rules were implemented. The changes included a complete stop to verbally forcing the moms to push, asking them to breathe during contractions, being in upright position during labor and not pulling the baby out after the head and shoulder emerge—as expected the rate of perineum tears during birth were significantly reduced from 6% to little over 1%. Due to this huge success, there have been plans to implement same procedures in all the hospital in the United Kingdom.
How Does The Birth Happen Naturally Without Really Pushing
Quick successive contractions are felt by the mother when the baby moves down into the birth canal during labor. The level of adrenaline hormone increases, which stimulates the nerve cells in the pelvis to contract the uterine muscles, causing the baby to move down. This is followed by the release of the hormone oxytocin, causing strong contractions to push out the baby, without the mother applying a conscious effort.
This is called fetal ejection reflex, which is observed when either the mother is in danger and the body considers birthing the baby over halting the labor or when the mother is completely undisturbed, feels safe and supported, and has privacy.
Why The Natural Birthing Process Is Interrupted
However, unlike having a peaceful labor, the bright lights and the sounds and commotion of the delivery room often disrupt the normal flow of events and fetal ejection reflex is rarely observed. When the care providers ask the mother to push or check if she had dilated, it interferes with the natural process, causing the mother to think or fear, deviating her attention from sensing how her own body is trying to react.
Mothers often choose to go to the hospital because it feels safer—come an emergency there is medical assistance available right at that point. This isn’t wrong, but the essence of natural birthing is no longer present. Medical interventions are only beneficial when really necessary in the case of pregnancy or birth complications. Clearly, we are no different from other animals, who seek privacy and a safe place for a natural, quick and easy birth even in the wild.