Monthly Archives: February 2011

“PUSH!” 

Except it was spoken in Spanish. 

Which I don’t speak.  And neither did my client.  But the nurse assumed from her dark skin that she did. 

My client was a first time mom.  She had spent most of her labor at home.  Beautifully relaxed.  Quiet.  Intuitive.  She was fully dilated when we arrived and pushing with small “ahhhhs” and grunts. 

When it was discovered in triage that she was fully dilated, the energy went through the roof.  Nurse yells for a precip tray, un-brakes the bed and begins rolling it down the hall.  Instructions:  “don’t push, honey, just breathe through them.”  Flurry.  Another nurse appears and looks at my client with pity, “Sweetie, did you mean to go natural?”  The dad is frightened by all the activity. 

We arrive in a room.  IV antibiotics are started (GBS +).  Belts strapped on her belly.  Blood pressure cuff.  Thermometer.  Dr. Ken Barbie enters. 

Mom asks if she can push in a squat.  Ken Barbie says “no, we need to get this baby out quickly because I don’t know what’s been happening in there.” 

Stirrups raised.  Legs held back.  “You’re having a contraction, can you feel that?” 

She shakes her head “no.”  I mean, she’s been a bit distracted by all the madness. 

“Well you are.  And you need to use it.  So take a deep breath, hold it, chin to chest, pull your legs back and PUSH.  1…2…3…4…NO, don’t let your air out!  Again, deep breath…”

And then the nurse switches to Spanish.

Sigh.  Many of  my clients choose to arrive at the hospital late in labor.  And I am struggling to find ways to lower the adrenaline when we get there.   Literally at a recent birth, the nurse was asking the mom (in between pushes) questions like “Do you have electricity in your home?”  “Is this man the father of the baby and will he be going home with you?”  And sometimes, it doesn’t matter how early we arrive, when a woman begins pushing at the hospital, the energy skyrockets.   I especially love the tray of scary instruments that is wheeled into view.   

Yet, out-of-hospital, this stage is often the quietest.  The mom is focused and serious.  The caregivers may murmur a few “beautiful…you’re doing it” or “push with your body” affirmations but are mostly quiet.  And the moms who are encouraged to “push with your body” don’t often “take a breath, hold it, chin to chest, PUSH!  1…2…3….10.”  They give 5 or 6 small grunty pushes or they breathe their baby down.  Sometimes they skip a few pushes to get some rest.  Often, their own adrenaline causes them to rise up, lean forward.  Rarely does a woman intuitively lie back and pull her legs back. 

I’d love to show L&D nurses videos like this one or this one: 

Instead, many of them are trained in this way.  I realize that most of their patients have epidurals and may need help with pushing but PLEASE remember that most unmedicated women do not need to know when or how to push. 

Norah (5 yrs), who has been helping me write this post, would like to tell everyone that “squatting is best.  I know it is best.” 

 I’d love to hear from other doulas how you change the energy during this stage.