A couple of questions, from someone with little experience of it herself…
Labor is a lot of work. But what would happen if someone just didn’t push at all when they were in labor? Would they baby just automatically come at some point, or what?
Along those lines, would it be possible for a comatose patient to give birth, or would a C-section be the only way?
Thanks!
The way it was explained to me when I asked someone this question was that pushing is reflexive, and the work is mostly to not push too soon. I think at some point overcoming the reflex to push would be difficult on the order of resisting the reflex to close your eyes when you sneeze.
But, I was also told that a baritone is a marching band’s French horn, so I’m curious to see what the right answer is, too.
My experience (twice) matches KneadToKnow’s description.
I have no experience, vicarious or otherwise on birth while in a coma.
IME–pushing is not a choice. They tried to get me to stop pushing when the baby was starting to come out not because there was danger to either of us, but because there wasn’t a doctor in the hospital yet and the nurses didn’t want to handle the delivery. Eff that. I made it through one set of contractions with them having me blow on a finger like I’m trying to extinguish a birthday candle, but I just couldn’t NOT push. I started apologizing as I started pushing with the next round.
Baby was born in minutes, and delivered by the nurses…who, I think, did a better job than the OB would have done. They were wonderful.
My baby is now a raging 19mo-old-toddler, just FTR.
A friend of mine was a nurse who did home care for a C3 (I think?) quadriplegic. The quadriplegic gave birth to three children but, since she couldn’t feel anything below her shoulders, she could not tell that she was in labor, nor could she actively push. Yet the babies got born with no trouble.*
*My friend’s involvement stopped once she noted signs of labor. At that point, she sent the patient to the hospital. So all I know is that they were all vaginal deliveries and all the babies were healthy. There may have been forceps or suction involved, though.
Not only is pushing a more-or-less automatic response in most women, but some studies have found that “coached pushing” - that is, pushing when the labor team shouts at you, “push”, is actually less good for the delivery and baby. It might shave a few minutes at most off of a delivery, and increases the risk of meconium staining and post-birth bladder problems. Pushing when you feel the urge (once the cervix is fully dilated and effaced) is actually better for the mom and the baby.
I had one vaginal delivery of a 10 pound 3 oz baby and one C-section of triplets. My pushing experience was that when the urge to push comes on that your body will push regardless of what you do.
However you also get an overwhelming urge to push, a need, a huge desire, nothing feels as good as pushing that baby out, it didn’t even hurt when I got a 4th degree tear because I only pushed twice and he was er, 10+ pounds and 24 inches long.
(It hurt later when the stiches ripped.)
They were trying to get me to “hold the baby in” until the lazy-butt doctor could get into the room; I normally am compliant with medical people and a little intimidated but I wanted to Push and Push I Did. I think actually my son was pushing as well. We pushed together.
The only analogy I can think of that is the same is not exactly a ladylike one, but if you really have to do a BM, when you sit down that BM is going to happen. You can help by pushing, but whether you push voluntarily or not, out it will come.
I will leave you all with that lovely image and hope that you were not eating. Oddly I first felt the urge to push in my bottom. The nurse rolled her eyes at me (it was that kind of nurse) until she checked and realized a person was about to fall out of me.
As far as comatose patients - there have been those horrible cases where a woman in a coma in a nursing home or hospice has been raped by some worker and fallen pregnant. I seem to remember this happening about a year ago… big debates about should she carry the baby or not, who had the right to decide because she couldn’t, etc.
The point is though that she had the baby while in a coma. Also for quite a long period women were actually chloroformed into unconsciousness during the last part of labor, and awoke to find a baby had arrived. Queen Victoria popularized the practice.
EmmaJane
Yes, pushing the baby out is not really a choice that you make; it is a mostly involuntary reflex.
Cites:
Cool, that makes sense. The BM analogy was actually really helpful. (Never thought I’d ever utter that sentence.) Thanks, you guys.
A better analogy I’ve heard is that telling someone not to push is like telling a vomitting person not to vomit. You can try to stop all you want, but when those muscles contract, they are doing their thing and there’s nothing you can to do prevent it.
When I arrived at the birth center with #1, the shocked midwife said, “you’re pushing!” That was news to me. I wasn’t trying to push. It was written in the file as “arrived at center pushing involuntarily.”
What you CAN do is to push harder along with that involuntary effort, to give more “oomph” to your body’s efforts to dislodge the cinder block in your pelvis. If this is beneficial and how it should be done is a matter subject to debate.
Ah, the joys of motherhood!
The BM analogy is a very fair one. Many a mom will tell you–and I echo it completely–that the moment that baby is pushed out is the best feeling in the world. The baby coming out is like once you’ve finally completed the largest, most painful, longest BM ever. And hey, the product of your work is way cuter.
I, too, hope no one is eating…but it’s a birth thread, so they should’ve known better.
Not all babies will come out without pushing. Before safe medical intervention such as c-sections, some mothers used to push until they couldn’t any further and either the mother or the baby, or both died.
When our son was born, we knew beforehand that there were going to be complications because of the birth defects. Ian’s head was the size of a 44 week-old baby, even though he was three weeks premature.
The doctors said that babies in that case do better with a vaginal birth than a c-section and recommended she try. Another consideration was that the Japanese hospital rules forbid mothers who had a c-section from going immediately to the ICU where the baby may wind up and if things went poorly really quickly, she wanted to make sure she would see him while she could. Also, we would have to wait longer to have kids after a c-section.
So, my wife was determined to have a vaginal birth. At some point, I should mention that this hospital is a “natural” birth type place, which means that they don’t give pain medication or epidurals.
They started inducing labor in the morning and that went on for more than 27 hours. They moved her into the delivery room at about 1:00 pm on the second day and her water broke about 15 minutes later.
She started the heavy labor, hard pushing every three minutes or so all the way, which continued for more than seven hours. I did mention somewhere that this was without an epidural, didn’t I?
Because of the size of his head, and her small frame, he would not have come out without pushing. The doctors tried forceps for a while then finally used suction, which finally worked.
We were going to give up at one point, after 5 1/2 hours of pushing, when she was totally exhausted, but just then the head slipped a little further and the doctors (there were 8 in the room when we finally finished) figured they could get him out.
I was with her for pretty much the whole time. She was hooked up to a fetal heart monitor as well as the device which measured the pressure of abdomen. Before hard labor started, it would get up to about 30 before it would really hurt (of whatever the units and) and once hard labor started it could be over 100. That really, really hurt.
The baring down seemed to help. If she didn’t push for some reason, she would need to pant to put up with the pain. She said afterwards it was all she could do to hang on.
We were in the delivery room for so long that I started figuring out ways to make her pushing more effective. You could read the pressure and see how effective the push was. The meter pegged at 199, and should would regularly get the on the first push in a contraction, but the second would only be in the low 100s or even as low as the 70s.
What she was doing first, was starting to push too quickly, and so she wouldn’t be able to use the contraction as effectively. I started to have her wait until the contraction built up to 50 or 60 and then start to push.
She would hold her breath and push, and then gasp and try again. This is why the second wasn’t doing much. I then had her take two breaths in between the pushes, which significantly increased the pressure. By putting my hands on neck and side, I was able to help her focus on the direction of the push.
Did I mention that the hard labor was for more than seven hours, with no medication?
It was all she could do to continue pushing. I asked her multiple times if she wanted to call it off and have the c-section, but she insisted on pushing. We had started at 1:00 pm and about 6:30 we were about through. She was still pushing, but the amount of force she could muster had steadily dropped down to about 150 160 range on the first push and 130 to 140 on the second.
The doctor said that if things didn’t improve soon, she’d do the c-section (all of OBs were women). At about 7:00, I was ready to force the issue and threaten to take her to another hospital if that’s what was required. They agreed to start preparing for the c-section when Ian slipped a little further along and it was agreed to continue.
My wife got her second wind, which I have no idea where it came from. I’m a wimp and would have quit hours before.
She was so completely focused on pushing that I needed to repeat the instructions for each and every contraction. Wait, wait, wait, wait, just a little more now, wait, OK, PUSH! PUSH! PUSH! (about 10 seconds here) OK, deep breath, NO! deep breath. OK, PUSH! PUSH! PUSH.
With the doctors trying the forceps, then section all while I coached her Ian slowly came out until the last push when the head finally got free and out he came.
They still talk about that birth at the hospital. How long she lasted and how difficult it was. Also, many Japanese husbands don’t attend the birth, and no one takes over the coaching. The OB said I was the best coach she had ever seen.
After our baby was born, I knew that my wife would always be my hero.
The uterus is smooth muscle. Smooth muscle is involuntary.