Directed Pushing vs. Mother Directed Pushing

Have you seen childbirth portrayed in movies and on TV?

"PUSH PUSH PUSH while counting to 10, take a breath and QUICK QUICK START PUSHING AGAIN while counting to 10, and ONE MORE GIVE ME ONE MORE REAAALLY GOOD PUSH counting to 10 and now RELAX RELAX JUST RELAX STOP PUSHING WAIT UNTIL THE NEXT ONE."

Everyone in the room: doctor, nurse, staff and family seems to be yelling at the birthing woman while she strains and tries to push her baby out.

A doula has written a blog post about her feelings on directed pushing:

Doula pet-peeve: directed pushing

She makes some really good points, and while the post is a bit angry it has some excellent information.

First, directed pushing is NOT based on evidence. In fact, it can lead to a greater chance of damage to the perineum and pelvic floor. As long as the baby is doing well, there is no need for doctors, staff and family to try to hurry or direct the pushing stage.

Directed pushing is sometimes referred to as "purple pushing" because many times women are told to hold their breath for the 10-count, resulting in a flushed face and sometimes even popped blood vessels in their eyes.

There is also the issue of how unfriendly directed pushing is, and how contrary it is for a woman who has had a peaceful labor and desires a calm birth experience. Another doula describes the practice in her own blog post:

Is Mother Directed Pushing Possible in the Hospital?

Her description is somewhat comical, but still accurate.

The best part of that blog post is the explanation and videos of Mother Directed Pushing. This may also be called spontaneous pushing. The concept is simple. Allow the mother to listen to her body cues and push as she feels the urge, and on her own schedule. This also includes allowing the mother to choose the position she wants to be in to push her baby out. As long as the baby is doing well (normal heart tones) then this approach is more favorable than directed pushing.

Why?

• Less likely to damage the perineum or pelvic floor
• A more peaceful, gradual birth experience, without people yelling and shouting
• Empowering and supportive of the mother in allowing her to decide how to birth her own baby.

This video about mother directed pushing was made by Sheridan, the author of Enjoy Birth Blog:

Please check out the links I posted above. There's also a good one about mother directed pushing at home:

Mother Directed Pushing at Home