"Push... 1... 2... 3..."
"Hold it, hold it, hold it!"
"Down to your bottom — atta girl!"
Every day across the nation, babies enter the world to these familiar coaching strategies. Compare this to a more subdued approach:
"You're completely dilated. Listen to your body. Listen to what it's saying."
"Baby is a bit high yet, so you may not feel like pushing. That's fine. Just take some minutes to rest now."
"Give in to those urges when they come. Bear down when you need to."
These directives help Mom save energy and allow for more maternal control.
Indeed, studies are now confirming what midwives have known for centuries — mothers know how to birth their babies. They don't require squads of coaches and cheerleaders and a gallery of spectators to tell them, even demand them, to push.
The notion of "closed glottis," "hold your breath and count to 10" pushing may well be a throwback to the days of twilight sleep when mothers delivered their babies in a state of semiconsciousness. If a mother has had an epidural and is not allowed to "labor down" until she feels the urge to push, coached pushing may be necessary. Most mothers, however, should be encouraged to push when they want to push and for as long as they want to push.
A 2005 study published in the Journal of Obstetric, Gynecologic & Neonatal Nursing reports that when caregivers and support persons encourage a mother in spontaneous pushing and discourage directive pushing, the mother will employ this more relaxed style. In addition, researchers found that spontaneous pushing did not significantly lengthen the duration of second-stage labor or total time spent pushing.