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Powerful Pushing

New Method Promises Safer, More Efficient Delivery

By Susan Hyde

It's "Labor Day" – the day you'll finally meet that little life that has grown inside of you for 40 weeks. Are you prepared to push? No doubt about it, the pushing stage of labor is a very physical experience. And while nothing can truly prepare you for the emotional end of your nine-month race, you can do a lot to prepare your body for the work ahead. In fact, you can train your body to work efficiently with your contractions if you coordinate your breathing and abdominal muscles while relaxing the pelvic floor muscles. The result, called coordinated pushing, is a safe and practical alternative to traditional pushing methods that are often less efficient.

The first element of an efficient, coordinated push is breathing. Not the "hee-hee, haw-haw" breathing that laboring moms often use to get through the first stages of labor, but deep abdominal breathing at the beginning of a contraction followed by a controlled full-belly exhalation.

Traditionally, when a woman is ready to push out her baby, she has been told to hold her breath and "bear down" in a fashion similar to passing a bowel movement. Certainly, this strategy will get the baby out; however, research shows that women who push this way have a higher rate of negative physiological results, including increased tearing of the perineum and decreased oxygen to both the mother and baby. Furthermore, breath holding during sustained muscle contractions reduces blood flow to the mother's heart and brain and causes increased blood pressure.

Perinatal fitness expert Sheila Watkins adds that breath holding during pushing causes a woman to "push her abdominals outward and reflexively tighten her pelvic floor." The result is a less efficient push since the abdominals are not working with the contractions, and the perineal area is not relaxed and ready for the exiting baby. "In fitness classes, we have all been told to 'exhale on exertion,'" Watkins says. "So why should women hold their breath during the biggest exertion of their life?"

Another negative consequence of breath holding is that increased blood pressure may cause small capillaries in the face to burst. For this reason, pushing without the benefit of oxygen is often called "purple pushing." Wendy Woodlief, mother of two, knows all too well about purple pushing. She emerged from her first labor and delivery with a beautiful little boy, but she looked more like she'd spent time in a boxing ring than a labor and delivery room. "My face broke out with small red dots, and the whites of my eyes were red – all from capillaries bursting!" Woodlief says.

Want to see more?

• Optimal Foetal Positioning: Rocking Your Way to a Straightforward Birth
• Avoiding Routine Interventions in a Hospital Birth
• Exercise Your Way Through Pregnancy
• Talk about it!

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