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.
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.
You can train your body to work efficiently with your contractions. |
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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.
I'm so glad to see this article. I've been teaching women, and training yoga teachers, about exhale pushing for years. However, it's not often well received in hospitals (until the drs. see a women successfully do this!) Doing exercises to strengthen the transverse abdominal muscles while simultaneously practicing the release of the pelvic floor everyday during pregnancy makes this happen intuitively when it's time to give birth. Using sounds like "sssss", "aaaaah" and "ooomm" not only release the muscles of the pelvic floor, but also help the transverse abs engage to "echo" the uterus as it works the baby downward. And, yes, I too appreciated not having a purple face and a diastsis recti after using this technique during the birth of my youngest son 12 years ago.
Thank you,
Mary Barnes, RYT 500
Director
YOGA FOR TWO: Prenatal and Mom & Baby
Great article on pushing! Finally someone is letting women know that there is a much better way than "purple pushing" to get babies out. I would add one thing that we also include in our Hypnobabies program: When our moms exhale, they also say, "AAAHHH", which allows their pelvic floor to remain relaxed as they push, since the relaxation of the jaw and face is directly connected to how relaxed their bottom is. It really works and they can even push their babies out in between contractions at crowning, to lessen the chances of tearing or episiotomy.
Thanks so much,
Kerry Tuschhoff,
Director of Hypnobabies
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