It Looks Like Maybe We Don't Have To Push So Hard During Labor (Yes, Really)
A handful of my friends have told me horror stories of giving birth, of being ripped from V to B while pushing their baby out. I cringed as I type that. It makes me want to slap every man who lets out an exaggerated groan when they think of being kicked in the balls. You don’t know pain, you wuss!
But one hospital in the UK has found a way to achieve better outcomes for mothers and their perineums.
They’ve stopped telling women when to push.
So instead of feeling like they’re on a rowing crew while having repetitive instructions bellowed at them during labor, women at Medway Maritime Hospital are letting their bodies do the damn thing and not being rushed through the process of birth. Trusting that maybe a woman knows what’s going on inside her body better than someone standing on the outside has led to a decrease in instances of tearing from 7% to just 1% over a period of 12 months.
Laboring mothers are also encouraged to try positions other than lying on their back, like coming up on all fours, standing upright, or squatting. Many women will tell you that lying on your back in labor feels unnatural and that they often feel an intense urge to come up into a more comfortable position. Lying on your back decreases blood flow and closes the pelvis by as much as 20%, increasing the chances of tearing or episiotomy. The World Health Organization even recommends against this position, calling it “clearly harmful.”
Midwives at Medway have also incorporated more ways to support the perineum during labor, like supporting the baby and allowing them to slowly emerge from the mother instead of pulling them out once the shoulders are free. Using a hand to provide counter-pressure on the perineal area during crowning and birth has also resulted in fewer instances of tearing.
And don’t worry. If a mother or child is in distress or there are other complications, the midwives aren’t going to let her just lie there while they shrug their shoulders and say “Well, we aren’t supposed to tell her to push.” There are exceptions to every rule. But birth is, typically, an uncomplicated matter. Our bodies tend to know how get ’em out of there. The times when this isn’t the case is why doctors and midwives are standing by rather than just some guy with a catcher’s mitt. They’re trained to handle those instances when something does go wrong.
That 7% to 1% decrease was so impressive that the results of this program have been published in the European Journal of Obstetrics & Gynecology and Reproductive Biology so that the updated approach can be considered by other hospitals.
The UK also has plans to implement this policy nationally because of how strong the evidence is for favorable outcomes, which should come as a welcome change for women across the country as more and more methods for safer labor and childbirth are becoming accepted standards of practice. Women don’t know whether to thank their doctors or let out a resounding “duh.”
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