Breathing technique for pushing?

[Hazel]

Hi, Cathe and Sheila. I've just returned from the first half of our prepared childbirth class (30 weeks and counting!) and had a question for you.

In speaking about the pushing stage of labor, the instructor demonstrated a technique she called "closed glottus" (sp?) breathing. Basically, she was saying you have to hold your breath during the push. I remember reading something on this forum--maybe in Jon's story about Eric's birth--about how Cathe used a different technique that possibly involved breathing through the push. But I've scanned the threads and can't find anything that addresses this topic directly.

Am I just making that up, or are you supposed to hold your breath while pushing? Isn't that how you end up with broken blood vessels in the face? It doesn't make any sense to me to hold your breath during exertion of any kind, but maybe I'm missing something here.

Thanks for your help!

 

[DebbieH]

Hi Hazel!

<center><font size="1" color="#ff0000">LAST EDITED ON Apr-29-00 AT 11:30PM (EST)</font></center>

No, you are not making it up. Go to the top of the page and click on "find", then type in "exhaling" for your keyword, enter "all forums" for the past "1 Year". It will take you to a page with about 4-5 different posts. Click on "Jon's side of the story" and it will give you the info you were looking for. Hope this helps! DebbieH

 

[Sheila]

"Purple Pushing"

<center><font size="1" color="#ff0000">LAST EDITED ON Apr-30-00 AT 09:35PM (EST)</font></center>

Hi Hazel,

Yes, you were right to question that method of pushing. Below is an exerpt from the "Healthy Moms Perinatal Fitness Instructor Training Manual"

“Purple Pushing” (Valsalva Maneuver)

Unfortunately, many women are told to hold their breath while pushing their babies out. This “non-physiologic” pushing is known as “traditional” or “purple pushing.” We have all been taught to “exhale on exertion.” Why should women be told to hold their breath during one of the biggest “exertions” of their life? Holding the breath while pushing can lead to the following:

·Decreased downward force leads to less effective pushing
·Abdominals are pushed outward with breath holding
·Pelvic floor reflexively tightens
·Increased blood pressure with brief periods of breath holding and decreased blood pressure with prolonged breath holding.
·Increased blood pressure may burst small capillaries in the face

I tried to search for Jon's post where he described Cathe's birth. I couldn't find it by using the forum's search tool when I put in "pushing" as the keyword. You can find this post on Page 3 of our forum.

Good luck. It is unfortunate that this method of pushing is still taught as the "method of choice" in a great deal of childbirth classes. I applaud those who have "bucked the system" and teach students to exhale while pushing.

Let us hear from you.

Sheila

 

[Cathe Friedrich]

Hi Hazel!

<center><font size="1" color="#ff0000">LAST EDITED ON Apr-30-00 AT 10:29AM (EST)</font></center>

I was so happy to have taken Sheila's prenatal course and learn about the problems that can occur with the purple pushing method. But as a fitness instructor(which you are also)you will automatically feel something wrong with this method because it goes against all of the safety issues that you have practiced and preached for years "EXHALE ON THE EXERTION".

When the doctor told me to take three deep breaths and on the last one hold my breath and push for 10 seconds, I nearly "fell out of the bed". I said, "are you sure I should be HOLDING my breath?" He said yes. I was not comfortable with this but being a cooperative patient I gave it a try. YIKES....my head filled with blood, my eyes bulged and filled with water, and I felt that I was giving myself heart palpatations. I did not like it and I was seeing absolutely no progress. By the third try with this awkward method I had gotton such a headache from the pressure. I told him that this method went against everything I was taught and that I feel that I would have much better progress if I could slowly exhale as I pushed. He reluctantly let me try it. Well, when he saw how quickly little Eric's head appeared he was impressed and encouraged me to continue.

What I did was take the three deep breaths and on the last one I contracted my abdominals and slowly exhaled for the 10 second push period(through the labor contraction). I just let a constant slow flow of air out. It almost sounded like a slow leak of air out of a tire. The doctor even joked around that he wanted me to come train his staff on how to teach others this method.

Good Luck and I say EXHALE ON THE EXERTION!!!!!

 

[Stephanie_B]

ITA with Cathe

With my first baby the doctor insisted I hold my breath and it felt wrong...I felt as though my head were going to explode and I would pass out. For some reason I did not hold my breath (call it instinct) with the next two of three pushes and voila he was out in three pushes! It was amazing for a first time birth from everything I had read anyway...baby No. 2 wasn't like that (she ended up being a C-section) but I definitely would not have listen if anyone would have told me to hold my breath if I ever made it to pushing with her.

Stephanie

 

[Mandy Lee]

Pushing the baby out

I agree with Cathe and Sheila! The way I pushed all my babies out was with a slow exhale. It's almost like doing an ab crunch but with more force. I always exhale when I do an ab crunch. My sister just had her baby and she had to push for 2 hours. She had broken blood vessels around her eyes from the "other" way to push.

 

[Hazel]

Thanks so much! And one more question . . .

Thanks everyone for your advice. My intuition told me that it didn't sound right, but I wondered if maybe you got more force behind the push by holding the breath. Sounds like the exact opposite is true! Once again this forum proves to be a god-send.

My additional question is--does it matter one way or the other whether you decide to have an epidural?

Thanks again!

Hazel

 

[Joanna]

Hi Hazel!

I love your name...same as my Aunt's

.

Here is my experience, albeit not that recent (youngest of my five is now 9!). I had an epidural with all but the last delivery. I found that my technique was really not the issue, rather the position of my babies and the size of their heads. Having no or little pain helped me focus on the process and I still felt like I had control and could sense what to do. With my last, which was very tough (go figure, she sure didn't 'slip' out like the nurse thought she would

) and without medication, I did feel more urgency to just get it over with! As noted on other posts on this thread, so much depends on your body and the size of your baby. I would love to go back and try the blowing out technique...makes sense. But, now that I think of it, five times was indeed enough!!

Have a great last few days/weeks. You are in for an amazing blessing.

Joanna

 

[Kristin Aziz]

Pushing technique

<center><font size="1" color="#ff0000">LAST EDITED ON Apr-30-00 AT 06:11PM (EST)</font></center>

I'm a nurse and a childbirth educator, and I just wanted to let you know that not all educators teach "purple pushing." We actually discourage it. We've been teaching exhale pushing for years. I'm so glad to see that some people are using it! You definitely may have to politely insist that you'd like to try your method, and then when the staff sees how well it works hopefully they'll encourage other women to use it as well.

As far as epidurals go, as with any medical procedure there are pros and cons. There is no one right answer that suits every situation. I'd recommend finding out as much as you can about them and their effects/side effects, and then making the decision that's best for you at the time. Please feel free to email me if you'd like to talk!

Kristin

 

[Mandy Lee]

Pushing natural vs Pushing w/epidural

Hi Hazel,

This is my opinion. I've delivered 5 babies naturally(including twins!) and then with my last baby, I had an epidural. I felt the pushing time was the same for me with an epidural but I was much more relaxed. It was still intense with an epidural but more of a "pressure" feeling during the contraction instead of a piercing pain that you can't control. When I was pushing without the epidural, I had this really burning feeling in my perineum area and it hurt bad. With the epidural, I felt no burning. It's up to you. I know some people swear to give birth naturally and some swear by epidurals. Gosh, I've done both ways and I'm going for the epidural with my next delivery. Everything went very smoothly and nothing went wrong. There are pros and cons with epidurals though. I had a catheter and couldn't walk around after I had the epidural put in. Also it took a while for the epidural to wear off so I could walk around after baby was born. But I didn't mind though. I was holding and nursing my baby. It was worth not going through the pain of transition and pushing the baby out. I labor in the tub untill I'm 5 cm and then that is when I get my epidural. I still have those strong contractions but only up to 5cm dialation. Also, when you have an epidural and you do need stitches in the perineum area, you are already numb and don't have to have a needle stick in you to numb up the area. Sorry to be so bland but these are important factors to discuss or to write down for your labor plan. Hope this helps!

 

[Hazel]

OK I lied--another question

<center><font size="1" color="#ff0000">LAST EDITED ON May-01-00 AT 05:51PM (EST)</font></center>

Actually, I meant did it make any difference in the use of the breathing technique for pushing if you'd had an epidural, not whether or not I should get one (I've pretty much already made that decision). But I went back and read Jon's post and it appears that Cathe had an epidural, so I guess I have the answer to my initial question.

My other question is--can anyone recommend a good book or article on this topic (i.e., the pushing technique that doesn't involve holding the breath)? I'd like to go in to my doctor's armed with some concrete information to back me up (not that I don't trust the great women on this forum, 'cause I do, but it might be harder to explain to the doc!).

And Kristin, thank you so much for your offer to chat. If you really don't mind, I'll try to find your e-dress on the VF forum and drop you a note soon.

Have I mentioned how much I love and appreciate this forum?

 

[Stephanie_B]

My favorite

Ok Hazel it's been awhile, but I am pretty sure it was in Natural Childbirth the Bradley Way by Susan McCutcheon (sp?) when I realized that exhaling IS okay to do. I really recommend that book highly. Also I agree with Mandy, with an epidural for me too it was more of a pressure sensation, it wasn't exactly pleasant; but, it didn't seem (and I am probably going to end up with a horrible labor next time knock on wood for saying this) as bad as it is in the movies-again this was just my experience. My girlfriend who delivered at the same time eight years ago couldn't tell when to push though (she said) because of the epi and went natural the next time which she also liked.

Stephanie :0)

 

[Leela]

Can I throw in my centavos?

I spent most of my labor all by my lonesome because i'm a speedster who gave birth a month earlier than expected. By the time I discovered what was going on - I had to call 911, and give birth at home.

The EMTs were not well trained in assisting birth - they had been trained however in handlng the baby post birth. So when I pushed, I jsut followed my instincts. Its alot like pushing other things out of your body, if you catch my drift.

And i'm not sure how i'd have dealt with someone shouting "Push!" . However - I can see that if you have had any kind of meds, that it might be a different case.

In any case - my point is - it came natural for me, and it may for you! The techniques I learned in bradley class were interesting - but not necessary in the end for the pushign phase.