What is the difference between spontaneous and coached pushing in labour?

What is the difference between spontaneous and coached pushing in labour?

Coached pushing is quite a controversial topic, find out how it differs from a spontaneous labour.

 Difference between spontaneous and coached pushing in labour

In labour, what’s the difference between spontaneous and coached pushing? They talk about it in my antenatal group and I’m confused – don’t you just push when you have a contraction?

In my experience the mums who have a spontaneous labour with no drugs – particularly an epidural – spontaneously push. Once they’re fully dilated, the baby moves into the birth canal and presses on the pelvic floor muscles, causing the sensation of needing to ‘bear down’ and push. It’s overwhelming and very difficult to control, so mums are encouraged to go with it and follow these urges.

Coached pushing, quite a controversial topic, is where the midwife and/or doctor tell the mum when and how to push. In my opinion this is sometimes needed, especially if the mum has had an epidural and can’t feel any urges to push. Again you will be fully dilated and in the second stage of labour; you will be encouraged to take a big breath at the beginning of the contraction and then, while holding it in, to push down as though you’re opening your bowels. Typically you will do this three times through a contraction.

If you’ve had an epidural it’s now common practice to wait at least an hour – sometimes longer – once you’re fully dilated, to allow the baby to completely descend into the birth canal, so pushing it out is easier. Sometimes the epidural can be allowed to wear off at this point, allowing you to feel those urges to push.

Alison Brown

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