"I Gotta Push. Please Let Me Push!" Social Interactions During the Change from First to Second Stage Labor

Bergström, Linda; Seidel, John; Skillman-Hull, Leslie; Roberts, Joyce

doi:10.1111/j.1523-536x.1997.tb00582.x

Cited by 25 publications

(7 citation statements)

References 6 publications

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“…Contradictory perceptions of progress can also occur during the expulsive phase of labour when women experience an uncontrollable urge to push [49]. Being instructed to resist the urge to push can be distressing for women [50, 51]. In this study, instructions to stop pushing were based on assumptions regarding normal labour timeframes, and on vaginal examinations.…”

Section: Discussionmentioning

confidence: 99%

Women’s descriptions of childbirth trauma relating to care provider actions and interactions

Reed

Sharman

Inglis

2017

BMC Pregnancy Childbirth

193

154

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BackgroundMany women experience psychological trauma during birth. A traumatic birth can impact on postnatal mental health and family relationships. It is important to understand how interpersonal factors influence women’s experience of trauma in order to inform the development of care that promotes optimal psychosocial outcomes.MethodsAs part of a large mixed methods study, 748 women completed an online survey and answered the question ‘describe the birth trauma experience, and what you found traumatising’. Data relating to care provider actions and interactions were analysed using a six-phase inductive thematic analysis process.ResultsFour themes were identified in the data: ‘prioritising the care provider’s agenda’; ‘disregarding embodied knowledge’; ‘lies and threats’; and ‘violation’. Women felt that care providers prioritised their own agendas over the needs of the woman. This could result in unnecessary intervention as care providers attempted to alter the birth process to meet their own preferences. In some cases, women became learning resources for hospital staff to observe or practice on. Women’s own embodied knowledge about labour progress and fetal wellbeing was disregarded in favour of care provider’s clinical assessments. Care providers used lies and threats to coerce women into complying with procedures. In particular, these lies and threats related to the wellbeing of the baby. Women also described actions that were abusive and violent. For some women these actions triggered memories of sexual assault.ConclusionCare provider actions and interactions can influence women’s experience of trauma during birth. It is necessary to address interpersonal birth trauma on both a macro and micro level. Maternity service development and provision needs to be underpinned by a paradigm and framework that prioritises both the physical and emotional needs of women. Care providers require training and support to minimise interpersonal birth trauma.

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Section: Discussionmentioning

confidence: 99%

Women’s descriptions of childbirth trauma relating to care provider actions and interactions

Reed

Sharman

Inglis

2017

BMC Pregnancy Childbirth

193

154

View full text Add to dashboard Cite

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“…Intrapartum obstetric care is characterized by rapid changes in patient status and by interprofessional care teams; these factors may lead to stressful, strained communications, which impact patient perception of the childbirth experience. Specifically, the role of communication between clinicians around the timing and logistics for needed procedures or actions – including epidural analgesia, additional fetal monitoring, the urge to push, or cesarean delivery – is important for high reliability obstetric care (36–38). In addition, communication with the patient during critical junctures of care or when there are changes in maternal or fetal health status is central to perceptions of the childbirth experience.…”

Section: Discussionmentioning

confidence: 99%

Positive Childbirth Experiences in US Hospitals: A Mixed Methods Analysis

Attanasio

McPherson

Kozhimannil

2013

Matern Child Health J

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Objective Research on maternity care quality in the U.S. often focuses on avoiding adverse events. Positive birth experiences receive less attention. This analysis used a mixed methods approach to identify factors associated with confidence and positive experiences during birth among a national sample of U.S. mothers. Methods Data are from a nationally representative survey of women who delivered a singleton baby in a U.S. hospital in 2005 (N=1,573). We explored the relationship between confidence, positive birth experiences and socio-demographic characteristics as well as factors related to the clinical encounter and health systems, including common obstetric procedures and interventions. Self-reported confidence during birth was the outcome in quantitative analyses. We used logistic regression analysis and qualitative analysis of open-ended survey responses. Results Approximately 42% of mothers reported feeling confident during birth. Confidence going into labor was the strongest predictor of confidence during birth (Adjusted Odds Ratio (AOR) 12.88 for nulliparous women, 8.54 for parous women). Black and Hispanic race/ethnicity (compared to white) and having partner support were positively associated with confidence during birth for nulliparous women. Qualitative analyses revealed that positive experiences were related to previous birth experiences, communication between women and their clinicians, perceptions of shared decision-making, and communication among clinicians related to the timing and logistics of managing complications and coordinating care. Conclusion For clinicians who care for women during pregnancy and childbirth, thoughtful, deliberate attention to factors promoting positive birth experiences may help create circumstances amenable to enhancing the quality of obstetric care and improving outcomes for mothers and infants.

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“…and DeLee (1951) and Bergstrom, Seidel, Skillman-Hull, and Roberts (1997) claimed that no voluntary pushing should be allowed in the first stage of labor because this may cause a swollen cervix that could obstruct labor and enlarge the possibility of tearing the cervix, thus causing hemorrhage. Similarly, Berkley et al (1931) and Benyon (1957) highlighted the negative and harmful aspects of pushing before full dilatation and strongly discouraged this practice.…”

Section: Methodsmentioning

confidence: 99%

Childbearing Women’s Experiences of Early Pushing Urge

Celesia¹,

Nespoli²,

Borrelli³

2016

Int J Childbirth

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AIM:To explore childbearing women's experiences of early pushing urge (EPU). STUDY DESIGN:A qualitative phenomenological study was undertaken in an Italian maternity hospital. The sample included 8 women that experienced EPU during labor. Data were collected through semistructured interviews. FINDINGS:The findings are presented as three main themes: (a) women's perceptions of EPU, (b) bodily sensations versus midwives' advice: struggling between conflicting messages, and (c) the "a posteriori" feeling of women about midwives' guidance during EPU. The perception of EPU was characterized by sense of obstruction, bone pain, and different intensity of pushing efforts when compared with those of the expulsive phase. Women found it difficult to follow the midwife's suggestion to stop pushing because this contradicted their bodily sensations. However, the women recognized a posteriori the importance of the midwife's support while experiencing EPU. Women appreciated the midwives' presence and emotional support most of all because they seemed to be more concerned with the personal relationship they formed in labor rather than the usefulness or appropriateness of their advice. CONCLUSION:Midwives should consider women's physical perceptions to help them cope with EPU, acknowledging that women may struggle when caregivers' suggestions are in contrast to their physical perceptions. The women's overall positive experiences of birth suggest that EPU might be considered as a physiological event during labor, reinforcing the hypotheses of previous research. The optimal response to the EPU phenomenon remains unclear and should be studied, considering EPU at different dilatation ranges and related clinical outcomes.

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"I Gotta Push. Please Let Me Push!" Social Interactions During the Change from First to Second Stage Labor

Abstract: A discrepancy between a laboring woman's sensations and caregivers' ideas about how labor should be conducted has implications for clinical care of women, wherein the goal should be to facilitate the woman's accomplishment rather than to direct the "delivery."

Cited by 25 publications

References 6 publications

Women’s descriptions of childbirth trauma relating to care provider actions and interactions

Women’s descriptions of childbirth trauma relating to care provider actions and interactions

Positive Childbirth Experiences in US Hospitals: A Mixed Methods Analysis

Childbearing Women’s Experiences of Early Pushing Urge

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