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

Abstract

Background: Forms of social interaction may occur among the participants in medicalized births, in which a woman in labor is experiencing strong involuntary urges to push but has not yet been found to have a completely dilated cervix. This article examines the social events and communications that occur at the change between first and second stages of labor: Method: Three cases are described from videotapes of women in the second stage of labor and their caregivers. Results: Severul social and interactive features occurred, in which (1) the caregivel; usually a nurse, by invoking the "no pushing rule," insisted that the woman suppress her involuntary urges to push; (2) both the caregiver and the parturient displayed an orientation toward the future and the eventual certification of full cervical dilation by a designated authority, usually a physician, regardless of the actual state of the woman5 cervix or her involuntary urges to push; and (3) the certification process marked a ritual transition to "official" second stage labol; in which the woman's involuntary urges were considered appropriate and actively encouraged. Conclusion: 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 "

Using Conversation Analysis in Feminist and Critical Research

“…the appropriate use of story prompts, continuers or silence) are being used as a tool to train midwives and other health caregivers in how to provide more effective support to women in crisis after childbirth (Kitzinger & Kitzinger, 2007). For video‐based studies of childbirth interactions that draw on CA, see also Bergstrom, Roberts, Skillman, and Seidel (1992) and Bergstrom, Seidel, Skillman‐Hull, and Roberts (1997).…”

Birth Talk in Second Stage Labor

“…Researchers from the Second Stage Labor Project (Roberts, McKay, Goodlin, Norr, & Seidel, 1989) described several social features of second stage labor (Aderhold & Roberts, 1991;Bergstrom, Roberts, Skillman, & Seidel, 1992;Bergstrom, Seidel, Skillman-Hull, & Roberts, 1997;McKay & Barrows, 1991;McKay, Barrows, & Roberts, 1990;McKay & Barrows, 1992;McKay & Smith, 1993). However, the focus of this study, the content and linguistic characteristics of birth talk, have not been described.…”

“…Most research on second stage labor has focused on physiological factors and procedures managed by caregivers, such as the nature of bearing down by women, positions to use for labor and birth, physiologic effects of bearing down on fetal oxygenation, and factors associated with perineal trauma (Roberts & Hanson, 2007;Roberts, 2002Roberts, , 2003Sampselle, Miller, Luecha, Fischer, & Rosten, 2005). Researchers from the Second Stage Labor Project (Roberts, McKay, Goodlin, Norr, & Seidel, 1989) described several social features of second stage labor (Aderhold & Roberts, 1991;Bergstrom, Roberts, Skillman, & Seidel, 1992;Bergstrom, Seidel, Skillman-Hull, & Roberts, 1997;McKay & Barrows, 1991;McKay, Barrows, & Roberts, 1990;McKay & Barrows, 1992;McKay & Smith, 1993). However, the focus of this study, the content and linguistic characteristics of birth talk, have not been described.…”

How Caregivers Manage Pain and Distress in Second‐Stage Labor

“…The purpose of the National Institutes of Health–funded grant was to describe care in second‐stage labor in enough detail so that care protocols could be developed and taught to obstetric personnel in order to conduct further studies on how care practices might affect clinical outcomes. The experimental phase of the project was never completed, but a large number of behavioral aspects of care in second‐stage labor were described, including specific social interactions, women's perceptions about labor, and caregivers' interpretations of sounds made by laboring women during the second stage 6–14 …”

“…The experimental phase of the project was never completed, but a large number of behavioral aspects of care in second-stage labor were described, including specific social interactions, women's perceptions about labor, and caregivers' interpretations of sounds made by laboring women during the second stage. [6][7][8][9][10][11][12][13][14] Studies about women's levels of satisfaction regarding their childbirth experiences have not targeted second-stage labor, but indicate that women value factors such as individual attention from caregivers; caring, competent caregivers; communication; information; advocacy; pain relief and physical comfort; emotional support; and personal control. [15][16][17][18][19][20][21][22][23][24] Hodnett's 24 systematic review about women's satisfaction found that attitudes and behaviors of caregivers were the most powerful influences on how women rated their satisfaction with childbirth.…”