Supporting women’s instinctive pushing behaviour during birth

MidwifeThinking

Artwork by Amanda Greavette

This article was published in The Practising Midwife journal in June 2015 along with ‘practice challenge’ questions for midwives (not included here).

Introduction

Clinical guidelines recommend that women should be guided by their own pushing urges during birth (National Institute for Health and Care Excellence (NICE) 2014). However, directing women’s pushing behaviour has become a cultural norm within maternity care. Women are still told when to push, when not to push and how to push. In order to promote and support physiological birth we need to reconsider the assumptions underpinning this practice. In addition, we need to reflect on how this practice influences women’s experience of birth. This article discusses supporting instinctive pushing behaviour during uncomplicated, physiological birth.

The current discourse around pushing and cervical dilatation is underpinned by a mechanistic understanding of the birth process: that the cervix opens first, then the baby is pushed through…

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