Purple Pushing – Valsalva Pushing – Coached Pushing vs Mother Directed Bearing Down

pregnant woman, Relax n' Birth, Darryl McCullagh 07751227738Ok. ok. So we’ve all heard the stories (or perhaps been part of the story ourselves) where the birthing mother is told to hold her breath and push, push, PUSH in cheer-squad style. This scene is regularly depicted in movies/sitcoms, media, even comedies. The expectation that a woman is purple in the face, eyes bulging, screaming and exhausted has become so ingrained in our perception of labour and birth that anyone who dares to disagree with it is considered either to be a freak of nature, or a lier.

Coached or valsalva pushing for a normal, unmedicated birth is not only unnatural – it is down right detrimental to both mother and baby!

In the Relax n’ Birth, mother-directed breathing/bearing down is taught as being the most effective, safe and satisfying method of ‘pushing’. And if the mother feels the urge to bear down and push – then she does this – instinctively.

When a mother can feel the sensations of birthing (ie. during an unmedicated birth or if an epidural has been used, but has worn off to the point where the mother can ‘feel’ the urge to bear down) – it makes sense that her  body is going to naturally expel the baby more effectively when not subjected to coached directions. 

Giving birth feels a lot like doing a BIG POO. When emptying our bowels, the natural expulsive reflex requires privacy, relaxation and trusting our natural instinct in order to work effectively. Similarly – the natural expulsive reflex during birth also requires privacy, relaxation and a trust in our natural instinct. Having a bunch of people calling out to you to “Hold your breath and now PUSH” would have to be as ‘un-instinctive’ as it comes!

Let’s now look at what the research says about the effects of valsalva (purple) pushing on both the birthing mother and baby.

Yildirim & Beji conducted a randomised study on the ‘Effects of pushing techniques in birth on mother and foetus’. You can CLICK HERE to read an abstract of the article.

In a nutshell the study concluded:

The second stage of labor and duration of the expulsion phase were significantly longer with Valsalva-type pushing. Differences in the incidence of episiotomy, perineal tears, or postpartum hemorrhage were not significant between the groups. The baby fared better with spontaneous pushing, with higher 1- and 5-minute Apgar scores, and higher umbilical cord pH and Po(2) levels. After the birth, women expressed greater satisfaction with spontaneous pushing.”

And that is only ONE study… google valsalva/purple pushing and you will find more studies backing up the fact that mothers and babies fare better with spontaneous, mother-directed bearing down – rather than valsalva/purple pushing.

And THAT is why hypnobirthing mothers go in to their birth informed, clear about their preferences and well prepared. 😉 THAT is why we trust our natural instincts to birth and practice mother directed breathing/bearing down.

It is absolutely to our advantage to be very clear about our reasons for using our breathing/bearing down technique BEFORE we go into labour. We need to make our birth preferences very clear to our caregivers ahead of time so that we are not subjected to forced pushing prompts during labour.

Also, be very clear yourself on your own reasons for practicing mother-directed bearing down during your birth, ensure that your partner is clear about your preferences and make it very well known to your caregivers before the birth/during labour.

Many caregivers (especially midwives and supportive doctors/obstetricians) will support your preferences to mother-directed bearing down. But just communicate your preferences early to ensure that everyone is on the same page.

Go into your birth prepared, with knowledge, tools and good support.

And if you truly want to give yourself the advantage in preparing for a calm and positive birth then go ahead and book yourself with Darryl from Relax n’ Birth.

Darryl McCullagh Dip Hyp / Cert HypB




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