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Old 03-21-2012, 11:22 AM   #31
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Re: 10 hours of pushing. Yes, I said pushing. Anyone else go long??

The part I find strange is that there was no head moulding that would indicate that there was a problem with positioning or something like that- If it was just the shoulders being stuck, that shouldn't have kept the baby from being pushed most of the way, right?
It's a very unusual birth story for sure! I would think that it's unlikely to happen that way again, and that maybe there was something phychological going on there, or a pushing urge that wasn't quite right. I don't know. It's great that you were both okay and suffered adverse affects; you would have been forced into a c-section for sure at the hospital, but obviously it wouldn't have been "needed" for your circumstance. But that doesn't mean that 10 hours of pushing is safe for most women and babies, either. The risk of excess bleeding would be my biggest concern, even if the baby's heart rate sounded good throughout.
I pushed in my first birth for 45 minutes or so, and just 10 in this last one. I can't imagine having that reflex for 10 hours. It really boggles my mind that you did that!

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Old 03-21-2012, 09:17 PM   #32
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Re: 10 hours of pushing. Yes, I said pushing. Anyone else go long??

Wow! I wasn't expecting to generate so much commentary with my birth story! I kind of thought the odds of finding someone else with a similar story were slim at best, but it truly sounds like I am an odd duck.

I was fully dilated to 10cm right around 12:00. I was beginning to feel the urge to bear down, so I asked my midwife to check my dilation. She told me I could push if I was feeling the urge, but not to worry about pushing if I didn't feel ready yet. My body wanted to push - so I followed my instincts. There was actually one point where my midwife suggested I rest through a few pushing contractions, but it was like someone telling me not to throw up. It was excruciating, and I couldn't do it. My body convulsed into bearing down no matter how hard I tried to control the urge. So there was no question - the bearing down instinct was there and it was strong.

As for a mental block... I feel dubious. From my POV I felt everything was going perfectly for about 16 hours. I was at home with my midwife & DH, as planned. The birth pool got me through 1st stage easy peasy (or as easy as that can be ), and I was confident I was going to see my baby within a very little while. It wasn't until I'd been pushing 4+ hours that I started to flag (10 years of martial arts training have probably increased my endurance and pain threshhold quite a bit). I wasn't anxious at all (that I can remember) before that point. I had no reservations going into the birth at all, I was 10 days overdue and ready to be done with it!

As I mentioned earlier, my midwife did mention that my muscles were spasming and that was probably a piece of the puzzle. She suggested after the fact that it might be Vaginismus of some kind, though I've never had any issues in that area. The pressure of DD's head was causing my pelvic floor muscles to spasm, which was hindering her progress down for at least a portion of the time.

It is strange that she was so perfect, despite the long pushing stage... but as I said she didn't descend very far at all until the last few hours. She came out rosy pink with her little round head, began to cry lustily, and nursed just fine. She wasn't stuck for very long. I pushed and her head was delivered, next push her shoulders were not delivered, so on the third my midwife helped rotate her and out she popped. I know she would have been stuck longer if not for my midwife.

I have a lot of food for thought now. The thought of something like this happening again, well - you can imagine. I can remember most of this quite clearly and it is a bit overwhelming to revisit. We started talking transfer at 5 hours, at 6 hours it was clear something needed to change so we planned to transfer... the hospital had been called, my DH had my bags by the door, but I wasn't ready to call it done. I wanted one more hour. It was me who wanted to try eating a meal, wanted to try nipple stimulation, anything really - even as exhausted as I felt. I played a huge part in the decision not to transfer right at 6PM. And by 7? Our drop dead time? Things had started to change. And I had my beautiful baby girl.

If I had been in the hospital, this likely would have been a CS. For 5% of ladies this is needed, and again thank goodness for doctors. But I did not need one this time. The midwife, my DH, and I made decisions based on a lot of different factors that were playing out. I really do see where all of you are coming from, and it leaves me feeling very confused about my next move. Thankfully I have time to think about it, as I am in no hurry to try again very soon.

Thank you for all of your kind comments, and voicing your concerns for my next birth. I really appreciate your input and will take all of it into consideration. We are indeed a healthy mommy and a healthy baby, and very blessed to be so.
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Old 03-21-2012, 09:33 PM   #33
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Re: 10 hours of pushing. Yes, I said pushing. Anyone else go long??

Wow, I can only imagine. My longest pushing was 2 hours with no progress, at which point we had a C/S.
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Old 03-21-2012, 10:11 PM   #34
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Re: 10 hours of pushing. Yes, I said pushing. Anyone else go long??

I am surprised at the people who think 2 hours of pushing is long, or had C sections at that point. My memory from my research before my first birth was that 2-4 hours of pushing was a fairly accepted range in hospitals. I pushed for 1.5 hours with my first and it seemed very normal. FWIW, I pushed for about 5 minutes with my second child and maybe 10-15 minutes with my third, although the really intense pushes were 5 minutes or less.

I am completely speculating but it seems like you had an urge to push way before it was productive. I guess the bigger question is WHY did that happen. Maybe like dry heaves long before you actually vomit.... you only get exhausted from them rather then it accomplishing anything. There are times our bodies work that way - another example, like a runny nose when you have no other cold or allergy symptoms and feel fine.

I mean, now that I think about it, what triggers pushing anyway? We don't really know what triggers the onset of labor - do we know for the pushing phase? Is it pressure on the cervix, is it chemical, is the sensation transferred by certain nerves? Chicken and egg question - does it start with baby's position or something else which then helps you move baby's position? Maybe if you find out more about how normal pushing is triggered and coordinated/conveyed by the body, you can speculate on what might have been different for you.

As for finding a physical therapist, try http://www.apta.org/apta/findapt/ind...ID=10737422525 and check "women's heath" as your specialty area.
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Last edited by aggfan; 03-21-2012 at 10:26 PM.
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Old 03-21-2012, 10:23 PM   #35
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Re: 10 hours of pushing. Yes, I said pushing. Anyone else go long??

If anyone has any links/research to the average time a woman is in the pushing stage, I would love to learn more about this topic.

OP, thanks for being so gracious with our replies. Birth stories are so personal that it can be so easy to feel attacked when sharing something so personal. I was very interested in your story as it does seem pretty unique. And that's saying something on such a large forum as this where many mothers are homebirthers, midwives, doulas, or mothers of multiples.
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Old 03-21-2012, 11:37 PM   #36
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Re: 10 hours of pushing. Yes, I said pushing. Anyone else go long??

Two hours with my first and over 5 hours with my second. I kinda lost track of time

#1 had shoulder dystocia and my ob tried some different positions to unstick him. She ended up using the vacuum extractor b/c his heart was decelerating in a scary way. If it hadn't worked I would have been wheeled into the OR.

#2 was sunny side up, something the dr. didn't share with me or my doula. The nurse mentioned it to my doula after the 5.5 hour mark. We repositioned and poof, he came flying out. The OB was scrubbing at that point and practically missed it.

With my new mw and birth center I asked and she said I could push as long as I could if the babies heart rate was fine. It is a 45 minute drive to the closest hospital so decels are grounds for a transfer. She said hours of pushing is normal (I asked about my 5+) for some women. Others are a few minutes. It varies from woman to woman and baby to baby.

#1 had no head molding other than the spot from the extraction.
#2 did not move down into the birth canal until moments before he came flying out, once my position was changed. I had been squatting almost the entire time and I actually went prone on my back to shift him. Not a text-book case.
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Old 03-22-2012, 12:46 AM   #37
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Re: 10 hours of pushing. Yes, I said pushing. Anyone else go long??

Quote:
Originally Posted by jacquelinemarie82 View Post
If anyone has any links/research to the average time a woman is in the pushing stage..
Most things I found support the idea of 2 hours of pushing (not 2-4 hours as I had said) as being normal, but there is some variation by source and even more variation among individuals. For women having previously given birth (multiparas), the pushing phase was much shorter than for first-time moms (nulliparas). For women with an epidural, pushing is roughly 20-30 minutes longer than without an epidural.

I'll divide what I found by medical sources first, then general pregnancy websites.

MEDICAL JOURNALS (all from Pubmed, part of the Ntl Library of Medicine at NIH)

… mean second stage labor duration was 52 minutes (SD +/- 42 min, range 2-450 min… Interquartile range (IQR)/median for .. second-labor was .. 50 min (IQR)/ median 40 min... http://www.ncbi.nlm.nih.gov/pubmed/9471433

Epidural anesthesia by women in this study was found to increase the average length of the second stage of labor by 38 minutes for primiparas and 23 minutes for multiparas. http://www.ncbi.nlm.nih.gov/pubmed/7876781

Increasing maternal BMI was not associated with second stage duration: normal weight, 1.1 hour; overweight, 1.1 hour; and obese, 1.0 hours (P=.13). http://www.ncbi.nlm.nih.gov/pubmed/22105260

Primiparous women ... second stage of labor up to 8 hours with no adverse effects .. Multiparous women ... second stage of labor for up to 4.5 hours with good birth outcomes. ..With the availability of technology to assess maternal and fetal well-being, labor should be allowed to progress past the rigid 2-hour time limit for the second stage of labor artificially imposed on women in some childbirth settings. " http://www.ncbi.nlm.nih.gov/pubmed/15561659
NOTE: I have some doubts about the quality of the sample used in this research. The researchers got a poor response rate to a survey (89 hospitals) where each picked 5 patient cases to submit, so 419 total cases. Seems far from a random sampling method.


GENERAL PREGNANCY WEBSITES

The American College of Obstetricians and Gynecologists (ACOG) has suggested that a prolonged second stage of labor should be considered when the second stage of labor exceeds 3 hours if regional anesthesia is administered or 2 hours in the absence of regional anesthesia for nulliparas. In multiparous women, such a diagnosis can be made if the second stage of labor exceeds 2 hours with regional anesthesia or 1 hour without it. http://emedicine.medscape.com/articl...view#aw2aab6b3

Average second stage 50 min nullipara, 20 min multipara. Prolonged second stage without epidural >2 hours nullipara, >1 hour multipara. Prolonger second stage with epidural >3 hours nullipara, >2 hours multipara. Taken from chart at http://emedicine.medscape.com/article/273053-overview
NOTE: I just realized this is the exact same info as above, but this was originally presented in a chart format.

The entire second stage can last anywhere from a few minutes to several hours. Without an epidural, the average duration is close to an hour for a first-timer and about 20 minutes if you've had a previous vaginal delivery. If you've had an epidural, the second stage generally lasts longer. http://www.babycenter.com/stages-of-labor?page=5

For first-time mothers the average length of pushing is one-to-two hours. In some instances, pushing can last longer than two hours if mother and baby are tolerating it. http://www.babies.sutterhealth.org/l...r/ld_push.html

The average length of the pushing stage is from one to one and a half hours in first-time moms. http://www.askdrsears.com/topics/pre...g-stages-labor
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Last edited by aggfan; 03-22-2012 at 12:49 AM.
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Old 03-22-2012, 01:14 AM   #38
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I pushed for about 3hours, maybe four? I realized that my fear of tearing was the reason I couldn't progress, I did a fear release with my hypnobabies program and he was out about a half hour after that. I ended up having some yogurt and cheese then "purple pushing" until he was born, I did end up with tears but was so relieved to have him in my arms it didn't matter. Hoping for a faster entrance for our second also Congratulations mama!!
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Old 03-22-2012, 06:09 AM   #39
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Re: 10 hours of pushing. Yes, I said pushing. Anyone else go long??

Quote:
Originally Posted by trying4more View Post
I've never been in labor that long!
WOWZA!
me either. my longest labor was 6 hours, 2nd labor was 3.
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Old 03-22-2012, 06:20 AM   #40
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Re: 10 hours of pushing. Yes, I said pushing. Anyone else go long??

I had a home birth, and pushed for about 2 hours. Near the end, the midwife was watching his heartrate and it suddenly dropped. She told me we had to get him out and did an episiotomy. She had her assistant push on my stomach as I pushed and DS came out pretty quick, but had shoulder dystocia and ended up breaking his right arm.

He was also big - 8 lbs 14oz.

All was well in the end though. The midwife found a great orthopedist and his arm healed very quickly. He's so healthy now I can barely remember those first few weeks of trying to hold him carefully. Last x-ray showed everything was completely healed.

The hospital on the other hand...they weren't so great to us. They made it clear that they disapproved of the home birth.
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