Purple Pushing: Just Say No.

What’s purple pushing (PP), you ask? It’s the moment in labor when care providers instruct you to hold your breath and bear down as hard as you can until they tell you to stop. Often, women are given just a few seconds to catch their breath in between bouts of PP. Some moms, depending on how light skinned they are, will actually turn purple during this stage.

So, why say no to PP? One of the things that we teach moms during childbirth preparation is to breath deeply, but not too quickly, to avoid hyperventilation. Mom’s breathing is the baby’s oxygen supply, and one of the last things we want during labor is for the baby’s access to air being compromised. Why, then, would we want moms to literally stop breathing during the most stressful moments of birth? No coach would ever tell their star athlete to hold their breath before making a play, I’m not sure why we think it’s a good idea for laboring women.

On second thought, PP isn’t about the woman at all! PP is part and parcel of managed care and the belief that someone outside of our bodies knows our bodies better than we do. PP usually happens in hospitals, where care providers have been trained to “deliver” babies of medicated mothers. In the hospital, things must be done as quickly and safely as possible. It fits perfectly into the equation when moms are instructed to push as soon as they dilate to 10, because the process will be over quickly once the episiotomy has been performed and your baby “delivered.”

During natural birth, a woman will feel the urge to push. It’s a natural, normal feeling that lets you know that something needs to exit your body. She will usually feel the urge when she’s fully dilated, but I’ve labored with some women who felt the urge as early as 4 centimeters. However, a mom who is numb due to medication won’t feel the urge to push. She will need to be told what’s happening to her body – when she’s having a contraction, when and for how long she should push. Doctors are taught to work with these moms, and so most moms are treated as though they’ve been medicated when it’s time to push. A natural birthing mom who has been educated and prepared for birth doesn’t need to be told when and for long to push. She will feel and be in communication with her baby.

Imagine, for a second, a comparison. You’ve had a meal, and 45 minutes later someone tells you it’s time to poop. You don’t feel anything, but you head to the bathroom anyway. 5-10 people crowd around your toilet bowl, and instruct you to push under bright lights. Not only are you uncomfortable, but now you’re working against your body that hasn’t yet given you the signal that it’s ready. You will have a traumatic bowel movement, and may even tear your anus due to excessive pressure. On the other hand, you can wait until you have the urge to go, head quietly to the loo on your own terms, and simply breathe out your waste without as much effort. Granted, a baby isn’t exactly the same, but the logic is.

When a mom is on her back, and being coached to PP, the baby is put in danger. Gravity keeps weight down on the baby, and increases the risk of compromised oxygen to the baby by creating pressure on the umbilical cord. This is true before mom even begins to PP. Add to that a mom who is holding her breath, and it’s no wonder that hospital born babies (those born to healthy, low risk mothers) are so closely monitored after they’re born.

Now, if I’m saying, “Say no to PP,” there’s got to be an alternative, right? You betcha! Left to her own devices, it’s extremely rare that a birthing mother will naturally bear down. She may grunt, scream, moan or simply breathe – all perfect ways to push. I’m reminded here of a mom who beautifully groaned throughout her labor, and finally pronounced, “I have you push,” to which her midwife responded, “You’ve been pushing.” The media, even when we think we’re beyond it, shapes our understanding of birth. Mom was expecting someone to tell her to hold her breath and count to 10. Realizing that PP isn’t the only way to push is half the battle.

We can take back our power! If you’re birthing in a hospital, there’s nothing that says you can’t take the initiative and get on all fours if you want, or that you can’t ignore the care providers when they tell you how to push. The key is having a great support system during labor – your cheerleaders who know exactly what you want the experience to be like for you under normal and safe circumstances. Hire a doula, take independent childbirth education/preparation classes, and have a plan for yourself.

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7 responses to “Purple Pushing: Just Say No.

  1. Gravity only works on baby when mom is on her back… putting the baby in danger due to compressed umbilical cord??? What a load of crap – another example of someone with just a little bit of knowledge spewing out half-truths and thinking themselves brilliant.

    Episiotomy is NOT the norm. Get your facts straight.

    • Jennifer, I’m afraid you misread the tone of the article. I’m not sure where you’re attending births, but in NYC a good number of mothers get an episiotomy. It’s great that this isn’t your experience!

  2. My first child was born while I was walking down the stairs to the car. I never once pushed. Bc of that extremely quick birth,I decided to birth at home the second time. I never purposely pushed (in fact, I think I may have been trying to hold him in lol) until after the head was out. The student midwife who was there said i was the most controlled mom she’d ever seen – although i certainly didn’t feel that way! I am so grateful that I’ve never experienced “managed” childbirth! I honestly don’t know how I would react to having to birth in a hospital that did not let me move around or labor at my own pace. Hopefully your article will help other mom’s realize that it is possible to manage their own virus!

  3. during my labor I was pushing on my knees and feeling pretty empowered till they insisted that I lay on my back and then I had no strength at all to push and they had to suction my baby out! How’s that for how dumb it is to put a woman on her back and forcing the baby to come when their not ready! “purple pushing” is definitely what you would call “forcing the play” and episiotomy’s are more common then they should be!

    • I know exactly how you feel. It is such a terrifying and powerless feeling when we are robbed of her birthright to our womanhood. We are treated as though we have no idea what we are doing and like we have NO RIGHT to dare even to so much as WANT to direct our labor. To doctors is such an indignant and offensive concept and it is truly heartbreaking that we are treated so savagely.

  4. When I was in labor with my daughter, my first and only child, I had such a bad experience. I felt that the birth of my child was more about the battle against my doctor than it was about what should have been a beautiful experience of bringing my daughter into this world. I had made it a point to independently educate myself with natural and alternative birthing methods to avoid a forceful and unnatural childbirth. My doctor had set me up for a delivery that would be dominated by “medical” interference from the start. Because I live in a smaller town, birthing classes were only available once every six months and she had assured me that she would notify me of the next available birthing class and register me for the classes and I trusted in her to do so because the classes were so small and infrequent that they had to be scheduled based off of the number of people that would attend the class. Not only did she not notify me of the class schedule but even neglected to give me information on how to get into contact with the people in order to get into any classes near my area despite my constant requests. In retrospect, I think this was done purposely as a means for her to keep me as ignorant of the birthing process as possible so that I would have no choice but to blindly follow her directions to suit her selfish desire to keep the birth as brief as possible. When I developed my birthing plan with her I had told her that I wanted a birthing bar and a birthing ball, neither of which were provided. The room I had had a Jacuzzi and it was the only thing that I wanted because of how relaxing and soothing it was for me, which would help the process naturally so that I wouldn’t become tense and halt the dilation process. She kept trying to make me walk around the hospital to speed up the process and bothered me constantly to do so which only caused more stress. During my contractions I figured out a way to breathe with the contractions that made them less painful and when I told her that it made me feel better to breathe with the contractions rather than hold my breath from the pain she snapped at me not to push because I was only 4cm and said it would cause swelling in my cervix and she would not listen when I told her that I wasn’t pushing or bearing down but just breathing. She made me get out of the tub and lay on the bed to check my dilation and when I was still at 4cm, and mind you that I was only in labor for about three hours at this point and it was a first delivery, she insisted that I allow her to break my water because she was “concerned for the safety of the baby” because I had “compromised” my delivery by prematurely pushing and that it would cause not only stress on my baby but put my own safety at risk because the “swelling” that I was causing would cause my baby to become stuck in my cervix. I was immediately terrified! Not just for my child but because the concept of anything that wasn’t a natural process frightened me. She forced me to let her break my water which resulted in immediate severe contractions. Within a half hour she had me on my back, which we had decided before was not a good way for me to give birth since my pelvis had not peaked properly and this position further narrowed the space in my pelvis, and telling me to purple push. This resulted in my daughter becoming stuck in my cervix and she had to reach her fingers in and lift my cervix while her head was lodged in there which was actually more painful than giving birth was. After her third excruciating attempt to lift my cervix failed I kicked her and told her to get her f-ing fingers out of me. She forced my active pushing to be done in 45 minutes, so that she could be in and out of there are soon as possible, which resulted in the blood vessels in my face and eye to burst. Luckily I had read the importance of perennial massage and was able to keep from having any severe perennial tearing. After my daughter was safely delivered she told me that I could rest before having to deliver the afterbirth but two minutes later she was trying to force me to push but the forceful labor had left me so exhausted that I didn’t have the strength to push that immediate second so instead she pulled the afterbirth out by the cord which resulted in some minor tearing on both sides of my labia. Seconds after that she had a needle ready to stich the tears and I told her to stop and asked her if it was medically necessary to which she replied that it was not and I had to fight her on the stitches and told her that I wanted to heal naturally. I am glad that I didn’t get the stitches because my best friend who had her baby a month after me had gotten stitches and she said that they were so painful and that they kept getting pulled and tearing when she had to use the bathroom and any time that she moved which caused her incredible pain and even scarring. The whole reason why I chose my doctor was because she was also a trained and certified midwife and assured me that I would be able to have a natural childbirth that would allow me to trust in my body’s natural instinct to bring my child safely into this world. What I got instead was a traumatic and painful delivery. My entire birthing process was slammed into a painful and draining four and a half hour torturous crucible. I really wish that I had read this article during my pregnancy.

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