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.