Sunday, January 16, 2011

how long is too long?

We had all been working very hard for a very long time....

Susan was having her first baby. She had a long first stage, but not really much longer than a lot of Mama's who are having their first. She had a good support system, had been able to keep up with food and fluids, and was hanging in there. The she was ready to push. And she pushed and she pushed and she pushed. Susan fought for every little centimeter of descent. But, there was descent...just at a slow, slow pace. Two times during her second stage, we stopped pushing to discuss if we should transfer to the hospital. Susan really wanted to stay, her vital signs were good, her baby sounded great and her husband was comfortable with Susan's desire. I have never seen a Mama push so hard for so long....

I have often had the feeling of treading a fine line. The line between hard work and pushing a woman to give and do just a little bit more when she can. Many women in labor, at a certain point, feel that they cannot continue the work. However, most of the time, this feeling means that they are just about done and will soon have their babes to cuddle. I am continually in awe of the power reserve that women are able to plug into at these moments. The fine line comes into play when a woman may be truly reaching her physical and emotional limit and can venture into the land of suffering. Hard work vs suffering....the distinction can many times be difficult to distinguish.

Susan's birth was one of these difficult times. She was actively involved in her care and the decision to continue with the work, but it was so very hard. Eventually, Susan gave birth to her baby and both were healthy. Susan felt empowered and was happy to have been able to birth her baby the way she did. However, when I saw Susan during her postpartum care, and I saw the multiple petechial bruises on her face and shoulders....a result of her extreme pushing effort over a sustained time, I definitely questioned my decisions. Had I pushed her too far? Had she truly suffered? It was Susan who then reassured me that she was still secure in her birth and confident in her own power as a mother who fought for her baby.

This balancing act is one that midwives must continually maintain. It is one that I am continually monitoring and debating when I am with a woman. Most of the time the line is pretty is those times when the line is blurry that we must be ever vigilant.


  1. I had those little red spots on my face, but I only pushed for 10 minutes, baby was OP and had a long decel. So even if you are in the hospital and pushing was only for a short time, those little breaks in vessels can show up.

  2. Anonymous, thanks for the input, yes these can happen after only a short time as well. In this case they were noticeable in that there were so many of them.