thedoulaguide.com

Reevaluation of Friedman's Labor Curve.  This study concluded that "women remained in...the second stage of labor up to 8 hours with no adverse effects."  http://www3.interscience.wiley.com/journal/118783693/abstract

"I had just begun an apprenticeship with a homebirth midwife in my area.  I had helped my two sisters-in-law with their hospital births.  The very first birth I was called to attend was for a woman having her 2nd baby, 2nd homebirth, in a farmhouse in a small town outside of a small city in the midwest.  There was a more experienced apprentice there as well.  She had pushed for 5 hours the first time, so we were anticipating a long 2nd stage again.  This time, she labored through the evening and into the night.  She began pushing at 10 centimeters, and did indeed push for over 5 hours.  She pushed slow and steady, and was only checked a few times.  The baby was monitored for distress, and she was kept hydrated and nourished a bit.  The baby had quite a conehead coming out, but was fine.  I believe this baby was a bit larger than her first one.  This was a great first experience for me as a student midwife.  It taught me that a woman can be allowed to push as long as she wants to, as long as the baby is doing okay and the mom is physically able.  There should not be a limit put on it if the above parameters are monitored." 

"My midwife arrived at my home when I was 7 centimeters dilated. After a while she checked and said I was 10 cm dilated. The next thing I remember I was on hands and knees and trying to push. I was frustrated and, of course, not in my head at this point but I remember feeling confused about what was going on. Finally my midwife encouraged me to stop pushing. She said, 'You are 10 cm but you don't have to push.'  I told her I felt pressure to push. I was not talking about a physical pressure to push, but social pressure. She connected this with my year of experience as a nurse on a Labor and Delivery unit.  My experience with women in labor was that when women got to 10 cm, they pushed. 

"She suggested I get in the bed and relax. My thoughts were racing with questions and fears like 'what is wrong,' 'maybe I'll have to have a cesarean.'  Then I answered myself with 'no, my mom didn't have a cesarean, my mamaw (grandmother) didn't have a cesarean, so I won't either.' I remember consciously having to remind myself to relax my butt muscles. Then after some time I felt my body push my baby under the pubic bone. I remember the distinct moment and feeling of my bones moving/separating for my baby. It was incredible to me. I went into the living room and after 3 pushes on the birthing stool I had my baby. The time from being fully dilated to birth was about 5 hours."

"I gave birth to my daughter in the hospital. The first stage of labor was very fast.  My water broke at midnight and I was dilated to ten centimeters by about 9 AM. The baby had not yet rotated down and I did not begin active descent until about 2 PM. I gave birth at 2:16 PM exactly (I remember it like it was yesterday!). During the second stage of labor the doctors and labor nurses behaved like this transition was not entirely normal. They were afraid that the baby was coming down 'too slowly' and talked about the need to 'speed things up' or 'consider alternatives.' I'm assuming they were trying to prepare me for the possibility of a c-section. I was diligent about being left alone and active descent came on naturally after a few hours. It always struck me how the nurses behaved as if the second stage of labor wasn't a stage at all and that anything other than a swift progression into active descent was a problem. I'd love to see more education and discussion out there about the second stage of labor and its importance!"

"My midwife, husband, and mom all slept through the night while I labored in peaceful solitude in my living room. Shortly after my midwife awakened, she said I was ten centimeters and I could start pushing whenever I wanted to. I wish I had known or understood more about pushing because at that point, I was so excited I just started pushing, thinking the sooner I started, the quicker my baby would be in my arms. Looking back, I now realize I started pushing much too early and this made for a long, exhausting second stage. I didn't understand the concept of bearing down, but rather pushed with every inch of my body, as evidenced by my black and blue swollen eyes after nine hours of pushing. I pushed in the birthing tub, with a rebozo (a scarf around the abdomen), using a birthing stool, on all fours, laying on my back, laying on my side, and holding on to the back of a chair.

"After the eighth hour of pushing, my midwife determined that my baby was malpresented and that perhaps a very small amount of Pitocin would give my contractions more 'umph' so I could get the baby down further. It worked like a charm, and 45 minutes later, I pushed out my baby. What a relief!  I'm not advocating Pitocin by any means. What I would like to recommend to other first time moms, however, is resisting the act of pushing until the urge is so strong that one can't NOT push! My current chiropractor (a mother of 6) tells pregnant mothers to delay the act of pushing until it's impossible to not push. In the end, I was able to give birth at home. The experience wasn't what I expected, but the outcome was what I wanted." 

"I arrived at the client’s home during the early morning as her doula.  We arrived at the Birth Center a few hours later and she was found to be 6 centimeters.  She was fully dilated about 5 hours later and felt an urge to push.  She pushed off and on for about 3 hours in an undirected manner, resting for some contractions and pushing when she felt like it.  The Birth Center has a 3 hour limit for pushing so the mom was moved to the hospital Labor and Delivery floor around dinner time.  As the mom was tiring, she decided to opt for an epidural in order to rest.  The epidural lasted about an hour and the mom again began to feel an urge to push.  The baby was birthed in the late evening and began to breastfeed within a few minutes.  Total time from feeling the urge to push to birthing was about 7 hours.  Mom and baby were fine."           

"I pushed for seven and a half hours -- the longest pushing phase for a mom who stayed at home in my midwife's 15 years of practice. The baby's heartbeat was amazingly strong through it all. I was plagued with nausea and vomiting, so I got IV fluids.  At 5 PM I was fully dilated and started pushing spontaneously -- but the baby was high up.  It was fatigue and dehydration that made it so my pushes weren't as strong as they needed to be.  With amazing encouragement and physical effort from all -- husband, midwife, midwife's assistant, and doula -- I just kept pushing and pushing and pushing and pushing...every contraction. I was in a thousand different positions, with birth stool, birth ball, legs up, squatting, partnering with my husband.  They were saying 'You're almost there!  We can see the head!' for 3 hours or more.  I was ready to give up a handful of times.  I did feel the head but it was a couple inches inside, not crowning.  I pushed as hard as I could.  I thought I would burst blood vessels or pass out (but I didn't).  FINALLY the baby crowned and then slipped out in two or three contractions. Our midwife shouted to my husband, 'Come catch your baby!'  He was the first person to tell me we had a girl.  Adela was born at 12:28AM, 8 pounds, 3 ounces, 21 inches.  I did not receive a single drug. Just a saline drip via IV to combat dehydration.  My husband and the team showed incredible endurance, patience, and compassion.  We all brought the baby to life."

"I was the doula at the home birth of a first child. One day her water broke after a pregnancy of 39 weeks. Labor started gently in the afternoon with 15 minute intervals. Her contractions were mild and did not get much stronger during the night. In the morning the midwife felt a dilation of 2 centimeters.  We all went for a walk in the woods and it made her 'let go' and then she started to really get into labor.  24 hours after water breaking she was fully dilated. The midwife let her walk around, so we could await the really strong contractions. She did not hurry anything but let nature do its job. She kept on listening to the baby’s heartbeat and it was still doing great. The midwife was very confident. She didn’t rush or hurry. About 5 hours after full dilation the contractions became stronger again and she started pushing on the baarkruk (a pushing seat). When the baby's head was showing on the perineum the woman went into her birthing pool. It was over 6 hours after full dilation when the baby was born. Very gently, in the warm water. The midwife didn’t touch the baby at all. Mother's hands were the first hands the baby felt on his body right after birth. Mother needed a full week to recover from her birth (total 30 hours), but was totally content with the support she got from both her midwife and her doula."