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why 'Purple pushing' is often to blame

According to Tracy Donegan (below), a doula and author of 'The Better Irish Birth Book', women should ask midwives to not 'coach' them during the pushing stage of labour.

"This is where so many pelvic floor problems originate," she says.

Sometimes known as 'purple pushing', this procedure involves the midwife instructing a woman to hold her breath for 10 seconds while forcefully pushing down during a contraction in the second stage of labour, instead of waiting for the mother to feel that insistent urge to push.

"The second stage of birth is a reflex, when your baby's head triggers Ferguson's reflex and your body automatically starts to nudge your baby down," Tracy adds.

"The top of the uterus gets thicker and thicker and moves down around your baby, like a tube of toothpaste. Essentially, your body does all the work for you."

If there is no urge to push, it is too early to try to do so, unless there is a medical emergency to get the baby delivered.

Tracy maintains that the use of coached pushing is largely due to time constraints.

"There are 30,000 births between the three Dublin hospitals each year and only 30 delivery beds, so do the math."

In 2003 the WHO recommended removing coached pushing, however this has not been brought into practice throughout the main Irish maternity hospitals, primarily due to the mounting pressures on services.

For now, it seems, it is up to the individual mother to request that her delivery be spontaneous rather than coached.

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