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Early urge to push

Tips and discussion

I think it is uterosacral ligament tension that causes the early urge to push. There may be deflexion (chin up) or Occiput Posterior presentation with that tight or twisted ligament.
Principle 1, Balance
We want to "make room" and "add balance" first.
A Forward-leaning Inversion through 3 contractions.
Followed by a sidelying release.
A pressure point massage around the edges of the sacrum and again around a margin about an inch away from the sacrum's edge helps mobility.
Finally, some women will benefit from a sacrotuberous ligament release, which is quite specific and intimate, even though external.
 
Principle 2, Gravity
Knee-chest with the mother's chin up, tongue out and panting reduces her body's spontaneous urge to push.
 
Principle 3, Movement
With the same knee-chest position of the mother, add a rebozo scarf over her bum and "shake the apple tree."
 
 
Interventions
A knee chest position reduces pressure on the cervix and the posterior portions of the pelvic area including the uterosacral ligament. This can reduce the urge to push.
 
Extreme panting-I learned this technique in The Yoga Journal. The woman puts her chin up and sticks her tongue out as far as she can and pants through the contraction. This posture with the tongue out prevents downward pressure on the cervix. Its socially awkward but really works. As a doula or midwife, I've joined the birthing woman with this technique to help her feel socially supported while doing it.
 
 
We may use Homeopathic tablets of Arnica and or Cimicifuga orally, or on the cervix and give orally according to directions. These must be the homeopathic versions of these herbs to be safe and appropriate.
 
Quieting the environment and letting the birthing mother rest on her side in a deep tub of water between 94 and 98 degrees Fahrenheit. A mature and soothing woman to reassure her and help her doze helps her mind calm down and the cervix to open. 
 
An experienced doctor, midwife or, possibly, nurse (if local protocols allow)
might be available with skills to flex and rotate the baby's head if these things don't work. I haven't found this to be a common need in these situations, but shouldn't be forgotten in cases where its appropriate.
 

The premature urge to push can be a real annoyance. Pushing on a cervix that isn't ready may rarely tear it, but rarely does.  Pushing early sometimes causes cervical swelling.
 
Time may resolve the swelling on it own or a resolution of the cause can be facilitiated. A stall in advanced labor with a swollen cervix is not IN AND OF ITSELF reason for a cesarean. Swollen cervixes will become unswollen when the head shifts and allows circulation.
 
We can move the mother to reduce her urge to push until her cervix is fully opened or so soft it slips over the baby's head if it is almost fully open. A knee-chest position is often helpful, though panting with the tongue out may still be needed!