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Poooooshing out babies

April 29, 2009

I was picking M up from preschool one day and noticed a drawing posted in one of his friend’s cubbies.  As I looked more closely, I noted that the drawing included rows upon rows of carefully drawn letters.  “How nice,” I thought.  “The kids are learning to write!”

And then I looked even more closely and saw what those letters were:

POOPPOOPPOOPPOOPPOOPPOOPPOOPPOOPPOOPPOOP

And I just had to chuckle.

When one lives with and cares for small children–a process that involves changing a few (thousand) diapers–it is inevitable that one will become at least somewhat densensitized to poop: to poopie diapers, to declarations of “I’M POOPING” in the middle of the grocery store, and even to the poop jokes that seem to be popular among the immature youth “these days.”

Okay, who am I kidding?  Poop jokes appeal to the immaturity in all of us.  In fact, as I was pondering what to entitle this blog entry, my mind went directly to poop puns: “Poop Goes the Weasel?”  “Poop Quiz?”  “Firstly, Secondly, and Turdly?”  (No, I am not a ten-year-old boy.  Really.)

But the kids at the preschool and…well, me, aren’t the only people currently pondering poop.  My friend over at Nursing Birth tells me that a lot of people–as in hundreds of people–who stumble upon her blog find it after searching for information about whether or not they will poop during labor. 

Do they want to know the odds?  (Don’t quote me, but I think that around 70% do…do.  Okay, sorry.)  Do they want to know what their care providers will think?  (Probably nothing, seeing that it’s nothing new to them and is actually quite normal and natural.)  Or are they simply fascinated by the fact that our bodies continue to perform their normal, natural functions during childbirth?  (It is, in fact, fascinating.)

No matter what the case, between all of the diaper changes, poop jokes, and births I’ve experienced over the past few months, I’ve had a few mini-epiphanies about birth and poop.  They are by no means dramatic insights, and they are probably not at all unique.  But I think that they are worth sharing, even if only to appeal to the immature ten-year-old in all of us.

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1. Just as we can all “have to poop” without being ready to actually poop yet, a mom can be “dilated to 10” without being ready to actually push out her baby yet. 

I’m hoping to avoid sounding completely juvenile and silly while explaining this point, and I have a feeling that I am going to fail miserably.  Nonetheless…

Okay, there are moments when you “just know” that you have to poop, but you’re not quite ready yet.  Perhaps you want to avoid unnecessary straining, perhaps you want to wait to make sure that you don’t just have gas, but perhaps you do know that you don’t quite have that “urge” yet.  And so you wait to go to the bathroom until you have the urge.  (Yes, I feel juvenile and silly…)

In any case, although some women will feel the urge to push (or the “fetal ejection reflex,” as French obstetrician Michel Odent calls it) well before their cervix has dilated to 10 cm, some will not feel an urge to push at all even after their cervix is completely dilated.  And unless the baby is in distress or there is some other pressing reason to begin pushing immediately, there is no need for the mom to start pushing “just because” her cervix has dilated to 10 cm!  Otherwise, she’s probably going to end up purple pushing, which can increase the incidence of tearing, make a mother feel more fatigued, and potentially deprive both the mother and the baby of oxygen.

As such, it is my humble (informed and evidence-based) opinion that just as we should poop while following our urge-to-poop, mothers should try to push while following their natural urge to push.  Not on their backs.  Not while holding their breath and counting to ten.  Not while straining so much that they end up feeling overly fatigued and potentially tearing their perineal tissue.  Second-stage contractions will naturally bring the baby down anyway (this is called “laboring down“), so it is best to conserve the mom’s energy for when she feels the urge to actively push her baby out.

(For what it’s worth, not all women feel an overwhelming urge to push.  Sometimes changing positions–especially leaning forward, or getting on hands-and-knees–can help to bring on this urge.  In addition, epidurals do not necessarily interfere with the urge to push, so no one should tell a mom that she cannot wait to push until she feels the urge just because she has an epidural in place.)

2. We should all treat a laboring mother with just as much (if not more) respect during labor as we would like to have for ourselves while we are pooping. 

This goes for partners, midwives, nurses, doulas, doctors, and other support people alike.  It’s sort of like the golden rule of labor (and no, I won’t call it the brown rule…).  But just consider the following questions: Can you poop peacefully with ultra-bright lights shining on you?  With people scurrying around the room?  With people hovering over you?  With others threatening you that if you don’t poop in the “right way” then they are going to manually extract the poop from you?  And for poop’s sake, can you poop while flat on your back?!

If you answered “no” to any of the above questions, then you can probably understand while most women prefer 1) dimmed lights, 2) low or no noise, 3) a supportive environment, and 4) being upright during birth. 

Now, I’m by no means implying that every woman should birth her baby all by herself in a bathroom whilst sitting on the toilet.  (That being said, this may be a perfectly acceptable and appropriate choice for some women.  And toilet-sitting is a great way to bring the baby down during labor!)  I’m also not implying that labor-support person(s) should leave a woman completely alone during birth–many women (though not all) appreciate gentle touch, encouraging words, and other comfort measures from others during childbirth.  In this respect, it should go without saying that pooping is, in many, many ways, different from birthing a child–especially when it comes to the “end result.” 

Nonetheless, it is still important–and dare I say, necessary–to keep in mind the idea of “poop respect” whenever one is with a laboring mom.  If you wouldn’t want x, y, or z to happen while you are pooping, then the mom probably doesn’t want it happening either.

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