Don’t Push: New Programme Could Save Women From Birth Injury

Photography: Brandi Johnson

By Hannah Schenker

For those who have been reading about and involved with the Positive Birth Movement and who have read about things like unassisted, ecstatic or orgasmic births, this may prompt you to throw your arms in the air and exclaim “No kidding! We’ve been saying this for aaaaages!”. For those who are pregnant and anticipating their birth experience, this may be helpful to know. Thousands of women could be saved from debilitating injuries thanks to a new midwife-led programme in the UK that aims to smash the myth that women need to force themselves to push during labour.

Designed by staff at Medway Foundation Trust in Kent, the programme has already reduced unintentional damage to the birthing mother by as much as 85 per cent in some maternity wards, and reduced the incidence of traumatic tearing from 7 per cent to just 1 per cent of mamas. How did they do it? Simply stopped asking mothers to push. They supported mothers to choose different birthing positions and to slow down. They stopped pulling the baby from the mother, and instead supported the weight of the baby. Seems so simple and logical, doesn’t it?

The programme was prompted by a call for action by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives, after they noted alarming rates of perineal tearing in women during 2013/2014. They saw a shocking 22 cases of third-degree tearing in women in just one month, which Dot Smith, head of midwifery at Medway Foundation Trust, told the Daily Mail was “not good enough”. She blamed a misconception among the public and medical professionals alike, that women must “push, and then push harder”.

This is very important stuff. One in ten women experience some form of tearing during childbirth. In serious cases it can lead to things like incontinence and even lifelong nerve problems. For mothers who have experienced tearing in a previous birth, they are over five times more likely to experience is with a subsequent birth, according to a study in 2014 of perineal tearing in NHS hospitals.


  • Love the idea of supporting the baby’s weight, and of course allowing mother to do whatever is comfortable. I have had four babies, all with midwives attending, who did not force me to push, my body pushed all on its own when I didn’t even want to, and I had third degree tear with my first baby. My second baby I had a second degree tear, and then some minor grazes on the third, and then nothing on the fourth. My body seems to be recovering well, so I think it’s possible to have more births without damage. I also encourage women to physically support themselves (their vagina) during birth – I did this with my second baby (with my own hand), which really helped.

  • Not to nitpick, but if you’re going to write about science you should provide an actual citation to the study which you are referring so that people can read it for themselves (in many cases they may not be available for free, although in this case it actually is, but if someone is interested they could purchase it). Linking to a Daily Mail article in the hotlink for “study” is not helpful, either link to the study itself or provide the proper citation for finding the study (at least the DOI).

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