A few friends have shared their birth stories with me, recounting the intense pain of pushing, and I can’t help but wince. It makes me want to tell every man who groans about getting kicked in the balls that they have no idea what real pain is!
But a hospital in the UK has discovered a new approach that might lead to better outcomes for mothers and their perineums. They’ve stopped instructing women when to push.
At Medway Maritime Hospital, rather than feeling like they’re in a rowing competition with repetitive commands during labor, women are encouraged to listen to their bodies and take their time. This trust in instinct has led to a dramatic reduction in tearing during childbirth—from 7% to just 1% in just one year.
Laboring mothers are also encouraged to experiment with different positions beyond lying on their backs. Many women report that being on their backs feels unnatural, often expressing a strong desire to get into a more comfortable position. Lying flat can restrict blood flow and close the pelvis by up to 20%, increasing the risk of tearing or needing an episiotomy. The World Health Organization even warns against this position, labeling it “clearly harmful.”
Midwives at Medway have also introduced techniques to better support the perineum during labor, such as allowing the baby to emerge gradually rather than pulling them out forcefully once the shoulders are free. Applying counter-pressure on the perineal area during crowning has also been shown to lessen the likelihood of tearing.
And don’t worry! If there’s any distress for the mother or baby, or if complications arise, the midwives will not simply stand by and say, “Well, we aren’t supposed to tell her to push.” They are trained to manage emergencies, ensuring safety while still respecting the natural birthing process.
The impressive drop from 7% to 1% has garnered attention in the European Journal of Obstetrics & Gynecology and Reproductive Biology, prompting discussions about implementing this approach in other hospitals across the UK. There’s even a national initiative aimed at adopting these practices more widely, offering a positive shift for women as safer labor methods gain acceptance. It’s a situation where women might feel inclined to either thank their doctors or shout, “Well, obviously!”
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In summary, a new approach to labor at Medway Maritime Hospital is empowering women to trust their bodies, leading to fewer instances of tearing during childbirth. This progressive practice is gaining recognition and support, potentially reshaping the birthing experience for future mothers across the UK.