The potentially dangerous birthing practice midwives want to put an end to.

“Push! Push!”

We’ve seen it in the movies and on TV: the woman in labour, being directed to push as hard as she can to get that baby out. Many of us can probably even remember being told to push when we were giving birth. I certainly can.

But medical professionals around the world are now accepting that coaching women to push during labour is not actually a good idea.

Puuuuush!... or maybe don't. (Universal Pictures)

In fact, it’s been linked to an increase in severe perineal tearing, which can cause incontinence and nerve problems.

In 2013/2014, almost 14,000 UK women suffered severe perineal tearing. It was a dramatic rise in numbers that got obstetricians and midwives looking for a different approach.

A new midwife-led program is now set to be rolled out across the UK. The program, developed by the Medway Foundation Trust, gets women to slow down during delivery. They’re told to breathe through their contractions, rather than push.

Listen: Mum of four Bec Judd talks pelvic floors on the Hello, Bump podcast. (Post continues after audio.)

Women are encouraged to try different positions, including standing, leaning or getting on their knees. Midwives are advised not to pull the baby out by the shoulders but to support the baby’s weight, reducing pressure on the perineum.

The program has been hugely successful. It’s managed to cut the rate of traumatic tearing from seven per cent of new mums to just one per cent.


This isn’t exactly news to midwives in Australia. Rachel Smith, a spokesperson for the Australian College of Midwives, says they’ve been trying to avoid “coached” pushing for a long time.

The 'push' scene is a common one in movies. (Image: Fox)

“What midwives have been doing for the last 10 years or more is recognising that the real directed pushing is not beneficial to women and babies,” she explains to Mamamia.


“They’ve been supporting the woman to push more physiologically, just following the cues from her body and her labour.”

Smith says midwives try to make sure that women are able to remain upright and active and find positions that are comfortable for them, and also have access to a bath or a shower. (Post continues after gallery.)

“But we also know that, with the higher rates of intervention, that sometimes stops women being able to be upright and active because they need to be monitored,” she explains.

“All of these things impact on the ability of the perineum to stretch up and maintain its integrity during childbirth, as does nutrition, women’s general health and wellbeing, and their expectations of childbirth.

"Some women are very proactive and they’ll do some perineal massage or perineal stretching to try and prepare for that.”

Listen to the latest episode of Hello, Bump here. (Post continues after audio.)

Smith says the idea that women need to be told to push isn’t the only wrong idea people have about the birth process.

“You’ve probably never seen a quiet, calm birth in a movie or on the television,” she points out.

“There’s a whole lot of issues around society’s expectations of birth.”