Pulling While Pushing: A Traditional Practice in Today’s Labor Ward

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During childbirth, everyone knows that the mother must push at certain times. But pulling on something is an old and accepted–and rather low-tech–practice that can help a mother push the baby out.

Pushing needs to happen during the second stage of labor. You are already finished with early labor, your cervix is dilated, and the baby is starting to exit. Your obstetrician or midwife is telling you to push and to bear down during your contractions.

This is the time when pulling can be helpful. In many cultures, women are given one end of a knotted cloth to hold. The other end is either held by someone else such as their birth attendant or partner. Or it could be tied or looped around a very solid, stationary object like a bedpost. You would basically be playing tug-of-war during your contractions.

Pulling during the second stage of pregnancy is widely used, said Lily R. Bastian, MSN, RN, CNM, Midwifery Clinical Practice Advisor with the American College of Nurse-Midwives. Having the mother pull on something is “a common technique used by midwives, labor and delivery nurses, and doulas alike,” she says.

One end of the cloth is held by the person giving birth and the other is held by a support person, such as the doula or partner, according to Bastian.  The sheet, towel, or scarf can also be wrapped around a squat bar, she said.  “The birth person has their legs butterflied or planted wide on a surface; or has their feet up on stirrups or the squat bar.” When ready to push, the birth person walks their hands up the sheet, and uses the cloth or towel to pull the upper body into a c-curve around the baby. “It helps them engage their abdominal muscles and stabilize their push,” she said.

The idea is to focus your strength on pushing your baby through your birth canal during your contractions. Pulling backward with your arms and upper body while you are pushing can give you leverage during each contraction. During this process, pulling helps you to bring your upper body up and forward.

Another version of pulling used at some birth centers is a birth support rope, a knotted piece of cloth hanging from the ceiling (and very securely fastened to that ceiling). This knotted cloth would be located over a mat, a birthing ball, or a birthing pool. It can help the woman in labor keep herself in an upright or squatting position as she bears down and pushes.

In Mexico and other Latin American countries, large colorful shawls called rebozos have long been used during birth. Their main use is to wrap around the mother’s hips to help shift and move the pelvis and baby gently during labor and are later used as a wrap for the mother and baby. But another way to use a rebozo during birth is to tie knots in it and use it for pulling during contractions.

Two products that assist in tug-of-war during labor are on the market. The LaborLink is a colorful fabric-covered device with handles on both ends. It was created by Pam Weaver, a midwife, who was looking for something to help facilitate and shorten the second stage of labor. The price is $46.50 through Amazon or $39.60 at the LaborLink website. It comes in a variety of fabric prints, along with cleaning instructions and a mesh bag for storage.

The other is the Birth Support Rope from Birth International, which is a long, knotted strip of cotton cloth that is to be hung from a ceiling. It sells for $89, which does not include any hardware needed to attach it to a ceiling.

Any sheet or towel can be used for pulling, says Bastian. Sheets or towels are already at hand in a hospital, birth center, or at home, and all that needs to be done with either is to tie knots to allow for a better grip. She advises against using a rope as a pulling device during labor since it could cause rope burns.

Valerie DeBenedette
Valerie DeBenedette is an experienced health and medical writer who lives about an hour north of New York City with a dog that is smaller than her cat. Her work has appeared in magazines, newspapers, newsletters, and on websites. She is a member of the National Association of Science Writers.

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