What is Purple Pushing?

You've likely encountered the term "purple pushing" in discussions about childbirth, and if you're a parent-to-be or simply curious about the birthing process, you're probably wondering what exactly it means. Let's break down this often-misunderstood labor phenomenon.

Understanding Purple Pushing

In essence, purple pushing refers to a specific technique or, more accurately, a combination of physiological responses that can occur during the second stage of labor, also known as the pushing stage. This stage begins when your cervix is fully dilated (10 centimeters) and you feel the urge to push. The "purple" aspect comes from the distinct changes in your body that are observable and can sometimes include a purplish hue to your skin.

Here's a more detailed look at what constitutes purple pushing:

The Urge to Push: This is the primary driver. When your baby descends further into the birth canal, it puts pressure on your rectum. This pressure triggers an overwhelming, involuntary urge to bear down, similar to the sensation you might feel when having a bowel movement.
Breath Holding and Straining: In the traditional or "coached" pushing method, laboring individuals are often instructed to take a deep breath, hold it, and bear down with all their might for a count of ten, then exhale and repeat. This forceful, sustained straining, combined with the physiological urge, is a key component of purple pushing.
Physiological Changes: The intense physical exertion involved in purple pushing can lead to a temporary increase in blood pressure and a rush of blood to the head and face. This can cause a noticeable reddening or even a purplish tinge to the skin, particularly around the face and neck. This is where the "purple" in purple pushing originates.
Increased Intra-abdominal Pressure: When you hold your breath and push, you're significantly increasing the pressure within your abdomen. This pressure helps to contract your uterine muscles and, in conjunction with the force of your contractions, helps to move the baby down and out of the birth canal.
Maternal Effort: Purple pushing is characterized by the significant physical effort exerted by the birthing person. It's a powerful act of using your body's strength to facilitate the birth of your baby.

Is Purple Pushing Always Recommended?

This is a crucial question. While purple pushing, particularly the coached breath-holding and straining technique, has been a common practice in many maternity settings for years, there's a growing body of evidence and a shift in recommended practices.

Many healthcare providers now advocate for a more intuitive or "spontaneous" pushing approach. This involves:

Listening to Your Body: Allowing the urge to push to guide you.
Shorter, More Frequent Pushes: Instead of long, breath-held pushes, this involves shorter, more frequent bearing-down efforts, often between contractions.
Open Glottis Pushing: This means exhaling or making a vocal sound as you push, which can help to prevent breath-holding and reduce intra-abdominal pressure in a way that may be less taxing on the birthing person and potentially more effective for the baby.

The rationale behind this shift is multifaceted:

Reduced Maternal Fatigue: Holding your breath and straining for extended periods can be incredibly tiring. Spontaneous pushing can conserve energy for the mother.
Improved Oxygenation: Continuous breath-holding can reduce the oxygen supply to both the mother and the baby.
Less Pressure on the Baby: Some studies suggest that prolonged, intense pushing can put excessive pressure on the baby's head.
Potential for Less Perineal Trauma: While not definitively proven, some believe that more spontaneous pushing might lead to less tearing of the perineum.

It's important to understand that the term "purple pushing" itself isn't a clinical diagnosis but rather a descriptive term for the observable physical manifestations of intense pushing, often associated with the coached breath-holding technique. The focus of modern midwifery and obstetrics is increasingly on supporting the birthing person's natural instincts and offering options that promote comfort and well-being for both mother and baby.

If you have concerns about pushing or want to discuss your birth plan, the best course of action is to have a detailed conversation with your obstetrician or midwife. They can explain the different pushing techniques and help you make informed decisions based on your individual circumstances and preferences.

Frequently Asked Questions about Purple Pushing

How do I know if I'm "purple pushing"?

You might notice a reddening or purplish tinge to your face and neck, and you'll likely be holding your breath and bearing down with significant force. Your healthcare provider may also observe and comment on your pushing technique.

Why is it called "purple pushing"?

The name "purple pushing" comes from the visible physical changes that can occur, specifically the purplish discoloration of the skin due to the intense straining and increased blood flow to the head.

Is purple pushing dangerous?

Purple pushing, when referring to the intense coached breath-holding and straining, isn't inherently dangerous for most healthy individuals. However, it can be very tiring. Modern recommendations often favor less strenuous, more spontaneous pushing techniques for various reasons related to maternal and infant well-being.

Should I try to avoid purple pushing?

It's less about "avoiding" it and more about being informed about different pushing approaches. Many healthcare providers now guide individuals toward more spontaneous, open-glottis pushing, which may naturally feel less like the intense "purple pushing" and can be more energy-efficient.