I've been hearing contradictory stories lately about the idea of the "premature" urge to push during childbirth, and I'm hoping that you can point me to some actual evidence on the topic. I've heard lots of anecdotal stories, but I'd love to see research.
We've all heard that pushing on a cervix that's not dilated to 10 cm is a Really Bad Thing and can cause the cervix to tear or to swell so badly that the baby can't emerge, necessitating a C-section. But is that evidence-based? I've been talking to a lot of women who started feeling pushy before 10 cm, often at about 7 or 8. Those who pushed as their body directed seemed to have good outcomes, with no swelling or tearing. Those who were directed by their midwife or OB to not push, and who resisted the pushing urge or had the cervical lip pushed back, went through a lot of pain and often had swelling. For many of them, being told not to push was the first intervention in the classic snowball, and some wound up with epidurals or even C-sections.
I've also read a couple of articles written by a midwife that suggest, based on their own experiences, that if a woman pushes as her body directs, even if she's not fully dilated she should be okay.
http://www.midwiferytoday.com/articles/pushing.asp: "It has become the paranoia of North American midwifery that someone will push on an undilated cervix. Relax, this is not a big deal."
http://www.midwiferytoday.com/articles/RuleOf10.asp: "Could professionals be mistaken about when women can begin bearing down during labor, because they forgot one simple part of the equation—that of observing non-medicated women in labor in their natural habitats?"
It almost seems like telling women to resist the pushing urge before 10 cm dilation, or manually pushing back the cervical lip, is one of the few interventions that most midwives accept, even though it might not actually be evidence based, and may be a relic of 1960s-era births.