This is a great thread!

most of the time I have witnessed women being told not to 'push' so the OB can be present for the delivery....i admit that this is mostly my experience in the private sector where most of the OBs wish to deliver the baby, but I am always of the opinion that nature works on its own, regardless of who is present

as Kelly has said that many women are told not too push with an anterior lip of the cervix...and that there is no further instruction, just dont push even though you really really want to. Often a woman simply pushes the cerivx out of the way, if it is soft enough it simply slips back as the baby's head emerges past the lip. Sometimes though pushing with a lip of cerivx can cause swelling of the cervix, which inhibits the ability if the tissue to retract.

the best position to adopt with an urge to push and a anterior lip is the hands and knees position, with bottom in the air and head down...not a very glamorous position ...as this takes the pressure of the head off the cervix, reducing the pressure sensation and hopefully allowing the cervix to fully dilate with the next couple of contractions

but of course in saying all this...there is no real reason for a vaginal examination at any stage of labor, unless of course there is a good reason...but a good midwife or doctor can simply know where a woman is in her labor, and will know when a VE is required if the women does not seem to be progressing from physical and psychologial observation of the laboring woman...

a vaginal examination is necessary in a number of situations, but many practitioners believe that regular VE's is the norm rather than the exception

xx yogababy