I think it is uterosacral ligament tension that causes the early urge to push, and you often see deflexion or OP, but not always with that tight or twisted ligament.

Principle 1, Balance

We want to "make room" and "add balance" first.

A Forward-leaning Inversion, sidelying release, and some sacral massage plus a sacrotuberous ligament release would be quite specific.

 

Principle 2, Gravity

Knee chest with the mother's chin up, tongue out and panting reduces her body's spontaneous urge to push, or at least helps her not to push much.

 

Interventions

A knee chest position reduces pressure on the cervix and the posterior portions of the pelvic area including the uterosacral ligament. This can reduce the urge to push.

 

Extreme panting-I learned this technique in The Yoga Journal. The woman puts her chin up and sticks her tongue out as far as she can and pants through the contraction. This posture with the tongue out prevents downward pressure on the cervix. Its socially awkward but really works. As a doula or midwife, I've joined the birthing woman with this technique to help her feel socially supported while doing it.

 

 

We may use Homeopathic tablets of Arnica and or Cimicifuga orally, or on the cervix and give orally according to directions. These must be the homeopathic versions of these herbs to be safe and appropriate.

 

Quieting the environment and letting the birthing mother rest on her side in a deep tub of water between 94 and 98 degrees Fahrenheit. A mature and soothing woman to reassure her and help her doze helps her mind calm down and the cervix to open. 

 

An experienced doctor, midwife or, possibly, nurse (if local protocols allow)

might be available with skills to flex and rotate the baby's head if these things don't work. I haven't found this to be a common need in these situations, but shouldn't be forgotten in cases where its appropriate.

 

The premature urge to push can be a real annoyance. Pushing on a cervix that isn't ready may rarely tear it, and sometimes causes swelling. Time may resolve on it own or a resolution of the cause can be facilitiated. A stall in advanced labor with a swollen cervix is not IN AND OF ITSELF reason for a cesarean. Swollen cervixes will become unswollen when the head shifts and allows circulation. We can move the mother to reduce her urge to push until her cervix is fully opened or so soft it slips over the baby's head if it is almost fully open. A knee chest position is often helpful, though panting with the tongue out may still be needed!