Before I gave birth the first time, I know I was wondering how in the world I would know when and how to push. I had seen all these faked birth sessions in movies with the moms screaming and pushing like crazy – and the midwives screaming at the same time! Not very tempting. Actually quite scary!
Since I am a researching kind of girl, and I was ordered bed rest for the last three months of my first pregnancy (Read my birth stories here.), I had plenty of time to read up on and practice relaxation as well as how to push during labor. So when the time came, I was quite prepared and it worked well! (It worked even better with my second child.)
So what is it like to push – really?
Here I try to describe what it feels like, how you’ll know when it is time to push and how to push effectively to avoid tearing and get your baby out quickly and safely.
How To Push During Labor
The Second Stage Of Labor – Time To Push
Before going into details on how it feels, let’s get into some basic facts.
The pushing is the very last thing that happens during childbirth but is still called the second stage of labor. It is the stage when the baby is pushed through the birth channel and comes out into the world. The placenta comes after (this is the third stage of labor), but honestly, I don’t even remember it coming out; I had a baby in my arms by then. So the pushing comes last. 🙂
It is also the stage of labor that is by far the shortest before the baby is born. For a woman giving birth the first time, this stage can last up to a few hours. For those giving birth the second or more time, the pushing stage can actually be as short as 10 minutes.
What Triggers The Pushing?
In movies, the midwife yells PUSH, PUSH and the mom starts pushing. In real life, it is (or at least should be) the baby’s position that will trigger the pushing in most cases. So the urge to push actually comes naturally from within of you.
Then sure, a good midwife or doula will help you and let you know if it is time to push or not, because quite often they will want you to wait a little to help the skin around your vagina adapt and thereby avoid being torn.
But it is your body that will signal when your baby has reached low enough in the birth channel, which triggers the pushing urge.
It is a bit spooky, especially the first time, when all of a sudden, your body starts doing something completely different from what it has been doing for the past hours during the contractions. Instead of the waves of labor pain, comes shorter downward pushing muscle signals. I didn’t understand what it was the first time it happened, but when it happened again, I realized it was the urge to push. Quite cool actually! 🙂
If and when you feel an urge to push, tell your midwife immediately! He or she can help guide you whether to hold back or go with the urge depending on if you are completely dilated and whether your skin needs a little bit more time adapt to avoid tearing.
So What Does It Feel Like To Push?
You probably heard people say that the urge to push during labor is like needing to go to the bathroom. I don’t agree. Going to the bathroom is usually not very painful, and unless you really, really need to go now, the need to push isn’t nearly as strong as when giving birth.
The big difference compared to the contractions before the pushing stage is that you can’t fully relax while pushing (obviously) while you can and absolutely should relax during all other types of contractions. The pain is still there, but instead of signaling to you to breathe and relax your body completely, these contractions will urge you to tighten your stomach muscles and push downwards. It is a completely different feeling!
It does hurt and it can be quite overwhelming to feel the head being on its way. But if you trust your body and the midwife and try to relax all other parts of your body than your belly muscles, your baby really is about to arrive. Something to hold onto!
For some women, the pushing stage is actually a bit calmer than the last part of the dilation, which can be extremely intense. It is also common to experience a short (and sweet) calm period with almost no contractions at all between the last part of the dilation and the pushing. It seems like the body is gathering strength for this very last and very important part of giving birth.
How To Do It?
Just like during the rest of the labor, the pushing stage can be lived through in a more or less effective way. The less effective is to become stiff, scared and tighten all your muscles, thereby literally working against the contractions. This will lead to a longer pushing phase, more pain and a higher risk of tearing. It also puts your baby at a higher risk.
Or you could really try to relax the muscles in your pelvic floor and envision yourself blowing out a candle with some force. Those are the muscles you should use while pushing. (Not the same at all as the ones used when going to the bathroom!)
Read the above sentence again. This combination of pushing with upper abdominal muscles and relaxing further down is the key to effective pushing. It can take some practice to be able to do this, especially while in pain. So practice how to push during labor before hand! Many times. And ask your hubby to remind you.
It is also your choice whether to hold your breath or breathe out (like slowly blowing out the candle) while pushing. Both methods work, but if you do hold your breath, only do it for a few seconds to avoid reducing the amount of oxygen available for your baby.
The pushing stage will go faster and be easier if you stay in an upright position (or at least NOT lie down on your back.) Lying on your side is OK too. (For more details on effective birth positions, read this article.)
What If I Don’t Feel The Urge To Push?
True, some women don’t ever feel an urge to push. Epidural is often a reason for this. These times, the doctor may want to wait you out if your baby is doing fine and see if the urge comes, or speed up the process by providing medication as well as directing you to push even without the urge. (This is called directed pushing.) Before accepting to push without the urge, make sure you ask why.
Spontaneous pushing (as opposed to directed pushing) has been shown to provide more oxygen for the baby, better APGAR’s and less trauma of the pelvis floor for mom. So unless your baby is at risk, waiting for your body’s signals to push can have real benefits.
Both WHO and the American College of Nurse Midwives (ACNM) are recommending spontaneous pushing these days, due to the benefits for the baby and mom.
If you have time and want to learn more about giving birth, a useful book to read is Mindful Birthing: Training the Mind, Body, and Heart for Childbirth and Beyond It even has a specific section about pushing and how to prepare for pushing naturally. One of the exercises is called “mindful pooping”, LOL! But it is a great exercise!
You can also check out midwife Hilary’s only birth class, which is down-to-earth and very helpful.
Spontaneous Pushing Video
Here is an excellent video clip explaining the benefits of spontaneous pushing using an upright position.
If you have any thoughts, experiences or questions on this, please leave a comment below!