Managing labour pain gets a lot of attention in the antenatal classes and pregnancy textbooks but what about the pushing part? Often very little time is devoted to that last hurdle of childbirth – actively pushing your baby out.
Once your body has done all the hard work opening up your cervix, the time has come to finally push – so how do you know if you’re doing it right?
Unfortunately there’s no way you can practice pushing a baby out until you’re doing it. It’s not something that you can practice techniques for, as it’s a unique situation and experience. However, for many women I’ve worked with I’ve found it helps to have an idea of what to expect from the experience beforehand. Imagine that you need to do a really big poo and have to push really, really hard. Just remember to leave your embarrassment at the door. Pooping is the nearest thing we have to compare pushing a baby out to, as unglamorous as that sounds, it’s a comparison that works well because you’re engaging a lot of the same muscle groups.
During the heat of the moment, when you’re pushing your baby out, you simply can’t get away from the fact that it feels like you need to do a big poo – that’s because the baby’s head will be putting a lot of pressure onto the rectum at this point – so whether you actually need to do a poo or not, it will certainly feel like it! Inevitably, sometimes you will do just that – poop while giving birth but try to see it as confirmation that you’re doing exactly the right thing. Don’t worry – whoever is delivering your baby will deal with it before you’ll have even noticed.
During your labour contractions your cervix is opening up to ten centimetres, after this time, your body will start to have pushing contractions that help the baby to descend down the birth canal. In other words, during your pushing contractions your little baby is gradually making their way toward the exit. Often during a pushing contraction the baby’s head comes down then goes back up a little when the contraction ends. Inevitably it can sometimes feel like you’re taking one step forward two steps back with your pushing, but don’t be disheartened if this happens to you, it’s very, very common, especially for first babies.
It’s worth saying that the amount of time that you’ll have to push for varies largely. Sometimes it’s as little as five minutes. For most first labours though, the normal range is between 30 minutes and 2 hours, although sometimes it can go on for a little longer. For second, third or forth labours often the pushing time is a lot quicker – sometimes as little as 5 minutes – as your body remembers what to do.
You can give your body the best chance at pushing effectively by sitting semi-upright or using a birthing stool as gravity can work to your advantage. While most TV labours show women pushing while lying on their backs, luckily most hospitals don’t encourage this. If you haven’t had the epidural analgesia then you’ll be able to follow your body’s lead with regards to your birthing position. It’s actually very likely that you’ll find yourself wanting to give birth on all fours, semi seated or on your side. In most hospitals these are common positions to give birth in and are fully supported by midwives and doctors. If you have had the epidural analgesia, then the most usual position to give birth in is semi upright with gravity on your side.
During the pushing phase of childbirth, it’s really important to listen to the midwives and doctors around you. They have a good visual of what is happening down there and can advise you on how hard or how long to push for. They can also help you to minimise tearing for a smoother, more straightforward birth experience – this is especially relevant when your baby’s head starts to crown. It’s normal at this stage to feel an intense burning or stinging sensation in and around the vagina. Your brain will want to stop pushing and you’ll most likely shout out that you can’t do it anymore. Trust yourself and your support team around you and listen to their words. You’ve got this!
Just like labour contractions, pushing contractions come in waves. These waves are usually more spaced out than dilation waves (labour contractions) and with good reason – Mother Nature gives you more time to mentally and physically recover between each one. Use the time between each one to mentally prepare for the next one. Take a sip of water and compose yourself and remember that each contraction is one wave closer to finally meeting your baby. Generally speaking you should expect to push three times during one pushing contraction.
There are things you can do to help with successful pushing. Try taking a deep breath then tucking your chin into your chest to really maximise the force of each push – you need to give it all you’ve got. Make sure to stay focused during each push and try not to strain your face – no one wants a burst blood vessel in their first pictures with their baby! Once your pushing has paid off and the head is born, it only takes one more push to get the shoulders and body out and then the magic starts – you can finally meet your baby for the very first time. Well done mama!
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photo credit:Jaydene Freund
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