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Pushing Techniques

Pushing begins during the second stage of labor and can take anywhere from 15 minutes to over 2 hours. This page can help you prepare for the experience in store when you reach this point in your pregnancy.

Positions for Pushing

Several different positions can be used for pushing so you will need to experiment and see which you are most comfortable with.

Side Lying Position - With the first urges to push you might want to stay in this position with your labor partner supporting your top leg.

Kneeling Position - Pushing in this position can help turn the baby if necessary.

Squatting Position - This is an excellent position to use for pushing. It opens the pelvis to the greatest diameter and allows gravity to do its part.

C-Curved Position - Be sure you are in an upright position with your back rounded and knees bent. You will bring your chin to your chest and push as if you were having a bowel movement. This will be the most effective method of pushing.

Breathing Techniques

While Avoiding Pushing
Sometimes you need to avoid pushing even though you may have the urge to push. If the cervix is not completely dilated, you will need to blow or pant to help resist the urge to push. You may also be asked to pant as the baby's head delivers to facilitate a more controlled delivery.

While Effective Pushing
You can use spontaneous pushing when the cervix is completely dilated and you feel the urge to push. This technique is a natural one, allowing the body's spontaneous response to bear down. When the contraction begins you will start with a cleansing breath. Then you can use any breathing pattern you prefer as the contraction builds. When the feel the urge to push, you will make groaning or moaning sounds while slowly exhaling with the bearing down effort.

Three to five spontaneous pushes will be made during the peak of a contraction ending with a cleansing breath. This technique is much less traumatic to both mom and baby than directed pushing. However, at some point during the second stage of labor, you may be asked to use directed pushing to speed the descent of the baby.

While Directed Pushing
You begin each contraction with a cleansing breath. As the contraction builds, breathe in and out two more times. For the third breath, hold it - but not for more than 6 seconds (your labor partner can help keep track of time). Blow that breath out and take a new one - hold and push. Repeat until the contraction subsides.

Pushing Strategies

  • Both types of pushing should have the same feeling as if you were having a bowel movement
  • Try to feel what is happening inside your body and visualize your baby moving down the birth canal
  • Your nurse or doctor may do perineal massage to help the tissues stretch
  • Try to push in a slow and steady manner
  • Stay as relaxed as possible

Birth of Your Baby

As you push, the baby slowly moves down the birth canal until the head appears on the perineum. As soon as your baby's head delivers, your doctor may ask you not to push as he or she makes sure the baby is prepared to come out. Your doctor may ask you to give a gentle push as the shoulders come out and the rest of your baby is delivered. Your feelings at this point can range from confusion to happiness so don't be concerned if you feel different than what you expected!

Delivering the Placenta

Within 10 to 30 minutes after delivery is over, you may experience another series of contractions. This signals the detachment of the placenta from the uterus. You will be asked to gently push, causing the delivery of the placenta.

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