What it is
Pushing is the second stage of labor, from fully open to baby. Pushing positions include squatting, kneeling, hands and knees, side-lying, a birth stool, and semi-sitting in the bed. Purple pushing is the old hospital style: hold your breath, count to ten, three times per contraction. Spontaneous pushing means you push when and how your body tells you, in shorter bursts, with sound.
What's typical
For a first baby, pushing often takes 1 to 2 hours, longer with an epidural, and ACOG allows 3 or more if mother and baby are well. Later babies often take 10 to 40 minutes. The ring of fire, a burning stretch as the head crowns, lasts a minute or two. With an epidural, some units have you rest an hour before pushing.
What's known
Cochrane reviews find upright positions without an epidural mean shorter pushing, fewer assisted births, and fewer episiotomies. Side-lying is linked with fewer tears and is easy with an epidural. No clear difference shows between directed and spontaneous pushing, so ACOG says follow the mother's urge.
What helps
- Change position every 20 to 30 minutes if the baby is not moving down.
- Try side-lying with your top leg on a peanut ball, especially with an epidural.
- Breathe or blow through crowning instead of pushing hard. It gives the tissue time to stretch.
When to call someone
- Nowat home, an urge to push you cannot stop. Call 911 and lie on your side.
- Today, after the birth: you cannot pee within 6 hours, or you cannot control gas or stool.
- At your next visitask how long you pushed and whether you tore.
Who helps
Tools: Birth Plan Generator
Related
- Perineal massage, tearing, and episiotomyGetting Ready for Birth
- The stages of labor, plainlyBirth and the First Days
- Back labor and baby's positionGetting Ready for Birth
- Pain options: from breathing to epiduralGetting Ready for Birth
- Your pelvic floor after birthPostpartum: Your Body
What mothers here say
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Sources
- Cochrane — Position in the second stage of labour for women without epidural anaesthesia
- Cochrane — Pushing/bearing down methods for the second stage of labour
- American College of Obstetricians and Gynecologists — Committee opinion on approaches to limit intervention during labor and birth
Sources are named, not yet linked. The steward verifies each one and adds the link.
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