Please tell me about pushing

[alton]

Was there anything that you found helped during the second stage of labour (pushing) - ways of breathing, particular positions, etc?
And anything that you wouldn't recommend?

[Ldavis24]

I don't know if it is something that you would be comfortable with, but one thing worked wonders for me when I was pushing...

I was in the semi squatting position and my MW was right down there obviously just keeping an eye on things or whatever she was doing and there was a paramedic in the room (she needed to witness a birth and I was the first woman to be pushing the baby out when she was around so she asked if I minded and I really didn't care who was there at that point I was concentrating really hard...anyway) so my MW asked if I wanted to have a mirror to see baby descend and watch her come out. I said yes and being able to watch my baby's head descend and then slide out of view gave me so much determination to push as much as I could it made a dramatic increase in the power of my pushes. DH even commented that he was amazed in the difference of the strength of my pushes between when I couldn't watch and when I was looking with the mirror..Just something to think about.

Besides that, I would urge you to just listen to your body and if someone tells you to push and you don't feel like it then DON'T!!! Although if you do feeling like pushing early on go for it, I started pushing when I was 6cm and I went from 6 to 10 in about 15 minutes because I was pushing! You will know what to do I feel like my body just took over at that point.
Good Luck!

[UmmAbduRahman]

Push with your instinct, don't need anyone to count for you.

Squatting opens the pelvis 10-15% and also makes moms feel like they are centered with what's going on.

But other than that, whatever position you feel most comfortable in is probably the best for you (other than flat on the back!!! )

Holding breath can help (think of being really constipated). In Bradley® classes we teach that as the contraction begins, you take two full breaths and exhale, letting the contraction build in intensity, then on the third breath hold it and push. When needed, exhale and breathe in again and push. Rest between contractions.

And I give two thumbs up to a cold washcloth to wipe the forehead and a cool drink between pushes!

[erin_brycesmom]

For me the best was just letting it happen on it's own. I didn't want any cervical checks. No numbers in my head. I just waited for my body to do it and let it lead the way. Once the pushing begins on it's own, I'm really just along for the ride. I've found that kneeling is what works best for me when pushing. I can rest my weight onto just about anything and I can brace myself easily for support if needed. Plus it allows easy access to feel and support myself. I have to say that birthing my baby's head into my own hand is truly the most amazing thing I've ever felt!

[*MamaJen*]

Do what your body tells you to do! In a normal birth, you don't need anyone to tell you how or when to push. Your body literally starts pushing on its own. You just kind of start bearing down with every contraction. You can kind of work with the pushing contractions and help them along.
Are you having a homebirth? Being in the tub was great for pushing, because I was able to kind of squat/sit back on my ankles in this really comfortable position, with the buoyancy of the water supporting me and keeping me from getting tired.

[sarahn4639]

Something that came be very helpful is pulling while pushing. It helps to engage the right muscles (some women need zero help with this and others find it extremely helpful). In a hospital setting they do this by having the woman pull back on her legs while she lays on her back pushing, but there are lots of other ways to do this. If a woman is pushing on a toilet or birthstool I will stand in front of her and hold her hands and she pulls on me while pushing or use a scarf or bed sheet and do sort of a tug-of-war with it. When a woman is squatting she will often want to hold on to someone or something for support and instinctively pull on that.

Another thing that is very helpful if pushing is taking some time, is to change positions. Push in one position for a few contractions and then do something else.

For many women, pushing is very instinctive and they just do it. Other's need a bit more guidance. Also, I totally agree to wait for the urge, don't push just because you're 10!

[Plummeting]

Honestly, I think you just have to do whatever feels right to you in the moment, because what works for one woman (or every other woman you talk to, lol) might not work for you. For instance, everyone says you should deliver squatting or on hands and knees...like seriously everyone. That did NOT work for me either time. The first time my midwife recommended I get on hands and knees because DD1 was posterior and she thought that would help. It felt worse - a lot worse - than lying on my side, so I went right back to lying on my side with one leg propped up on the midwife's shoulder and that's how DD1 was born. Squatting wasn't even an option, as being upright was so, so, so uncomfortable. DD2 was a precipitous labor and the midwife hadn't made it to my house yet when I started pushing. I tried hands and knees a few times while I was laboring and it felt worse than just lying back in the bathtub, semi-sitting with legs straight out in front of me. I couldn't squat, because once again there was just no way. It was too intense, too fast, too much pain. I couldn't get into that position. I pushed DD2 out in the reclined position with my legs straight out in front, pushing against the tub jets with my toes for leverage. lol

Before DD1 was born I was so sure I'd push squatting or on hands and knees. After she was born, I realized it's silly to go into birth thinking you are going to do it any certain way. Have tools at your disposal, but don't have a plan, other than that you plan to use whatever tools feel right when the time comes.

[Funny Face]

Follow your instincts. If you aren't having clear instincts (I have a friend who absolutely does not have an urge to push) then don't be afraid to ask for some tips or help from your care provider.

I really liked the freedom to switch positions the water gave me. I also liked having my hand down there, not someone else's. I asked someone to give me some rectal counter pressure and that really helped me too.

Go with what your gut (no pun intended ) is telling you!

[Plummeting]

Originally Posted by Funny Face

Follow your instincts. If you aren't having clear instincts (I have a friend who absolutely does not have an urge to push) then don't be afraid to ask for some tips or help from your care provider.

There's actually nothing wrong with not pushing if you don't feel the urge. Not having the urge to push doesn't mean your friend's instincts are letting her down or that she's not having clear instincts. It just means her instincts are different than the ones people expect her to have. Some babies come out without pushing. It's happened to my sister twice. And research has shown that babies will descend without pushing, so it could very well be that there is a reason your friend doesn't have the urge to push. Unless there is evidence that the baby is in distress, there's no rush to get them out, and listening to one's body, without asking an OB or midwife what to do, is perfectly fine.

[Comtessa]

I never ever had the urge to push. I had an epidural at 10 cm just to slow labor enough for me to rest so I could push -- I was exhausted (HB transfer after 2 days). Five hours later they said, "ok, you should probably start pushing this baby out now" and I was like, "can I sleep a little longer first??" In hindsight, I probably should have waited until my body felt ready, b/c the pushing stage was a grueling 4 hours and nothing really happened for the first hour -- I didn't feel baby at all, and just wore myself out trying to go along with the nurses' coaching.

I'd like to second the recommendation to not go into labor with any preconceived ideas about how you will actually birth. I had every intention of birthing in a squatting position - even practiced squats to strengthen my legs - and in the end, I had NO strength to hold myself up. And squatting was horribly painful.

Originally Posted by UmmAbduRahman

But other than that, whatever position you feel most comfortable in is probably the best for you (other than flat on the back!!! )

Actually, this is the position that worked best for me! In my case, after trying a bunch of positions, my MW finally recommended lithotomy position because the baby was having trouble getting under my pubic bone and that position actually seemed to make the most difference in helping her descend into the birth canal.

Once I was in the hospital, the epidural and IV made changing positions very difficult, but I tried a few anyway, I was so determined NOT to birth on my back. But in the end, it really was most effective (especially with as exhausted as I was - I was falling asleep between contractions). So you never really know what will work until you're in the moment.

[cocoanib]

I agree with following your instincts. I had read and watched so many birthing videos and thought that I was prepared for the pushing stage. It felt nothing like I could have imagined! I had the pushing urge and it was the craziest feeling of my life! I tried a few different positions, but for me squatting and hands and knees felt best.
Once the baby's head was out, I had to push without the pushing reflex because of decel heartrate, blood loss and a sticky shoulder. Pushing without the urge was alot more difficult.

[callieollie]

I agree with others - follow your body. I had planned to push in a squatting position in the water with my dd and instead I ended up pushing on all 4s. I was trying to get out of the tub to use the bathroom so I got on my knees to stand up and then my body just started expelling my daughter out of me! So I stayed on all 4s for the 4 minutes of pushing and she was out!

[HeatherB]

I agree that having something to pull on is really helpful. I'm another one who ended up pushing/birthing flat on my back with one baby, likely to get baby out faster as they were concerned about his heart rate. I remember in that one holding one leg back, and holding...err, pulling.. my DH's EAR! I finally decided it was better to hold both legs than to rip his ear off. Baby was born very, very quickly after that.

With my 2nd homebirth, I had precipitous transition/pushing after a long, lazy labor. So when the pushing began, it was freaking me out; I was terrified it was too soon and the baby would be hurt (when, really, it was ME who would be hurt if I pushed too early). My MW had be not add to the pushing - just let my body do it. And it was REALLY good that way. I loved being able to just experience it. But, I also needed something to hold onto. The handles in the BPIAB were *awesome* for that.

Also, she asked me to feel baby's head as he began to crown. THAT was SO COOL!

I had wanted to squat and catch him myself (seems a common theme!), but was on my knees at that point. She had me turn over and sit down, and I ended up pushing him out that way so I did get to catch him.

So, do what your body says to do. Listen to your MW, too. Touch your baby when you have the chance. And be prepared for it NOT to go just like you planned - but to still be awesome!