How to Push in Second Stage Labor

Most women get really excited when it's finally time to push. It means the time is close to seeing that beautiful baby. But, how do you know it's time? It is common for many women to experience a lull in contractions as soon as they are completely dilated that may last 20 or 30 minutes. Other women feel like pushing before they are completely dilated. Either way, when it's time, there are two basic ways to push: spontaneous and directed. Spontaneous pushing means that your body will begin pushing on its own, like a bowel movement. It's uncontrolled, and well, spontaneous. When the mother feels these strong urges to push, she responds by gently pushing down or blowing, however she chooses to push. Directed pushing means that you are being told how and when to push. This is also called "purple pushing." This article will explore the two different techniques.

Instructions

Difficulty: Moderately Challenging

How to Do Spontaneous Pushing

1. Find the most comfortable position for you. If you aren't having a real urge to push and the baby is still high, above a 0 station, you can try squatting. This generally produces the urge to push within a few contractions.
2. Remember to use the correct muscles so that you will save your energy. Your uterus will involuntarily push, so try not to stress your arms, legs and face with pushing techniques. That will just expend your energy unwisely. Just remind yourself to let your limbs be loose as you concentrate on pushing with your abdominal muscles.
3. Breathe however you want as your contraction is building. Then, when you feel the urge, you should push however it feels good to you. Some women like to hold their breath and others like to make small, short grunting sounds with a little push. Since your uterine muscle is going to push (involuntarily) for you, you don't have to strain and bear down.
4. Push as often as you feel the peak of each contraction. Soon you'll be holding your baby.

How to Do Directed Pushing

5. Begin each contraction with a deep, cleansing breath. This just means to take a deep breath in and blow it out. You should do this at least once, and twice if you can.
6. After you finish your cleansing breaths, take a deep breath in and hold it for a count of 10. To get more pushing power, you can tuck your chin to your chest and use grip bars or pull your legs back if you are in a lithotomy position.
7. After the count of 10, release your breath and immediately take in another deep breath and hold for the count of 8. Push the same way that you did in step two. You can repeat steps two and three as many times as you can while the contraction lasts.
8. Once the contraction is gone, you should take another deep cleansing breath and relax until the next one comes.

Tips & Warnings

• For directed pushing, you should try to wait until the baby's head is at a +1 station before pushing. The lower the baby's head is when pushing begins, the quicker the birth will be.
• Your doctor or nurse can put a gloved hand into the vagina or possibly just a warm compress on your perineum so that you can feel the direction to push.
• Use a birthing mirror to view your progress. Sometimes seeing the baby's head gives you an incentive to push harder.
• Use visualization to bring your baby down. Every time you push, imagine the baby's head coming lower and lower into your vagina and out of your body.
• If you feel the urge to push, but are not completely dilated yet, you should try to pant or blow when your body begins pushing.
• Make sure you rest between your contractions. Sometimes it takes two to three hours of pushing or more before the baby is born. Resting between contractions ensures that you will have the energy you need to complete your task.