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Welcome back to part 2 of the Different Phases of Labor series! Let's get straight into it....pushing. Let's talk about how you'll know it's time, what it feels like, and ways to push effectively.
As shown above, just give a good sneeze and baby will come flying out...right?!
Eh, not quite but I promise it isn't as daunting as you may think! A lot of people report really enjoying pushing after working through labor. You get the opportunity to switch from the mindset of "relax and release" and enter into an active role that allows the sensation of the contractions to feel less 'all-consuming'.
Knowing When it's Time & What it Feels Like
After transition is over, the body begins to signal that it is ready to push. The cervix is typically close, if not at, 10cm. Let's also clarify that it is TOTALLY normal to still have your water bag intact at this point. Quite a few people's water doesn't break until they are actively pushing and for some individuals, they deliver the baby with the waterbag intact! It's called delivering en caul. The uterus begins to focus less on pulling the cervix out of the way, and more on pushing down on the baby. The best way that I can describe this initial feeling is that it is similar to that 'wretching' sensation that comes with vomiting, where it makes you clamp down on your abdomen and curl into it, but without the vomiting! That might not make much sense now, but I promise you'll know what I'm talking about when it starts happening.
It can be beneficial to have a vaginal exam from your provider prior to pushing to ensure that the cervix is fully out of the way. Sometimes the body can begin signaling the urge to push before the cervix is fully out of the way. If you push and cervix is still present, it can become inflamed and swollen, which could prolong the pushing experience and could injure your cervix.
Ways to Push Effectively
There are a few ways to really get the most out of each push. Using gravity in your favor is one of them. Pushing can be done in all different types of positions. First-time birthers tend to push for an hour or two, so don't feel like you need to get locked into one specific position. This is something that your provider can help guide you through based on your specific baby's position in your pelvis to best encourage descent into the vaginal canal.
Some positions that people enjoy include: hands and knees, a lunge position with one of your legs up while leaning on a hard surface such as the bed, or side-lying with a leg up on a peanut ball. I would recommend trying a different position every 20 minutes to keep the pelvis opening in a variety of ways to allow for baby to move.
Another factor of effective pushing is engaging the proper muscles. During labor, breathing out of your mouth is the most effective way to keep the body relaxed. When pushing rolls around, letting your breath out of your mouth can take away the strength of the push because of its muscle-relaxing effects. I would recommend taking a nice deep breath and filling your lungs as the contraction begins to strengthen and then at its peak strength, focus on holding the air in your lungs and imagine that you are going to release that breath out just like a fart. I know, I know...that sounds ridiculous but I promise you, it's a way to trick your body into engaging the proper muscles. As you are fake farting (or real farting, no judgment here), curl around your tummy in whatever position you are in and tuck your chin to your chest. Do this for about 10 seconds before taking a deep cleansing breath again and repeat. See if you can get two or even three rounds of this type of pushing in for every contraction.
What's Next?
The closer you get to your baby stretching your vaginal tissues, you may begin to feel lots of pressure in your vagina. Welcome this pressure as it means that you are getting that much closer to meeting your baby! It can be beneficial for the skin and may relieve the sensation of pressure by having your support partner get a washcloth wet with warm water and place it over your tissues, gently holding it in place. As the baby begins to stay in between pushing right at the entrance of the vagina, the tissue may begin to feel a bit burny (don't be afraid, this is ALMOST over!!). This is when it is most important to go back to your labor breaths and breathe through it. The body will work with you to birth the head, so you can just focus on breathing through this part. This will give your tissue lots of time to stretch and help avoid tearing. Your provider can offer you counter pressure on your tissues at this point to help aid in comfort and avoiding tearing.
I hope this was helpful and I hope that you are excited to meet your little one! If you have any additional questions about labor, feel free to drop them in the comments!
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