Pushing a Baby Out and What to Expect

You just do not know what to expect, you've never pushed a baby out.

The realization hits you, that you must push this baby out at the end of it all. We want to share with you as much as we possibly can, what to expect when it comes to pushing a baby out.

How will you know what to do?

Your body will know just what to do for two reasons. The first is that your body will know what to do, eventually it will begin to push all on its own. Your contractions are working to bring the baby down into the birth canal, when the time comes, the urge to push will take over. You cannot fight it, just like you cannot fight a bowel movement. Sorry, but that is the best way to describe the feeling and pressure, a bowel movement. Second, your care provider and support team will help you find your rhythm if you need more support during the pushing process. Your provider/the nurses will tell you it is okay to push and your doula will work with your partner to help you know where to direct your pushes, make sure your breathing, and encourage you all along the way.

How will you know when to start pushing?

Most providers want you to "labor down" meaning they want the contractions to bring the baby down lower into the pelvis before you start pushing, this helps reduce the energy and time you spend pushing. And why not, if you do not have the urge to push, letting your body do some work only saves energy in the long run.

Without an epidural:When you have the urge to push or your provider encourages you to try pushing, this is when you start pushing. The urge to push, as described earlier, is the feeling of intense pressure with an uncontrollable urge to push, just like with a bowel movement.

With an epidural: When you have an epidural you most often cannot feel the urge to push. Your providers will continue to check you until you are fully dilated, once you are 10 cm they may wait for baby to come down in the pelvis a little more before pushing. When the baby is down enough your nurses and doula will help you try out a few pushes.

What if I poop when I push?

A very common question. No one wants to think too much about this and sometimes it makes women scared of pushing at all. Sh*t happens sometimes. Your nurses will change the chux pads often and use cleansing wipes to help keep things clean, you and your partner will hardly notice, if at all. If you are having a water birth, it gets scooped away with a special scooper. That's all. You may still be nervous about doing this, but often, you are just so excited to be pushing you don't notice it if it happens.

Will I like pushing?

Pushing is hard work. Some women enjoy it because it is the last part of labor and they can actively work to make it end. Some women dislike pushing because of the pressure and intensity of this stage of labor.

What if I am having trouble pushing?

Sometimes for first time, and occasionally multip moms, it takes a while to "figure out" the best pushing position for you and how to direct your energy/pushing. Once you get the hang of it or the urge to push really kicks in it will be easier. Sometimes though, a mother might need more assistance. This can be done in a few ways. Your provider or nurse can apply pressure to your perineum, this will help you "feel" where to direct your pushes, your provider may have you switch around positions, you may take a rest all together, or you may need assistance with a vacuum or forceps, especially if labor has been long and you are exhausted.

How long will you push for?

Your average first time mom pushes for 2-3 hours. However, it can be shorter or longer depending on many factors: position of mom or baby, baby size, length of labor, when you start pushing and so on.

What position will I push in?

There are many positions you can use to push in. For a first time mom, and sometimes other moms, getting the baby's head under the pubic bone can be the longest stretch of pushing. Depending on your preference, whether you want the traditional on your back pushing or you want to try something else, you can opt to push however you would like.

Upright positions:

  • Squatting (on the floor, on the bed)
  • Birth Stool
  • Standing, leaning over the bed/chair
  • Sitting in the bed

Side lying positions:

  • Left or right side with leg up, held by support person
  • Left or right side with leg up, supported on the squat bar

All fours:

  • Hands and knees, leaning over the back of the bed
  • Hands and knees, leaning over a chair/ball

Using the Rebozo:

  • In any position for leverage, support, and something to pull on

During your prenatal visit with your Doula team from Virginia is for Doulas, they will go over these pushing positions, your pushing wishes, what to expect and how to prepare.