Mastering the Art of Pushing: Essential Tips for a Smooth Labor

As with describing what contractions feel like, explaining how to push during labor can be challenging. In my practice, each first-time parent gets the idea to click with different suggestions and techniques. It can be even more difficult to figure out how to push if you have received an epidural because you will not be feeling much more than pressure, and in some cases, you will feel nothing at all. 

What Is "Pushing"?

Some ways that I have heard pushing described are: First, the most commonly used explanation is to push like you are pooping. This one tends to work, and although you are not using the same muscles, it seems to do the trick in most cases. Another that I have heard is to push like you are trying to push a seatbelt off of your belly. This can also be a great way to describe holding the push in between breaths to try and keep with the momentum. If these explanations just don’t cut it for you, I will share a few ways I have found helpful for teaching individuals to push during labor.

How to Push

Pelvic Exam Method

The first way that I find extremely helpful, although somewhat more invasive, is to do a pelvic exam and have them push my fingers out. This method is helpful because they can feel what muscles my fingers are near and use those muscles. It is also good because I can tell them how accurately they are pushing or if their pushing is doing anything to help move the baby down. Typically, this is not the method I recommend first due to its invasive nature, but it is one that many clients end up utilizing, even just for a few moments while figuring out how to push.

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Tug-of-War Method

Another method is the tug-of-war. Using a scarf, rebozo, or towel, we have the laboring parent pull on one end while the care provider or doula pulls on the other during a push. This way of pushing can give someone the oomph and activate the back muscles, making more room in the pelvic outlet and sending the force of your pushes downward.

Upright Method

Pushing upright is another excellent way to work with gravity and help your baby come down and out. Upright laboring positions are more likely to cause tearing, but if pushing is hard to get the hang of, utilizing gravity can be a great aid. Typically, birthing parents are tired when pushing is here, so a supported squat is a favorite. Still, I have caught many babies of parents who are standing or in some variation of an upright position.

Coached Method

Coached pushing is a technique that has been quite demonized across the natural birthing community as it is typically used in hospitals and can be crucial for some parents with epidurals. With that said, I have found that some of my clients respond well when I encourage their proper pushes, having them hold their breath for a push and sometimes counting to 5 or 10, depending on the scenario. I also find that when we get to crowning, coaching parents to slow down, pant, and do small pushes can help avoid tearing in many cases. Coached pushing is not for everyone, but I have seen it make a big difference in some birthing scenarios.

However you choose to give birth, pushing is something that we all have to learn for the first time, and it is okay if it takes a few minutes or even an hour to find your groove. A good provider will be willing to work with you to find a position and technique for pushing that feels best for you. One of the coolest parts is that, eventually, most individuals will reach a point where they cannot push. Our bodies know what to do and will ultimately teach you how to get your baby into your arms, even if it takes some time.

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