The American College of Obstetricians and Gynecologists considers 3 hours or more (especially with a first time mom and/or those with epidurals) to be perfectly normal.
With epidural anesthesia, pushing can be delayed up to 2 hours for nulliparous women and up to 1 hour for multiparous women (Hansen, Clark, & Foster, 2002; Simpson & James, 2005).
For first-time mothers the average length of pushing is one-to-two hours. In some instances, pushing can last longer than two hours if mother and baby are tolerating it. Normally, the baby is born with his face looking toward mother's back (referred to as an anterior position).
The use of an epidural will most likely not have any great effect on your ability to push, with the most likely complication being a lengthier pushing phase. That said, many women gladly trade a few extra minutes of labor with the pain relief provided by the epidural for the alternative.
When your baby is ready to begin the journey through the birth canal, your cervix dilates from fully closed to 10 centimeters. This process can take hours, days, or even weeks. But once you hit active labor – about 6 cm dilated – it's usually just a matter of hours before you reach full dilation.
If your water (aka “amniotic sac,” “bag of waters” or “membranes”) hasn't broken on its own when you arrive at the hospital, and you're five or more centimeters dilated, your OB might recommend bursting the bag by hand—especially if your cervix seems to be making slow (or no) progress.
Stage 2: Pushing and Birth
The second stage of labor begins once you are fully dilated to 10 cm. Your provider will let you know that it is time to start pushing your baby out. This stage can be as short as 20 minutes or as long as a few hours.
The NICE guideline on care during labour (updated 2017) advises that in women who have an epidural (and combined spinal-epidural), pushing should be delayed for at least one hour after full cervical dilation and longer if the woman wishes. Women without an epidural should be guided by their own urge to push.
Thanks to one of my colleagues who is a specialist in obstetrical anesthesia at Beth Israel Deaconess Medical Center, Dr. Phil Hess, we now have strong evidence just published in the journal Obstetrics and Gynecology that epidurals do not prolong labor or increase cesarean rates.
Does an epidural slow down labor? There's no evidence that an epidural will slow down labor, but getting one may extend the length of the second stage of labor by an hour or more with your first baby and less with subsequent children, according to some research.
Pushing can be one of the most intense and exhausting parts of the labor and delivery process—and it can take anywhere from several minutes, up to a few hours to push your baby out.
Getting up and moving around may help speed dilation by increasing blood flow. Walking around the room, doing simple movements in bed or chair, or even changing positions may encourage dilation.
Bum-first or feet-first is not the optimal position for a vaginal delivery. Many hospitals and OBs will not allow women to attempt vaginal breech births (though some do specialize in this—ask your provider), and midwives in Canada don't typically deliver breech babies, either.
You can still feel some pressure of contractions, but you don't have constant pain going through your entire body. Study participants said having an epidural had a positive impact on their birth experience, changing their challenging situations into something manageable and even enjoyable.
Difficulty pushing and potentially prolonged labor – For some individuals, the epidural's strong impact can make it hard to feel contractions and push during delivery. Also, if the baby is in an abnormal position relative to the pelvis, an epidural may make it more challenging for the baby to move out of this position.
Epidural is one of the most effective methods for pain relief during delivery and childbirth, and it has minimal side effects on both mom and baby. It works quickly and can begin to relieve pain within 10 to 20 minutes . Most women who have an epidural feel little or no pain during labor and delivery.
Laboring down is the process of not actively pushing once the second stage of labor and intense contractions begin. Some people wait one to two hours before pushing, which allows the baby to naturally move down the birth canal. Laboring down has risks and benefits.
Some providers still prefer to wait until active labor. However, studies have shown starting an epidural in early labor, compared with later in labor, is not more likely to prolong labor or lead to a c-section or other interventions.
The American College of Obstetricians and Gynecologists considers 3 hours or more (especially with a first time mom and/or those with epidurals) to be perfectly normal.
Until recently, women have been asked to start pushing as soon as the cervix has dilated to 10 centimeters, but as long as you do not have a fever and your baby's heart rate is normal, there are many benefits to waiting to push until you feel the need to push.
Pushing Can Feel Like Relief
Your baby's head may press on nerves that desensitize the pelvis, and many people report feeling a numb sensation before the "ring of fire" (when the baby's head begins to emerge from the vaginal opening, a stage known as "crowning"). Some even say it feels good, similar to orgasm.
A C-section is major surgery. The procedure can increase complications for the mother and raise the risk during future pregnancies. Women giving birth for the first time should be allowed to push for at least three hours, the guidelines say. And if epidural anesthesia is used, they can push even longer.
No, it shouldn't hurt when your waters break or when they are broken for you. The amniotic sac, which is the part that 'breaks' doesn't have pain receptors, which are the things that cause you to feel pain.
As cervical dilation increased, there were significant increases in self-reported pain and observed pain on all the cited measures. Pain was characterized as 'discomforting' during early dilation and as 'distressing, horrible, excruciating' as dilation progressed.
So does it hurt when they check for dilation? If you have a care provider that cares about your comfort and wellbeing, then it should not hurt when they check for dilation and many people don't experience pain during their exam.