The length of this stage varies with the position and size of the baby and your ability to push with the contractions. 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.
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.
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.
Delayed pushing had some adverse consequences. Four percent of women who waited to push had excessive bleeding after delivery compared with 2.3 percent who pushed right away. The delayed pushers had more bacterial infections: 9.1 percent versus 6.7 percent of the women who pushed immediately.
Pushing your baby out
You may not feel the urge to push immediately. If you have had an epidural, you may not feel an urge to push at all. If you're having your 1st baby, this pushing stage should last no longer than 3 hours. If you've had a baby before, it should take no more than 2 hours.
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.
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).
Three to four pushing efforts of 6 to 8 seconds in length per contraction are physiologically appropriate (AWHONN, 2000; Roberts, 2002; Simpson & James, 2005). When the time is right for pushing, the best approach based on current evidence is to encourage the woman to do whatever comes naturally.
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.
The cervix must be 100% effaced and 10 cm dilated before a vaginal delivery.
Your body goes through exactly the same process of labour regardless of your baby's size. In fact, the size of your baby has no influence whatsoever on the first stage of labour. Your cervix doesn't know there's a 4.5kg (9.9lb) baby sitting on top of it. It has to fully dilate regardless!
But if you're close to 10 centimeters dilated the research suggests it's not an issue. Evidence suggests it's more of a theoretical fear that just adds additional stress and in some cases results in an epidural (or a higher dose of epidural) to mask that urge.
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.
Pain during labor is caused by contractions of the muscles of the uterus and by pressure on the cervix. This pain can be felt as strong cramping in the abdomen, groin, and back, as well as an achy feeling. Some women experience pain in their sides or thighs as well.
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.
How long does it take to push baby out? In all, delivery generally takes 30 minutes to an hour, but it could take as long as three hours, especially in first babies (second and subsequent babies usually pop out a lot faster), or as short as a few minutes.
The second, pushing phase of labor continues after the cervix is fully dilated (open) to 10 cm until the delivery of your baby. It averages 4 to 8 hours but can be as short as several minutes.
The most common description of the level of pain experienced was extreme menstrual cramps (45 percent), while 16 percent said it was like bad back pain and 15 percent compared it to a broken bone.
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.
If your baby is not born after approximately 20 hours of regular contractions, you are likely to be in prolonged labor. Some health experts may say it occurs after 18 to 24 hours. If you are carrying twins or more, prolonged labor is labor that lasts more than 16 hours.
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.
Pushing on command may also contribute to fetal heart rate abnormalities, lower blood oxygen levels in babies, and an increased need for such medical interventions as instrument-assisted delivery. (It can be helpful if you've had an epidural, however.)
Do you poop while giving birth? You might. It doesn't happen to 100% of people, but it is something you should expect, and it's really not an issue. Your nurse has seen it time and again, and will be there to help quickly clean up without bringing attention to it.
Put Your Chin to Your Chest
If you notice during pushing that you're focusing a lot of your energy and tension in your face or upper body, try your best to relax those areas. Concentrate all of your efforts on pushing down through your abdomen, while relaxing and opening your pelvic floor.
In cases where your baby is at least 37 weeks, current research suggests that it may be safe to wait 48 hours (and sometimes longer) for labor to start on its own. (But your caregiver may have a different protocol, like 24 hours.)