Tell your health care provider if you feel the urge to push. If you want to push but you're not fully dilated, your health care provider will ask you to hold back. Pushing too soon could make you tired and cause your cervix to swell, which might delay delivery.
Some women will instinctively push before their cervix is fully dilated. This is often treated as a complication, and a common approach is to encourage the woman to stop pushing due to fear that cervical damage will occur. However, there is no evidence to support this concern.
Once the cervix has reached 10 cm, it is time to push the baby out. Contractions continue but also produce a strong urge to push. This urge might feel like an intense need to have a bowel movement. This stage can last anywhere from a few minutes to a few hours.
It used to be thought that early pushing could cause injury to your cervix, a longer active labor stage, and more fatigue, but studies now show this isn't the case. Waiting until you're 10 centimeters is generally an outdated practice, though some doctors might still recommend it.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.
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. This is because the weight of the baby applies pressure to the cervix.
The most common reason for telling a women not to push is that her cervix is not fully dilated. Often when a baby is in an occipito posterior position the woman will feel the urge to push before the cervix is completely open.
For most people, active labor is more painful than pushing because it lasts longer, gets more and more intense as it progresses, and involves many muscles, ligaments, organs, nerves, and skin surfaces.
Doctors have to wait until the cervix is at least 4 centimeters dilated before doing an epidural. Otherwise, the epidural will slow the process down too much. However, once the cervix becomes fully dilated it is too late for an epidural to be given.
(Some OBs will go ahead and break your water at 3 or 4 centimeters.) The reasoning behind this: “Artificial rupture of membranes” (popping a hole in the amniotic sac) will usually jumpstart labor by getting serious contractions underway.
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.
However, women who delayed pushing experienced longer labors and higher risks of severe postpartum bleeding and infections. Their babies also were more likely to develop sepsis—a serious complication related to infection. The study appears in the Journal of the American Medical Association.
You shouldn't push until your cervix is completely dilated. This is because pushing before your cervix completely opens can cause swelling on the cervix that can make a vaginal delivery more difficult.
As baby engages lower into the pelvis, they are likely to apply pressure to the cervix. While this can occur long before labor, sometimes it is a sign of early dilation.
Second Stage or Active Labor
The second stage is the most painful stage of labor. The baby passes through the cervix, through the pelvis and birth canal, and out through the vaginal opening.
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.
While the experience is different for everyone, labor can sometimes feel like extremely strong menstrual cramps that get progressively more and more intense as time goes on1.
Purple pushing, coached pushing, holding your breath, all mean basically the same thing. Mothers being instructed on pushing causes them to hold their breath and push down into their bottom. Another more normal and less exhausting option would be “breathing or bearing down” working with the contractions.
Applying fundal pressure by pushing on the mother's abdomen in the direction of the birth canal is often used to assist spontaneous vaginal birth, shorten the length of the second stage and reduce the need for instrumental birth (forceps‐ or vacuum‐assisted) or caesarean section.
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. This stage of labour is hard work, but your midwife will help and encourage you. Your birth partner can also support you.
Supported squat
Try to achieve a deep squat with your legs in a “V” position. This position can really help to open up your pelvis, move your baby down, which can also help to dilate your cervix.
We love Ina May Gaskin's quote, “Squat 300 times a day, you're going to give birth quickly.” However, if you have not been squatting at all, start with our minimum of 25 squats a day.