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.)
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.
Once you start feeling the urge, you may push for just a few seconds during the peak of the contractions at first, and not during every contraction, or you may push with tremendous force – again, doing what your body tells you to do. Women who aren't being coached generally let a contraction build before bearing down.
While slightly more than half said having contractions was the most painful aspect of delivery, about one in five noted pushing or post-delivery was most painful. Moms 18 to 39 were more likely to say post-delivery pain was the most painful aspect than those 40 and older.
Pushing too soon could make you tired and cause your cervix to swell, which might delay delivery. Pant or blow your way through the contractions. Transition typically lasts 15 to 60 minutes.
According to Meehleis, some providers might tell a laboring person to slow down or stop pushing to help prevent perineal tearing. Or, sometimes, the cervix isn't dilated all the way.
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.
There shouldn't be any problems in delaying pushing until the woman feels the need to bear down. Delayed pushing might take a few contractions or there could be a time when contractions seem to stop for a short while.
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.
Some people describe the feeling as being like intense period cramps, others say it feels like a tightening or pounding feeling in your uterus or across your belly, others describe the feeling as being like very intense muscle cramps, while still other people describe contractions as being like the sort of wrenching ...
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.
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.
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.
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.
Deliver in an upright, nonflat position.
There are a number of delivery positions that might reduce the risk of a vaginal tear during childbirth. Rather than lying down flat during delivery, deliver in an upright position. Your health care provider will help you find a comfortable and safe delivery position.
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.
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.
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.
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.
"Most hospitals and providers prefer this position because of the ease of the doctor being able to sit at the feet of the woman, and the way in which hospital beds are designed to transform into a semi reclined or flat laying position," Biedebach explains.
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.
Tuuli says based on these findings, he suggests women begin pushing immediately when they are fully dilated, whether they have an epidural or not.
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.
According to the American Nurses Association, the pledge was named after Florence Nightingale, who is considered the founder of modern nursing. In the pledge, nurses promise to uphold the Hippocratic oath, do no harm, practice discretion and be dedicated to their work as a nurse.
During the pushing stage, you will most often feel a strong expulsion sensation with (and sometimes between) contractions, a feeling very much like having to poop. It's not uncommon for contractions to slow down quite a bit during this time, allowing rest in between.