By the time we get to second stage of labor (aka pushing) in the Childbirth Ed class I teach I have already stressed how important it is to move around in labor, listening to your body. When we get to second stage I get another opportunity to talk about how important changing positions, using gravity, and moving can be for the pushing stage of labor.

I describe pushing the baby out kind of like trying to take off my wedding band – with the pelvis being like the ring (I know it’s not perfect, but you’ll see what I mean in a sec.)  I’ll  grab hold of my wedding band and pull forcefully toward the tip of my finger.  In variably, it moves a fraction and then gets stuck.  The flesh between the band and my knuckle gets all bunched up, my finger starts to turn frighteningly red, and I begin to wonder if the ring will ever come off. On my second try, I tug on the ring while gently jiggling it back and forth.  This time it moves right along without any trauma to my finger at all.

All of the moving and changing positions while pushing  – hands and knees, lunge (or Captain Morgan position),  side lying,  squatting,  sitting on a toilet, standing – are the equivalent to the jiggling I did to ease my ring off.  Lying flat on your back and pushing with all your might for two hours or more is the same as grabbing my ring and yanking full force.  In theory yanking can get my ring off, but there sure are gentler more effective ways of doing so.

If you are interested in a gentler more effective way of pushing your baby out check out this fantastic video from mothersadvocate.org:

While we are talking about pushing, I have to mention the fact that you may be asked to not push when you feel VERY much like doing so.  In fact, if you are having the overwhelming urge to push it is going to be a lot like throwing up, except this time your body is throwing down.  You can’t help it.  Your body is on a mission of expulsion and you are along for the ride.

So let’s say you find yourself in a situation where your body is very much telling you that PUSHing is what needs to happen and the people  around you are telling you not to.  The first thing you do is find out WHY.  If there is a good reason why you shouldn’t be pushing -  like you went though transition at how and now you are in the car and you really don’t want your baby to be born on Lake Shore Drive.  Or if  your baby’s cord is prolapsed and the pushing is jeopardizing the baby’s oxygen – those might be situations in which you might not want to push.

If that’s your situation there are a couple of things you can do: Blow Raspberries.  This is where you blow forcefully and let your lips flap away.  Like if you were going to imitate a horse noise.  I used to call this “horse lips” until a client misunderstood me and thought I said they were getting out the forceps. For me they are now forever “Blowing Raspberries” as I don’t like to terrify women in labor.  Blowing out like this keeps you from holding your breath and bearing down.

I have had personal experience with this one with my second child.  She came unexpectedly fast and I didn’t have the luxury of birthing in a facility with L&D rooms.  I was in an L room when the throwing down began and I the nurse desperately needed to get me to a D room two floors below!  My dear second daughter could have been born in an elevator, but I wasn’t too excited about that so I did my best to not encourage my body and two pushes was all it took once we got to the D room.  (I certainly hope they put some more thought into the design of that place down the road!)

Then there was the time when I was a doula for a primip (mama giving birth for the first time) who was having an exceptionally quick labor. I didn’t even made it to their home to support them it went so fast.  As I was turning down their street the dad called me to say they were headed to the hospital.   I saw their car pass me, made a U-turn and pulled up right behind them.  I stayed on the phone with the mom while following them to the hospital.  She was vocalizing loudly in the back seat and it sounded like transition.   I coached her as best I could through a hands-free device.  All things considered she was doing marvelously.  Soon I heard a catch in her voice and knew that she was feeling like pushing.  So for the next 10 minutes getting to the hospital we blew raspberries to each other on the phone.   She did a fantastic job and was able to push her beautiful baby out in two pushes once she got to L&D.

So there are times when it might be a good idea to not push even though you feel like everything in your body is focusing on bearing down.  However, I have witnessed on several occasions in several different hospitals circumstances where a mother is experiencing an overwhelming urge to push and everyone around her is telling her not to, and the only reason is because her chosen care provider is not in the building yet.

One time it was another surprisingly quick primip.  Other occasions it was winter in Chicagoland and the labor progressed quicker than the snowplows could keep up with the snow, so the doc was in transit.  Every single time a L&D nurse was present and every single time there was also a qualified OB on the floor who could have stepped in at any moment.  All of these mothers were unmedicated.  The main reason the mother was told not to push was because the staff wanted to wait until the mother’s chosen care provider arrived on the scene.  Arrgh!

If this is your situation and you don’t care who catches your baby (an L&D nurse can catch a baby just fine) then go ahead and push!  Not pushing with an overwhelming pushing contraction is pure misery.  If  not pushing along with you body saves your baby’s life, I am all for it.  However when it is simply for the convenience of someone other than the birthing mother, I am all for tuning in to your body, informing the staff that the baby is coming – doesn’t matter who is or isn’t in the room – and birthing your baby.

Another great resource for pushing and following what you body is telling you can be found here.

You may also like:
Good Things Come to Those Who Wait – Successful VBAC mom who did tons of scooching and changing positions in second stage