In my childbirth classes, on the night we talk about how to push during labor and delivery, these fantastic pushing questions come up almost every single time.
- How do I know when to push?
- What if I don’t feel the urge to push?
- How long will it take to push out my baby?
- Can I push without pooping?
- How can I push without tearing?
- How can I push through the pain?
Since everybody is discussing them in class, let’s discuss them here too, shall we?
How to Push During Labor and Delivery
Before we discuss the ins and outs of how to push during labor, let’s spend a moment reviewing the three stages of labor.
Stage 1: Labor and Dilation
Stage 2: Pushing and Birth of the Baby
Stage 3: Delivery of the Placenta
(To read more about the stages of labor and how to cope through it all, check out my post The Doula’s Guide to the Stages of Labor.)
How do you know when to push?
The first question is how do you know when to push? Well, there are a few answers to this question.
The easiest answer is that you push when your body just does it. I know that’s not too helpful for those who are pregnant and never pushed out a baby before, but pushing can be compared to a sneeze or vomiting reflex.
Pushing is an involuntary response. It can actually be hard to NOT push, when your body is pushing.
If you are unmedicated and feeling the urge to push, it is likely time to push. Often at this point a woman may agree to a cervical exam to ensure she is fully dilated (10 cm). If she isn’t 10 cm she may be asked to pant, blow, and/or change positions to push less or possibly stop pushing (which is likely impossible).
How do you know when to push with an epidural?
On the other hand, if a woman has an epidural, she will not feel the urge to push. In this case, she will know when to push when her nurse or doc says so.
However, even with an epidural, many women know that something has changed when they begin to feel a ton of pressure in their pelvis.
A lot of times with an epidural birth nurses will let the mom “labor down” before beginning the pushing stage. Basically, this means they are letting the baby come down on its own without pushing (after a mom is fully dilated).
Since it usually takes a lot longer to push out your baby with an epidural, “laboring down” helps your body do some of the early work so you don’t have to.
What if you don’t feel the urge to push?
If you have had a vaginal exam, are 10 cm but don’t feel like pushing or bearing down, what’s a gal to do?
If something isn’t working, try something new!
One of the first things to try to bring on the urge to push is to change positions. If you have been lying down, try standing up, squatting, getting into the tub, walking, hoolahooping, lunges, etc.
If after trying some position changes and you still feel no urge to push, you could just do nothing. When mom and baby are fine it’s ok to just try to rest and take a break before the big finale. Not feeling the urge to push in and of itself is not an problem or emergency.
If you are over it and ready to see your baby try bearing down a little and see how that feels. Sometimes women don’t feel an overwhelming urge to push and bearing down a little during contractions help. This tiny push may spur on the urge to push and you will be well on your way to baby.
(Someone who was in one of my classes said that with her last baby she never felt the urge to push, but she decided to push anyways and her baby practically fell out. lol!)
How long will it take to push out my baby?
How long does it take to push out a baby anyways? Let’s see… my vaginal crystal ball says 30 minutes. Oh, wait… 90 minutes. I mean 180 minutes. Honestly, nobody knows how long it will take you to push out your baby.
For a first time mom, the pushing stage may take around 1.5 hours. However, for some women they may give birth faster or slower than the average.
Expect pushing to take awhile!
How long will it take to push out my baby with an epidural?
If a first time mom has an epidural the range of normal is even longer. She could be pushing for 4-5 hours (or even more). ACOG supports first time moms with epidurals to push up to seven hours, assuming mom and baby are healthy. It could be awhile!
On the other hand, two women in one of my recent childbirth classes took about 30 minutes to push out their first babies. So, your guess is as good as mine.
TIP: To speed up the pushing process try an upright position and make sure you’re off your back!
In the above photo I am pushing my first child out. I had to push with everything I had! I was a bit surpriised at how much work it was. It took me 2.5 hours with my first.
With my second and third, (see the three photos below) however, I pushed them out in a matter of minutes. It was shockingly different. They came so quickly!
Can I push without pooping?
Will you poop in front of everybody? Possibly. Probably. 😉
If you have ever looked at the anatomy of a pregnant woman you can see that to push your baby out, your baby’s head will be pushing EVERYTHING that’s there, out.
But get this. When I see poop during the pushing phase at birth I get excited because I know she is pushing correctly and making great progress!
To birth professionals, pooping during pushing a no big deal type of thing (and even celebrated!), but to a pregnant mom this might be giving you nightmares.
TIP: If you’re wanting to push without pooping, use an enema in the early stages of labor (with the guidance of your care provider) to clean yourself out.
TIP: If you’re unsure of what the early stages of labor looks like, head on over here.
(Let’s Talk More About Pooping)
What would this mean to you if that happened? What would you tell yourself about yourself?
Think about that for a moment. What would your I AM statement be if you pooped when you pushed out your baby?
I AM _____________.
Now, take another moment and think about if that I am statement is serving you. No? I didn’t think so!
Ok, then what would you like to tell yourself about yourself if you were working really hard, pushing with all you had, bringing your baby down and you pooped.
I AM _____________.
See if you could look at this potential situation with new eyes, eyes of love and acceptance.
How Can I Push Without Tearing?
There are many things that can prevent tearing at birth. Unfortunately, many of these techniques are not practiced in most birth settings. Instead, common mistakes are made that actually don’t prevent tearing.
Here are a few helpful ideas to get you started.
- Use warm compresses on the perineum when baby begins to crown
- Do not use perineal massage during the pushing stage
- Care providers should use a “hands poised” instead of “hands on” approach
- Use pushing positions where pressure is off the sacrum
- Avoid the squatting position unless squatting is part of daily life
- Relax the mind and body throughout the pushing stage
Head on over here to read a popular article about how to prevent tearing at birth.
Want more? Here’s a follow up article about preventing tearing with even more ideas!
How can I push with labor pain?
Many women want to know how to push through the pain of pushing when having an unmedicated childbirth. I’ve got some good news for you!
After transition, one of the most difficult parts of labor, many women report their experience becoming easier. Not only do contractions sometimes space out during the pushing phase, but women typically are able to cope through the pain of contractions better as well.
Because contractions sometimes space out a tiny bit during the pushing phase, women have more opportunity to rest, relax, and even sleep between pushing contractions. This helps tremendously when coping through labor unmedicated.
Also, because women are now able to “do something (push) with their contractions” instead of just experiencing them, women typically prefer pushing compared to other parts of labor like transition.
Of course, women will continue to benefit from using breathing techniques throughout labor on into the pushing stage. Especially for those that are unmediated, it’s often best to let a woman breath and push spontaneously and naturally to maximize oxygen for mom and baby. Oxygen is wonderful! 😉
How to Push During Labor and Delivery
To recap, these are the questions answered in this blog post.
- How do I know when to push?
- What if I don’t feel the urge to push?
- How long will it take to push out my baby?
- Will I poop in front of everybody?
- How can I push without tearing?
- How can I push through the pain?
What About You?
Now that you’ve read this post, what new questions do you have about how to push during labor and delivery? What mistakes did you avoid during pushing?
Let me know what you think by leaving a comment.
Check out my NEWEST eBook: A Simple Guide to the Hard Parts of Labor! What's inside? ---->> ALL of my best information about getting through the hard parts of labor. Want a copy? Simply click the image above, follow the prompts, and it will be delivered to you today!
sara says
I had no idea I needed to push.. I just had great pressure like I needed to relieve myself, but when I sat on the toilet, it was much too uncomfortable. I don't recall pushing to get the head out. When it was time, my body took over. I dropped into a semi squat position and howled loudly as the baby's head made its way out. Honestly, I thonk had I pushed when i first had the urge to relievw myself, my baby would have been born a half hour sooner… As for the poop…. mass quantities, so I've been told. But the LAST thing on my mind while bringing my baby into the world. Lindsay, one day we need to get together and I'll tell you the whole story.
Olivia says
I want. My pregnancy test
Lindsey Morrow says
Sara! Hi!
Either someone in one of my class or Alice mentioned to me how fast your baby came and how there was poop. lol! I'm glad you didn't start pushing a half hour sooner… that would have been crazy fast. How fast was your birth anyways? And yes, we need to get together some time. Maybe we should have a reunion class? Has everyone in your class had their babies?
sara says
Morgan was the last and she had hers this past week. I had a hula performance that night and a few hours after I was done, the baby came. Craziness
jane says
I was in labor for 27 hours with my first baby jada Victoria.i did with very little drugs only headache medicine.i stuck with my Lamaze breathing and my husband and my girlfriends and doula and midwife coaching me.i am 4-11 my daughter was in posterior position I was my hands and knees pushing her out.i told my husband this it our baby was coming.with midwife help he got deliver our baby.it took 1 hour of pushing to get her here.everyone impress that I did a good job pushing for first time mom.she weighed 7 pound three once 22 inchs long.that was good size baby size baby for someone under 5-1.my husband and my girlfriends gave me pin purple heart metal style pin for being a female warrior.11 months latter I had twin boys.labor 15 hours and pushed 30 minutes .
Elaine says
Ha ha! I had the worst constipation with my first pregnancy, the WORST. And I suffered from IBS since my 20’s. When I pooped during childbirth, I practically cheered! Baby came soon after. And strangely, I haven’t had IBS since.
Ashley says
Wait.. 1.5-5 hours JUST for pushing?!? My first child was maybe 5 minutes and my other three were around the same. I mean, I’ve heard it’s harder to push when you have an epidural because you can’t feel when you should be pushing, but everyone I know that has had a birth with an epidural says the pushing wasn’t very long.
Lindsey Morrow says
Yep. You are in a small minority for pushing time with your first child. Congratulations! 🙂 Seriously though, it can definitely take some time to push out a baby.
Heather says
You’re very lucky!!! I did not have an epidural and pushed for just under 4 hours!
Amber says
No epidural either. First baby I pushed for 5 1/2 hours, second was 3 1/2, but ended in an emergency c-section. So jealous of 5 min pushing
Anita says
Agreed. I had an epi with my two oldest and i pushed for about 10 minutes with both of them.
Ashley says
Hi! I am about to have my second in about 10 weeks. I didn’t have any meds with my first and pushing was EXTREMELY painful. I feel very scarred by it and now I am pretty scared about pushing this time around. (She was asynclitic so I’m not sure if that makes a difference.) I definitely felt like I had to do a lot of the work in getting her out and not my body. Is pushing supposed to be THAT painful? Was I doing something wrong?
Lindsey Morrow says
Oohhh girl. Asynclitic? Yep. That’ll do it! When a baby cocks its head at a funny angle the circumference of the head is actually bigger when trying to fit through the pelvis. I would bet money that the second time around will be easier!!
Fel says
I’m a first time mom and only pushed for 30 minutes before my baby was born. All women are different, so don’t go based on articles as I had before labor. I had the epidural and still felt the urge to push.
Amanda says
I had an epidural with my 1st, pushed for 3.5 hours and finally needed the vacuum to assist with delivery. Once his head was put I pushed him the rest of the way. I certainly hope my next is much faster. The goal is no epidural this time but…that was also the goal last time……ha!
Amanda says
I didn’t have an epidural and was standing up through the transition. I felt like I wanted to poop. I pushed without even realizing it. The nurse saw me and had me sit on the edge if the so she could check me. We sat for I think 20 minutes with her hand up there holding me back because I still had a lip of cervix and the doctor had went home to rest because she didn’t think I would labor so quickly. As soon as doc arrive I pushed for 45. I had wanted to push in a kneeling position but couldn’t bear down right and ended up sitting on the edge of the bed with my husband and a nurse holding up my legs. The biggest thing I remember was that nurse kept telling me if I was making noise I wasn’t pushing right and and to put all my energy into the push. That really helped me.
Bradie says
With my first, I started grunting during pushing and my midwife told me the same thing about noise–that if I was making any, I wasn’t pushing right. And then not even ten seconds after I felt the need to push hard and I yelled–couldn’t stop it. My midwife paused and then basically ordered me to do that again! Haha! I think it depends on the woman (like all aspects of labor) if yelling/screaming can help or not. All I can say is that it helped me with both of my kiddos, and I expect something similar for this next one; but another woman might find that something else works better for them.
Marisol says
No one told me anything about yelling or not yelling in labor, but after my daughter was born at home 11 years ago, I remember thinking that if I could do it again, I would have made far less noise. I yelled and moaned and grunted and screamed all throughout active labor, transition, and pushing, cuz I had the idea going in that this would release energy and thereby help push the baby out. But I think it only made me more tired than I would have been if I’d stayed quiet and conserved energy instead. I noticed that my most effective pushing took place at the very end when I finally quieted down and put everything into pushing her out.
I’m going to get a chance to see if I’m right–I’m due with #2 in another few weeks!
Sarah says
I had to laugh about the pooping part, and especially the comment someone left about it. Anyway, I’m pregnant with my fourth baby, and though my first three labors were all different (the first was 14 hours, the second 5 hours and the third…I forget, honestly), but what was common in all three: 1) I couldn’t get an epidural- the first time I didn’t want it, the second and third I desperately wanted it, but I progressed too fast both times and missed the chance, and 2) Pushing was completely 100% unstoppable. Once the urge came I couldn’t have not pushed if I tried. I definitely had the experience at least once of a nurse yelling at me to not push because the doctor/midwife wasn’t there yet, and I was like, “Are you crazy? There is no NOT pushing!” And as for pooping…the idea still grosses me out a bit, even after three babies, but what can you do? If I’ve ever done it I don’t even know because the medical staff doesn’t even say anything, they just clean it up and move on, and I’m so far in the zone by that time that not only was I not aware if I pooped, I also didn’t feel myself tear (which I’ve done all three times). Birth, especially the last phase, is the one of the most awesome, scary, unreal, extreme, painful and miraculous moments of life.
Jessica ann doerfler says
If Maria Shriver told me when and how to push I would do so without screaming.
kaitlyn says
As a medical professional who has the privilege of performing rectal exams and fecal disimpaction (fishing really constipated stuff out with my own lovely finger) on patients when needed, I can honestly say most medical professionals have been there, done that, and don’t care if you poop. It’s all in a day’s work and there’s no reason to be embarrassed.
As for pushing during labor, I describe it as having raging diarrhea where your body doesn’t care where you are, you are GOING and there’s no stopping it! My nurse had me use the toilet after 9 hours of pitocin and fluids and not thinking I was progressing much, but I started pushing as soon a my bladder was empty, I just didn’t realize what was happening yet. It’s like everything in your abdomen clamps down and goes GET OUT! I think an empty bladder helped the head engage, so I’m peeing more often with this next one. I wound up pushing for only 20 minutes with baby #1 and refused to move to any position other than lying on my right side, since that provided some relief, which I guess worked out since 20 minutes is pretty darn quick. Wound up with an episiotomy, though, since it went so quick, which sucked, but it healed just fine.
jewelz says
I got an epidural with both my girls and both times i knew when it was time to push. And both came out pretty quick. I was told pretend like you were pooping. Bam! 2 to 3 pushes and both came out.
Ashley says
I had an epidural with both deliveries and felt the urge to push. Also I only pushed for 5 minutes with my first and less than 3 minutes with my second! With my first there was no poop at all; with my second I pooped all throughout my labor. The point is: Every labor is different! Go with the flow ladies! Your body knows what to do!
Amber says
My first was unmedicated. However I pushed for 5 1/2 hours including the 45 minute ride from birth center to hospital. They had to use a vacuum. My second child, I pushed for 3 1/2 hours and needed an emergency c-section because she was face up. Labor progressed great up until pushing! I’m now 8 weeks pregnant with my third and already dreading birth. I just want a natural birth for crying out loud!!
Amber says
Oh and in my case pooping definitely did NOT mean progress
Gabby Young says
I had a 13 hour all natural (no pitocin, no epidural, etc.) hospital birth with my second baby. My water spontaneously broke while I was laboring in an upright position with my knees on the floor and my hands on the bed. The second it broke I felt the extreme urge to push and started yelling, “I’M PUSHING! I’M PUSHING! I CAN’T STOP IT!” The nurse had me change positions to check me and then I got back into an upright position on the bed. I pushed intuitively with no assistance from my doctor or nurse and it ended up taking about 30 minutes (with me screaming my head off the first half and holding my breath and pushing silently the second half.) It was extremely painful but sooooo empowering. After I had her, I remember saying to the nurse “that was soooo hard but I think any woman who wants to can do it. Women are amazing and so capable!” Check out my YouTube channel to see a montage of my labor and delivery. https://www.youtube.com/channel/UCycEIcqd7Blr1iV1MrjvISQ
Fran says
I pushed with my first and then read ina mae gaskins guide to childbirth and realized pushing was bad. Ruining the pelvic floor of far too many women and causing unnecessary exertion. So I decided for our next 6 babies I would let my body have its fetal eject reflex and wait …..boom…..no one needs to push. Changing position to help baby wriggle into optimal position is great, but women in comas deliver. Women unconscious deliver…….our body does more pushing alone without our extra exertion. Provide your body with oxygen and rest and try to remain as calm as possible and it will happen fast when it does. With 6 babies, I rode out extra contractions, and in the end, I grunted, and with that contraction my babies were born. It’s unbelievable that our bodies don’t need anything to tell us when to push. Our body will do it. Fight the urge as long as you can, and grunt a little if you need a release, baby 8 is due in may……and my pelvic floor is as good as when j was a young woman. I can flex strong enough to crack my back, and I’ve never peed even a little after childbirth. Heck…..i spent 7 hours vomiting after my 6th babies birth and still I never leaked anything. Girls, save your lady bits.
But in all honesty your article is great in encouraging moms to listen to their bodies and their tells.
Amber says
Ugh so not true in my case! My first I definitely pooped while pushing lol. But it had nothing to do with efficiency! I ended up pushing naturally for 5.5 hours 45 minutes of which was on an ambulance. My second I pushed 3.5 hours and ended up with an emergency cs due to her position. Currently in early labor with my third. Going to try for a vbac. Both times I couldn’t NOT push. I knew as soon as the urge came because it was sooo strong! Not sure why it didn’t work. I saw a chiropractor this time so hoping it helps!!
Confused mom says
I already have 2 girls both were induced because I had cholastasis, now I am expecting twins and with cholastasis they planning to induce the labor too, but I am so scared I am having contractions babies are both head down Thanks God, (I really want a vaginal delivery) I don’t know what to do since with my first two I didn’t feel anything until I got the Induce medicine. I got checked my cervix yesterday and was 2 centimeter dilated, today I been feeling so bad, I haven’t sleep in 3 day because of the itching caused by the cholastasis, I been vomiting almost everything I have eat today and also have heartburns, I feel so miserable and confused, I don’t know what to do, I’m 35 weeks and 5 days, and my induced is scheduled until 37 weeks, I really want to make it to that point. I am so scared because I don’t know if the contractions I have are because I am in labor, water hasn’t broke yet.
Please any advice.
Nathalie Duverna says
I’ve had a few children and now I will be giving birth to twins. I’ve had both big babies and smaller babies but like I said now TWINS!!! I’m slightly afraid due to the complications of the pregnancy so the birth fears are a nightmare. Any advice???
Lindsey VanAlstyne says
You got this! (How is it going between you and your care provider?)