How to Push During Labor and Delivery
Parents usually have six questions about how to push during labor and delivery.
- 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?
In this article we will answer these questions, but also talk about the ins and outs (pun intended!) of all things pushing.
On This Page
9 minute read
↓Understanding the Stages of Labor
↓How Do I Know When to Push?
↓How to Push With an Epidural
↓Laboring Down
↓What if I Don't Feel the Urge to Push?
↓How Long Does Pushing Take?
↓How Can I Push Without Pooping?
↓How Can I Push Without Tearing?
↓How to Push Through Labor Pain
Understanding the Stages of Labor
Before we discuss how to push during labor, let's spend a moment reviewing the three stages of labor.
Stage 1: Labor, Dilation, and Descent
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 I Know When to Push?
Many parents wonder how they will know when to push. There are a few answers to this question. The easiest answer is that you push when your body "just does it". Pushing can be compared to a sneeze or the vomiting reflex. Pushing is reflexive and believe or not, it's called the fetal ejection reflex (lol).
Pushing is an involuntary response. It can actually be hard to NOT push when your body is pushing.
If unmedicated and feeling the urge to push, it is likely time to push. At this point women sometimes ask for a cervical exam to ensure she is fully dilated. 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 to Push With an Epidural
On the other hand, if a woman has an epidural she will not feel that reflexive feeling/the urge to push. She will know when to push when her nurse or doc says so. However, even with an epidural many women know something has changed when they begin to feel a ton of pressure in their pelvis.
Laboring Down
Sometimes with an epidural birth care providers have parents "labor down" before officially starting the pushing stage. Basically this means they let the baby come down on its own without getting into the pushing position and bearing down.
Since it usually takes longer to push out a baby with an epidural, "laboring down" helps the body do some of the early work of the pushing phase.
What If I Don't Feel the Urge to Push?
If you get a vaginal/cervical exam and are 10 cm but don't feel like the urge to bear down, what's a gal to do?
Not feeling the urge to push isn't necessarily a problem. Right before pushing contractions sometimes space out and an opportunity for rest between contractions presents itself. Take advantage of this! This could help build energy for what's to come. However, I do understand wondering if there's a way to turn on the pushing reflex and get the show on the road.
Try Something New
One of the first things to try to help 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. You could also try sitting on a birthing ball. The pressure from the ball could make that urge to push happen quite quickly!
If position changes don't trigger the 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 a problem or emergency.
If you are over it and ready to see your baby, try bearing down a little and see how that feels. (Bear down like you're having a bowel movement.) Sometimes women don't feel an overwhelming urge to push and bearing down a little during contractions can 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. We never know!)
How Long Does Pushing Take?
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.
Ok, ok... The average first time mom takes around 1.5 hours to push her baby out. However, some women will give birth faster or slower than the average.
TIP: A mistakes new moms make during pushing is to think the third stage of labor will be quick! Hollywood certainly has taught us that birth is an emergency. 😉 Do yourself a favor and expect pushing to take awhile.
How Long With an Epidural?
If a first time mom has an epidural the range of normal is even longer. She could be pushing for 3-4 hours, or even more! ACOG supports first time moms with epidurals to push for many hours, assuming mom and baby are healthy. It could be awhile!
Two women in a 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!
ABOVE PHOTO: Here 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.
BELOW PHOTOS: With my second and third babies, however, I pushed them out in a matter of minutes. It was shockingly different. They came so quickly!
How Can I Push Without Pooping?
Will you poop in front of everybody? Possibly. Probably. 😉 Looking at the anatomy of a pregnant woman shows us that to push a baby out, the baby's head pushes EVERYTHING out with it.
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 - even celebrated! Understandably so, this may give a pregnant person nightmares.
Here's some good news! A sign of labor and symptoms of early labor both include loose stools. Sometimes everything works itself out before pushing even happens.
TIP: If you're wanting to push without pooping, some parents use an enema in the early stages of labor (with the guidance of their care provider) to flush themselves 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 you pooped during pushing? 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!
What would you like to tell yourself about yourself instead? If you were working really hard, pushing with all you had, bringing your baby down, and then you pooped...
I AM _____________... what?
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 techniques that can prevent tearing at birth. Unfortunately, many of these are not practiced in the average birth setting. Instead, common mistakes are made that actually don't prevent tearing.
Here are a few helpful ideas to reduce the chance of tearing.
- 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.
TIP: Here's one of Mother Rising's most popular articles - all about how to prevent tearing at birth.
How to Push Through Labor Pain
Many parents want to know how to push through the pain of 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. Rest helps tremendously when coping through labor unmedicated.
Also, women usually prefer pushing over transition because now they are able to "do something with their contractions" instead of just experiencing them.
Of course, women will continue to benefit from using breathing techniques throughout labor on into the pushing stage. Especially for those that are unmedicated, it's often best to let a woman breath and push spontaneously and naturally to maximize oxygen for mom and baby. Oxygen is wonderful! 😉
Want More?
Want to learn more about birth and pushing?
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.
I want. My pregnancy test
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?
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
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 .
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.
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.
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.
You're very lucky!!! I did not have an epidural and pushed for just under 4 hours!
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
Agreed. I had an epi with my two oldest and i pushed for about 10 minutes with both of them.
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?
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!!
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.
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!
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.
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.
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!
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.
If Maria Shriver told me when and how to push I would do so without screaming.
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.
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.
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!