How to Push During Labor

Straight Talk on What You Really Want to Know

If you’re expecting your first baby or if your last delivery was by caesarean section, you may be worried about what to do when it comes time to push the baby out. After all, giving birth is an experience like no other. Rest assured: You will not be expected to magically know how to deliver your baby, and you’ll have a team of professionals to guide you.

When Is It Time to Push?

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Once your cervix is completely dilated, you will be instructed to start pushing. How long you’ll have to push is difficult to predict. It could be for a few minutes, or it could be a few hours (let’s hope for the former). Sometimes, subsequent babies come out more quickly than the first child. At this point, your contractions should be regular, lasting approximately 60 to 90 seconds each. You will have about two to five minutes in between each contraction, which gives your body a chance to rest and you the opportunity to refocus. Some women feel a second wind at this stage of labor, perhaps because the time to push out the baby has arrived. Other women feel fatigued.

How Do I Push?

If you haven’t had an epidural, you may start to feel an overwhelming urge to push. You also may feel pressure in your rectum. If you have chosen to have an epidural, which decreases the feeling in your lower body, you may not experience these sensations, and delivery may take longer. Either way, your doctor will advise you when it’s time to push. She may ask you to give three good pushes during each contraction, resting in between.

Push as though you are having a really large bowel movement. This is the easiest way to describe what you need to do. And yes, while you’re pushing, urine or feces may leave your body. Although you may be mortified by the thought, your health care team sees this all the time and is not phased by it. Stay focused and make each push count by giving it all your effort. Don’t hold tension in your face and focus on your lower body. You may feel like taking a deep breath, then exhaling as you push. Trust your instincts and let your body guide you. A nurse may count down as you push or may direct you when to take a breath and when to give another big push. Remember that you are not in this alone, and you are not expected to know exactly what to do. Your health care team is there to help you.

When Do I Stop Pushing?

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You may be instructed to push more gently or to stop pushing completely during a contraction. Slowing down may allow the vaginal tissues to stretch and help prevent tearing. In between contractions, you will be told to stop pushing. Try to relax for these few minutes. If you feel the urge to push, try panting instead. When it’s time to start pushing again, give it all you’ve got.

Your health care team will let you know how delivery is progressing. For example, they will tell you when they can see your baby’s head. Many women find this motivating. You also may be given a mirror so you can see the baby’s head yourself as it begins to emerge. If your labor isn’t progressing as it should, or if other complications develop, you may be instructed to stop pushing. At this point, your health care provider will make a decision as to how to proceed, which may include having a C-section to safely deliver your baby.

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