Starting & progressing through labour
Expected experiences while pushing during labour
Spontaneous vs directed pushing
Spontaneous pushing is where women follow their own instincts and push around 3-5 times per contraction
Directed pushing is done during the second stage of labour. You take a deep breath at the beginning of the contraction and then push throughout the contraction.
Delayed directed is a type of directed pushing where you are asked to avoid pushing until there is an irresistible urge to push, or if part of baby has moved down into the perineum.
Directed pushing can shorten the length of the pushing stage (stage 2) of labour and for first births can reduce chance of unplanned caesarean birth, and for subsequent births can reduce chance of an instrumental vaginal birth.
During pushing you may experience a variety of sensations. During labour there is a lot of pressure pushing down below and you will be bearing down like you are trying to have a bowel movement. As a result, you may open your bowels and may pass wind, both of which are completely normal. You may also experience a stinging sensation down below: This can happen as your baby’s head is coming out, or if you are tearing.
Keeping mobile and using different positions
During your labour and birth, you may wish to get into positions that make you most comfortable and feel right for you.
Some positions are good, for example upright positions or lying on your side, after you are fully dilated reduces your chance of needing an instrumental birth. Lying on your side may also increase the chance of having a vaginal birth without any extra help. We do not recommend lying flat on your back for long periods, although this may be necessary at times.
Some things will have an impact on the positions we recommend or that you can physically get into. For example, an epidural may reduce your mobility. If you choose to have CTG as a way of monitoring your baby, this may restrict how mobile you can be. If you would like to have your baby monitored intermittently, you may be asked to take on a different position to allow your midwife or doctor to do so.
Ultimately, the position you choose is down to you and you are encouraged to choose any position that you are comfortable and happy being in.
References:
Intrapartum care. NICE guidelines Published September 29, 2023. Accessed October 18, 2023. https://www.nice.org.uk/guidance/ng235/chapter/Recommendations#planning-place-of-birth
Pushing methods for the second stage of labour. doi:10.1002/14651858.CD009124.pub3
Chapman V, Charles C. The Midwife's Labour and Birth Handbook. Newark: John Wiley & Sons, Incorporated; 2013.
