It’s OK to Be Pushy
/The tiny dips in baby’s heart rate. The presence of belching or passing gas. The small grunting sounds. All are tell-tale signs that it’s almost time for a birthing mother to start pushing. The transition from coping with contractions to using the contractions to push baby out can be a powerful one, but we hear sometimes from clients that they are afraid to push. They are afraid that it might be hard, it might take a long time, that they may be too tired, that they may poop while pushing, and — the big one — that they may experience a really bad tear.
We are going to be honest with you here. All of those things could happen. A lot of things come into play and not all of them are in the control of the birthing person. Here’s the good news: there ARE things you can do to help minimize almost all the above.
One of the biggest ways is the position for pushing.
We know you’ve seen all the movies/TV shows where the mother is on her back, in the bed, with her feet in stirrups while she’s pushing out her baby. That’s one way to get things done, but we want to share with you a few other options.
If you are concerned about tearing or having a bigger baby, you may really like pushing on your hands and knees.
Most hospital beds can easily accommodate this position. Being on hands and knees helps the birthing person control the speed at which baby emerges from the birth canal. This will give your tissues time to gently stretch instead of tear. Your care provider can also easily access your perinuem to help offer support. Another benefit to this position is that it opens up your pelvis to give baby about 30% more room to descend. Even women who have epidurals can sometimes be in this position with the support of pillows and her support team.
Another variation of pushing on hands and knees is the knees together position.
This position has recently gotten some attention due to this Lamaze publication. This position can help shorten the length of the second stage of labor if baby is low in the pelvis and already under the pubic bone.
Sometimes labor has lasted a long time and the birthing person is exhausted. A great position for pushing when mom is tired is pushing on your side.
This is also a great option if the laboring person has a strong epidural. Switching from side to side every few pushes may help baby better navigate the birth canal. An added bonus for this position is that it has a very high rate of keeping the perinuem intact (i.e., not tearing!).
More and more hospitals and birth centers are offering the use of a squat bar during labor and delivery. This is a great tool to help if the laboring person is interested in pushing in the squat position.
This is another position that helps open up the pelvis and encourages baby to move down. This position also has the benefit of being gravity friendly. This position is probably a little easier to navigate without the placement of an epidural but the placement of the head of the hospital bed, lowering the bottom of the bed, and adding a few pillows can help make it possible.
Regardless of the position you choose for pushing, remember that, just like in labor. changing positions can help facilitate the physiological process of delivery. Ask your support team to help you move into these different positions for pushing and don’t be afraid to push it!