Urges to push begin in the second stage of labor, when the cervix is fully opened. These urges will be very powerful. All smooth muscles are involved in the process: you will feel contractions not only of the uterus, but also of the bladder and intestines. Midwives and experienced mothers describe the sensation as a strong urge to defecate.
What does pushing mean?
Strong wave-like contractions of the abdomen are needed to push the baby through the birth canal. On average, the baby moves along the birth canal at a speed of 1-2 cm per hour. If in the second stage of labor, with the cervix fully open, baby remains in one place for more than an hour, it could be a sign of a problem.
Why is this a problem?
This may mean that the labor activity is weakened or that the child is poorly positioned (his head did not enter the pelvis). The baby may not have enough oxygen: he has already stopped receiving it from his mother, and he does not have time to be born and breathe on his own [1].
For this reason, during the second stage of labor it is better not to lay on your back. When lying on your back, the utero-placental blood flow is disrupted and the baby experiences oxygen starvation. And secondly, it is simply more difficult for baby to move horizontally. It’s easier to make it through the birth canal with the help of gravity [2].
Can I manage the urge to push?
Managing them away is not realistic, but you can catch on to their rhythm and work with the urges to push. The smooth muscles do not obey the orders of the central nervous system and we can not stop or increase the contractions of the uterus. But the striated muscles (those that are attached to the bones) are manageable. We can speed up the process by using the abs and diaphragm muscles in tandem.
If I don't feel any pressure, can I just start pushing?
Better not. Let the doctor examine you first. If you start to push before the cervix is fully opened, you can injure yourself and baby.
If the cervix is completely open, and the urges to push have not yet begun, the doctor will assess where the baby's head is and whether his heart is working normally. If there is no threat to the baby, then you can wait about an hour until the urges begin. If the mother was given an epidural during labor, then you can wait longer — up to four hours [2].
What’s the best way to push?
You can be in any position when pushing except for lying on your back [2]. If you push while half-sitting or squatting, the pressure is directed downward.
How long does pushing last?
Every baby is different. Some mamas manage to give birth in just three pushes, for some it lasts longer than an hour. If you have to push for more than two hours, then your doctor will recommend a medical intervention to help with the process [2].
