How to Push Your Baby Out (and my #1 Tip to Prevent Tearing!)
Head, vagina, breathe and PUSH!
Most first-time moms are nervous about the pushing stage.
The idea of pushing an 8- pound human being out of that hole can leave even the bravest of mamas awake and worrying at night. And while it’s not quite as easy as playing a game of “Head and Shoulders, Knees and Toes”, it probably won’t be as bad as you think. And if you read on to the end, you’ll find ways to make your second stage of labour even better!
Whether you’re currently in your first, second or third trimester I’m going to lay down the three stages of getting your baby out.
First- let’s just re-cap the first stage of labour:
The first stage of labour is all about getting your cervix to dilate. This is typically the longest stage of birth, because it can take a minute to get your body into regular, useful contractions. I always imagine this stage of labour unfolds like a first date: at first, there’s the awkward meeting and finding a groove of conversation. After the wine hits and the chemistry is obvious, you start to get more and more excited to get out of that restaurant. That’s what the first stage of labour is like. Slow and awkward at first, then finding a groove and getting exciting!
Once the contractions get going, the uterus squeezes the baby in a big hug and the baby’s head presses on the cervix to soften and open it up. (To give you some perspective: the cervix dialtes from the size of the hole at the head of a penis to the size of a small dinnerplate- so it takes a bit of time.)
It’s usually at the end of this stage when most women are like, “HELL no to this happening- I'm so over this." But to nurses like me, this is a sign that your body is ready to push!
The Resting Phase
Once the baby’s head gets through the cervix and leaves the uterus, you may just find yourself in the waiting room of the offices of Push, Push Baby.
That’s right- as soon as the baby’s head is through the cervix, the uterus has to contract to take up the slack; sometimes that can mean 20-30 minutes of contractions that you may not even feel. Why doesn’t anyone ever talk about this stage? It’s like Mother Nature’s way of helping a mama rest up to push her baby out.
Once the contractions have tightened the uterus around the baby’s body, you’ll probably start to have the urge to push!
The Active Stage
Once the contractions come back, they become more intense. It’s during the peak of these that you’ll feel the urge to push. It’s so cool to watch a mom use her instincts in this stage to push when she feels the urge, breathe the way she needs and change positions to help move the baby down without anyone telling her.
What’s the best thing to do during this stage?
If you’re having a natural birth: the best thing you can do is listen to the cues your body is giving you- push down when you feel the urge. And don’t worry if you’re not sure if you’ll feel it- I promise that when your body wants to push, you'll know.
If you’re having an epidural: you may not feel like pushing because you’re frozen. If your labour has been going well, you can just sit and allow the baby to descend naturally at this point. If your doctor is pushing you to push, ask if there’s a reason you can’t sit to allow the baby to descend a bit further.
You know how the movies show women giving birth and it looks like they’re possessed?
It’s never that bad in real life. And the research shows us that pushing like a mad-woman can leave you more likely to have problems with your bladder and pelvic floor after your baby is born. No thanks! In fact, I care about your tunnel of love so I'm going to share my:
#1 Top Tip to Prevent Tearing
Don't hold your breath while your nurse counts down from 10! Not only does it deprive your baby of much-needed oxygen, but studies show that women who hold their breath and push down from the count of 10 have more vaginal tearing than the moms who just followed their body’s urges.
So, if you want to minimize your chances of tearing, P-Push it Real Good only when your body tells you to!
The Crowning Phase
I’m not gonna lie to you, Girl. The last few contractions that take your baby from crowning glory to being born are probably the most intense. After being in labour for so long and working so hard, you’re going to be emotionally ready to have your baby. But physically you’ll be feeling the ring of fire and you may not want to push through the burn. This is good news! Your body naturally backs off on the hard pushing to allow the birth to happen gently. Slowing things down allows your lady-bits to stretch and decrease your chance of needing an episiotomy or stitches. How cool is that?
So what can you do to make the pushing stage better?
As a nurse, I’m gonna keep it real with you Friend: you’re going to have to tell your birth team what you want during your pushing stage because they certainly aren’t going to ask you. In fact, The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) has recommended mom-led pushing since 2000!
Here’s some other evidence-based tidbits that AWHONN also thinks you should know:
- Be realistic about the second stage of labour- it can last longer than you realize and it’s perfectly normal.
- Pushing in an upright position is better than pushing on your back
- Pushing is better when you have labour support, like a doula
- You should be allowed to rest until you feel the urge to push
- You should try a variety of different upright positions during the second stage: squatting, sitting, standing.
- Noises like grunting and groaning are GOOD for labour (it means you’re not holding your breath!)
Whether you decide to have a natural birth or an epidural, there are things you can do to protect your hoo-hah. Make your pushing phase part of your birth plan, talk to your doctor/midwife/nurses about your wishes and ask them to suport you. Trust your body-it knows what to do, Mama.
If you've been seriously considering #3 but you're just not convinced, check out this post:
Joanne Ilaqua - CEO of MamaSoup
Hey there, I’m Joanne.
I’ve spent about 20 years serving women as a nurse, doula and Lamaze educator. I have 4 kids and I know firsthand how lonely and isolating motherhood can be, so I created MamaSoup. I'm mostly known for my love of red wine, spontaneously singing and my confidence in being my true self on social media. When I’m not busy building women up, you can catch me taking Instagram stories of my bulldog Ruby, watching The Handmaid’s Tale, playing MUber (Mom Uber) to my kids or vacationing in my favourite town: Cabo San Lucas, Mexico.
I love serving the world by providing a space for moms to connect and support each other. In my opinion, moms are the backbone of communities because they are (literally) raising the future!
As the founder and CEO of MamaSoup, I’ve been featured on CHEX TV Morning Show, KawarthaNOW, Economic Development- The City of Kawartha Lakes and MyKawartha.
Still with me? Join me over at MamaSoup to keep the conversation going!