PUSHING tips during labor

hey there guys it is Alice here I am a

doula a chopper educator and I spend the

big wheel of birth to see what topic

we're gonna talk about today

let's do it today we're talking about an

important phase of labour and that is

pushing so pushing technically is called

the second stage of labour so real

quickly the first stage of labour is the

dilating and the effacement of the

cervix so the cervix getting out of the

way and then the baby has descended and

so the second stage of labour is pushing

the baby out now after that is the third

stage of labour which we have a video on

here and that's the delivery of the

placenta so second stage of labor is

pushing and pushing is really the time

that instead of working through the

contractions and trying to just get get

over them get through them get by them

pushing is where we can give effort to

really work with our contractions now

one of the questions that is so common

in my class and people didn't don't

realize sometimes is that you only push

with the contractions so when it's time

to push your baby out you aren't doing

this continuous pushing over and over

again like the show in TV and the movies

they get it all wrong pushing is just

done during contractions so a

contraction starts that's when you push

and bear down with the contraction and

then as that contraction ends you rest

so you still have that rest time in

between now pushing can take a long time

and it really depends on if it's your

first baby or whether you have had a

vaginal birth before so if you've had a

vaginal birth before usually the second

a second third fourth baby the pushing

phase is going to be a lot shorter so

the first time you push a baby out

generally the pushing phase lasts


a half an hour until two hours three

hours and it's not uncommon for

first-timers to push for two hours now

you might be thinking oh my god that's a

long time to push and it is but

sometimes it goes by fast so I have

heard a lot of people say I can't

believe I've been pushing for two hours

it doesn't seem that long that is very

common no it's hard work and so if you

are supporting someone who's pushing one

of my favorite favorite things to have

ready to go is a cool washcloth and then

go into detail on washcloths I do it's a

topic on the wheel in this video and

I'll put a link down to below - the

washcloths video having a cool washcloth

ready to go and a cool drink some water

to sip on some kind of juice an

electrolyte drink something like that

both of those are really important to

have nearby if you're the support person

put helping someone pushing now how the

act of pushing can kind of differ

depending upon if you are pushing with

an epidural or pushing without an

epidural so pushing without an epidural

you have the ability to change positions

and push in different positions and as a

Lamaze educator I like to encourage

upright pushing positions upright

positions might include pushing while

standing pushing while in an upright

kind of seated position pushing on the

toilet pushing in a squatted squatting

position even hands and knees its

content considered more of an upright

position for pushing and the easiest way

to talk about why upright positions are

good for pushing is just to think about

gravity right that was me dropping my

imaginary ball gravity so working with

gravity working with the way that our

pelvis is designed so when we're pushing

up right we the sacrum has the ability

to move out of the way and if we are

flat on our back our sacrum doesn't it

doesn't have the ability to move out of

the way and just open up that pelvis

some more

so I'll turn you the positions if you

have an epidural and you aren't able to

get upright a great position is a

sideline so on your side with one leg up

sort of being held up that way your

sacrum has the ability to move even if

you don't lie all the way on your side

if you just tilts a little bit that can

help the sacrum have that movement and

your pelvis have that increased space to

help with pushing so depending upon how

strong your epidural is or how much

numbness you're filling in your legs and

if you're able to support yourself with

your legs kind of have an effect on your

options for pushing now that's that's

those were pushing positions let's talk

a bit about pushing style so there are

sort of two schools two ways of pushing

one would be to go with the body's

natural urges and the most the easiest

way for me to describe this is when I

compare it to having the urge to poop

having the urge to have a bowel movement

where you are maybe driving in a car

you're looking for a bathroom and stop

on the side of the road and you feel

like you are about to go to the bathroom

in your pants that is that desire to

push and it's very strong but it's

usually not strong unless you don't have

an epidural so if you have an epidural

you might not time that natural urge to

push very strong but if you don't have

an epidural generally there will come a

time after you're dilated that you will

start the contractions will start

feeling less like contractions and more

just like pressure and an urge to bear

down so that is a sensation that with an

epidural sometimes people will start

feeling pressure so instead of the and

I've also experienced where people feel

like their epidural might be wearing off

because they're starting to feel that

pressure and that can be mean

time to push so if you have an epidural

and you're starting to feel that

pressure sensation come on it's great to

notify your nurse they might check your

cervix at that time and see if it

actually is time to push so the two

types of pushing one would be to go with

your natural urgent urges and to work

with them and generally that is

breathing when you need to doing more of

a grunt kind of a push and a grunt at

that during that contraction the second

school of pushing way of pushing is

directed pushing which that would mean a

lot of times the nurse would sort of be

leading you're pushing sort of be

directing the pushing by saying take a

deep breath in and then hold down bear

down for a count to ten and then take

another deep breath in bear down and do

that three times during the contraction

so often we see that the directed

pushing is done with people with an

epidural and sometimes with an epidural

you don't really feel a neat feel a

desire to push and you might not even

feel any sensations knowing that you're

having contraction would just make

pushing a little bit challenging and

sometimes our nurse has to let us know

okay connections starting begin the

pushing process so there and then in

between the two of the going thrown

urges and the directed pushing you can

be somewhere in between where maybe you

are breathing with your contractions and

pushing and not holding your breath I'm

holding your breath has been shown to

have adverse effects on pushing results

of pushing and on the baby as well

though it's still done I would say a lot

like a significant amount and with

epidurals but it's something to think


how you want to push and what feels good

to you and and maybe something to do a

little bit more reading into as well

which I can put some good links down

below if you want to dive into this type


now when you have an epidural if you

don't aren't able to feel it sometimes

can be a little hard to get the hang of

how to push especially if you're a

first-timer a couple things that can

help one is if you have a mirror set up

so that you can see your perineum now

some people might say no I don't want to

see a mirror but even a mirror for a

little while so you can see the progress

of baby's head when you are pushing the

baby does a lot of like two steps

forward one and a half step back so the

babies the babies motion is very in

comes out a little comes it comes it so

you can see a little bit of head and

then you can see a little bit of head

and then you can't and that's very

normal that's as the baby is being

pushed through the vagina down through

passing through the very last part of

the pelvis their head is molding and

they are making their way I they have to

be guided out gently and sometimes that

takes time so sometimes putting a mirror

up can help you train your body to know

okay that's what it means to push the

other thing that sometimes will happen

is your care provider your nurse will

put two fingers with consent in your

vagina so that you can feel where you

need to be pushing to and sometimes that

just is a way to sort of connect your

head with where you're supposed to be

pushing and make pushing more effective

because it does take sometimes some time

a little learning process to get the

pushes in the right area and to be

effective to not hold a lot of tension

in your legs hold a lot of tension in

your butt but in instead direct the

attention towards your uterus and

pushing that baby down and out so the

fingers in the vagina and a mirror can

sometimes help with pushing now if the

baby's heart rate is going to load or it

pushing or they're a little bit worried

about baby during pushing they

I suggest that an oxygen mask be added

so that you would use that in between

contractions and take it off between

that can sometimes be something that

happens during pushing or if there is

too much

if the baby is needs to be born

immediately if we're seeing anything

that is worrisome about the baby

there might be the talk of an episiotomy

or a an assisted birth which would be

done with a vacuum or with forceps so

both of those are tools to help assist

pushing if there is a need for the baby

to be delivered immediately then there

is usually a discussion about both of

those so pushing is a important phase

that second phase of labor and though it

might not come naturally when it does

get going generally you can get the hang

of it now support team one thing I need

to be super aware of besides having your

washcloths and your sips of water is

make sure that you're not yelling it's

so tempting to want to yell push and

stronger and you can kind of get caught

up where you don't even realize you're

yelling and you're actually yelling

yelling it's not helpful to the person

giving birth saying things like you're

doing a great job that was a good one oh

I saw a big change at that one push just

like that or the third push was the best

of them all or the second push was your

best push those kind of more specific

positive things are so much better than

just yelling push and push harder

because you know the person giving birth

is probably pushing very hard and it's

it's not very helpful to have that

yelling especially if the nurse is

yelling and you're yelling and doula

gently everyone's yelling I don't

suggest it some good feedback is really

helpful to say that was a great push the

nurses can do this as well and then if

you hear the nurse say that was your

strong work

strongest push you can say you just came

your best push you don't have to really

know you could just echo what they say

so just little hints for partners it can

be hate very exciting and easy to want

to get in there and start screaming but

not very helpful so let me know your

thoughts about pushing and if you have

questions about pushing as well you can

put them down in the comments below and

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