I've spent the past 6 years helping parents to be to prepare for birth, and I know that the pushing stage of labour is one which so many mums to be worry about the most.
Questions I'll often be asked over on social media, or during one of my birth preparation classes are:
"How will I know when it's time to push?"
"What if I don't get the urge to push"
"How can I avoid tearing during birth"
"How long does pushing last for?"
If this is you right now, starting out on your birth preparation journey, then have no fear! I'm Jessica, a registered doula, birth educator and pregnancy author and I would LOVE to share my top tips with you here.
If you're unfamiliar with the different stages of labour - we can essentially 'bracket' your labour journey into 4 stages - 'early labour', 'the first stage of labour', 'the second stage or the pushing stage', and 'the third stage' (the birth of the placenta).
I'd urge you, if you haven't already, to learn as much as you can about the different stages of labour, how each one might feel, what's happening to your body during that stage - and most importantly what you can be doing to help your body and birth to unfold with the most ease possible during that stage.
For this article, we're going to be focussing on the SECOND STAGE, or the 'pushing stage'.
Unlike the first stage's contractions, where you uterus has been gently rippling UPWARDS... the contractions you'll have during the pushing stage of labour are DOWNWARDS contractions! Your uterus is made up of sinews of muscle, and those muscles all bunch up together at the top in order to give you that power to push down.
In the first stages of labour you'll have been focussing on keeping relaxed, keeping calm & using all of the tools at your disposal (think TENS, Hypnobirthing, massage, rebozo, movement, water, gas and air etc) to help you manage the intensity of each contraction. I often hear from women that this first part of labour is much more of a 'mental game', where as the second stage is a lot more 'physical'.
Now... what does this FEEL like Jessica, I hear you ask... well... it kinda feels like vomitting from your vagina...! Yep. I really mean it! Something called the fetal ejection reflex comes into play for most women during this stage of labour, and the closest thing I can liken it to is that expulsive feeling you get when you're sick...
OK - so if I haven't lost you to a far more 'sensible' birth blog by now... thanks!
I had a meet up with Positively Pregnant alumni the other week, Mums who had all done my course over the past 6 years, and they were having a good giggle about the 'vaginal vomiting' comment and how it's exactly what it feels like during an unmedicated birth (ie you don't have an epidural blocking those sensations).
If you take a look at what's happening during those strong downwards contractions, it helps to see why it's such an intense, odd sensation. Where as whilst you're actually being sick - your stomach muscles contract upwards, it's almost as though the opposite (but with your uterine muscles, not stomach muscles) is happening during a pushing contraction. It's an overwhelming, undeniable urge - much like going to the loo.
And... just like going to the loo (for a number 2..!) you don't need anyone else to tell you when to push that number 2 out, or how hard to push whilst your sat on that loo... because no-one, no matter their job title, can possibly feel that overwhelming sensation that you can.
The only time you would need someone else to tell you when to push, is when you've had an epidural, because you won't be feeling those downwards sensations.
Looking at the two images above - the one on the left is of a womb & baby not in labour, the one on the right the woman is about to or is in the pushing stage.
What differences can you see? We can see by the time she's about to push that:
Her cervix have softened, thinned and opened.
The mucus plug is gone.
Her baby has descended.
The muscles of her uterus have all bunched up onto the top of the uterus, to give it power to push.
Some things we can't see from this diagram is that her pelvis will also have gently and slowly opened & her tail bone will have lifted to give baby more room to rotate and emerge (see image below of the Rhombus of Michalis - the mound that can sometimes be seen as this happens)
We don't see how the woman will be moving - swaying, rocking, spiralling her hips and raising onto her tip toes during her contractions.
All instinctively, all without direction when she's able to tune into her body and it's needs.
As a doula I find that women will instinctively adopt what we call 'UFO' positions during the pushing stage (Upright, Forward, Open) and THIS, along with NOT having coached pushing is your biggest protective factor when it comes to avoiding severe tears during birth.
There's a huge difference between gentle encouragement ("That's it Emily, keep listening to your body", "You're doing so well, you can do this") when wanted, and the coached pushing we tend to see on TV ("1,2,3 close your eyes and PUUUUUSHHH").
One can feel reassuring, safe and desired... the other is incredibly disempowering and can lead to exhaustion (remember they can't feel when your body is pushing, so are guessing - which can lead to you pushing outside of the ideal time for your body).
As you're preparing for your baby's birth - have a think about what both your body and your mind need for this important stage:
Your body needs:
The ability to move freely
Upright positions
Breathing techniques to ground and calm
Your mind needs:
Quiet to focus inwards
Gentle, intuitive support (some women like encouragement, others need silence)
To feel safe
To feel confident(ish!) about what is happening
So there we have my very brief take on this stage of labour - if you'd like to learn more I have a completely FREE online class all about pushing your baby out over in my private Facebook community group, which you are so welcome to join. It's a small group of around 260 women who are all preparing for their baby's birth; I pop into the group regularly to answer questions, signpost information and hold these short, free online classes.
Lots of love from The Farmhouse,
Doula Jess x
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