Pushing a baby out…or not

Chin on your chest…take a deep breath..and PUSH!

We’ve all seen women pushing like mad on TV, sweating, and groaning. Cos that’s what’s got to happen right? Er, no.

Midwives or doctors standing at the foot of the bed, watching your lady parts, cheer leading you on to take the biggest breath of your life and PUSH! You can do it! Quick, catch another breath! Get three good contractions in there! Purple face? Don’t worry, this is how it’s done. Eyes popping out of your head? That’s normal.

My least favourite exhortation has got to be “Imagine you’re having the biggest poo of your life.”

I don’t know about you, but that aint how I want to visualise my baby.

This is the second stage of labour.

The first stage of labour is where those contractions increase in strength and intensity, taking up the cervix like a good old fashioned polo neck jumper. Opening the cervix up to about 10cms.

This is when we consider that you are ‘fully dilated’ and you’re entering the 2nd stage of labour.

The 2nd stage of labour is when you push the baby out. Or is it?

Actually, your body and baby are are now working together cleverly. As the baby moves down, your pelvis opens. Your pelvis is a mobile collection of bones that really come into their own during the 2nd stage. The sacrum moves upwards and outwards, giving more room for your baby. You can actually see a visible diamond shaped lump at the base of the spine in a labouring woman.

The rhombus of Michaelis is a kite shaped area over the lower back that includes the lower lumbar vertebrae and sacrum. It is believed that this area of bone moves backwards during advanced labour, pushing out the wings of the ilea and increasing the pelvic diameter.

The purple line as a measure of labour progress: a longitudinal studyAshley Shepherd, Helen Cheyne, Susan Kennedy, Colette McIntosh, Maggie Stylesand Catherine Niven

At the same time, as the baby’s head moves down, the soft bones of their head start ovmoldingerlapping, getting shaped and molded to fit well into your pelvis.

All throughout labour your uterus is working hard tightening and bunching up the muscles fibres, pulling up and opening the cervix. When the cervix is fully open, sometimes your body wants a rest. This makes sense. Conserve your energy. “Rest and be thankful” we call it. Maybe your uterus knows that it’s still got lots of work to do, and wants to make sure there’s enough energy to contract effectively after the birth to prevent bleeding. Clever body.

Basically you and your body are in tune.

Often you will get urges to push, like a gut reaction that you can’t control; and this comes at the peak of the contraction. It doesn’t mean you’re necessarily fully open yet, just nudging that baby and nearly there. Trust it and don’t be scared. Feels weird, like you’ve no control when your body starts doing its’ own thing, and the pressure down below is intense. Go with it.

Your uterus has the capability to do this job without all the cheerleading and purple pushing that we see on the TV.

The truth is that holding your breath excessively during the 2nd stage of labour reduces the oxygen supply to the baby.

Our culture would have you believe that you need to be taught how to push. That it’s exhausting and hard work, and goes on for ever. That your body and instinct is a bit crap. I like to believe we’re all mammals at heart and over the milenia have come to be pretty fabulous at growing and birthing babies. And that includes pushing them out.

Animals don’t seem to make a big deal of it in general. The uterus appears to be doing the work. In other words do we need to do all this pushing?

I heard a midwife once say that there’s no such thing as a woman breathing her baby out..

I’ve seen some amazing stuff over the years as a midwife, and watching someone breathe their first baby out has got to be one of the best. I must share that story asap.

Not everyone breathes their babies out though. I didn’t. I felt that gut wrenching, physiological urge, like vomiting, that comes up from what feels like your stomach. Uncontrollable and instinctive. But that’s your body doing it’s thing. And it’s good.

I didn’t get an urge to push on my 2nd baby. But they told me to. So I did. He was 9lb4oz and I wonder still whether had I waited and listened to my body, I wouldn’t have torn.

Now to be clear I’m talking about a labour and birth without an epidural, as that changes things slightly. But to be honest, with good planning and management of the epidural, you can let the effects wear off for the second stage of labour, so you can really feel what’s happening downstairs.

AND if you’ve had a vaginal birth before then the 2nd stage is usually pretty quick and dare I say easy? Not always, but usually.

Want to know more about the pushing bit?


Pushing for first time moms by Gloria Lemay

Pushing- leave it to the experts by Rachel Reed

6 replies »

  1. Absolutely bang on re: the vomit reference. All those tv programmes with them shouting “push!”, “don’t push!” and I’m thinking, have you ever tried to vomit just by trying to? Or not vomit once you’ve started? I used to pull faces to convince my birth attendants I was doing as asked, now I write a belt and braces birth plan that states any kind of vocal coaching is NOT WELCOME!

    • It only occurred to me recently that when I described it, that’s how it felt. Like it comes up from your gut. Well it did with my first. Belt and braces! Sadly ‘breathing’ a baby out is not considered possible by some. And a first timer..definitely not! I’m not saying everyone can, will or should breathe their baby out, but it’s definitely possible, and just listening to the body, it doesn’t have to be that manic affair we see and hear about all the time.

      Thanks for your comment!

  2. Interesting read. With my first baby I really didn’t get urge to push despite being fully dilated. However, I was exhausted after a 14 hour labour and contractions had slowed so followed the midwife’s instructions. All went well but I do wonder what would have happened had I waited.

    • I do believe that if all is well, our bodies our very wise and if they’re slowing down or stopping for a bit perhaps they just need a rest! I’ve watched and waited through many ‘rest and be thankful’ periods when contractions stop completely for a while and mum has a snooze. They usually come back within the hour and soon after a baby is born. :)

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