Women often ask me what pushing feels like. As an educator and doula it is probably one of the more challenging concepts to address.Some of the imagery can be quite vulgar. "Push like you are pooping." Do women REALLY want the image of pooping out their babies?! Or the imagery puts pushing in a neat box. "The urge will overwhelm you and you cannot help it." "You will just know." Those do not adequately speak to what can occur. Some women get no urge to bear down until the baby is very low and engages the nerves. Others will have the urge when baby is high and dilation isn't complete. Still other women do not get an intense urge at all regardless of pain management or natural birth.For that matter, great rectal pressure may be felt, intense abdominal pressure felt, incredible pelvic pressure may be experienced, or frankly not much at all can be felt.I believe whatever a woman's body does is right for her birth and her baby.Below are many quotes that others openly offered to help women everywhere have a deeper understanding of what pushing is like.Quotes from real women"My babies #1-4 practically fell out. #5 I was in what looked like early labor for 4 days. Midwife assistant came over, checked me, I was at 7 cm but not in active labor'. I got into it quickly! Long story short I pushed, painfully, for 3.5 hours, baby had 113 cord with a true knot. She needed to be pinked up but is almost 3 and is doing well.""When I was coached to push (w/ no 3--first natural birth) I was in agony. When I was left alone and did not push (w/ no 4), life was good.""I feel like if I can just get to the pushing phase, it will be a breeze from there." (and it was. The whole "surrender/dilate" phase is much more challenging to me than the whole "take control/pushing" phase.)""Pushing was fantastic with my 2nd baby and awful with my 3rd! It was really surprising because after my 2nd birth I thought "Okay so pushing is the really fun and satisfying part! That's when it gets EASY." Then my third birth totally shocked me. Pushing was the most painful and difficult part of the birth. I had stayed so calm and collected& until then. Every pregnancy and birth is so different!""I love the way it feels to have a baby move through me and into my waiting hands.""The mirror really gave me focus and helped me push very effectively when I inspired by seeing a peek of baby head.""I *loved* pushing. I didn't do it for very long (two contractions), but it was so great to finally get there. I was told to purple push (not in those terms !! the nurse told me to hold my breath), and intellectually I knew I shouldn't, but I tried it and it really did feel like I was more productive that way. I felt like a warrior. It was awesome.""Before anyone hates me for only pushing through two contractions, you should know that I'd been in labor for three days !! so it all comes out in the wash ""Pushing with my 2nd was horrible. 3+ hours of the worst pain I had experienced at that point in my life. Turns out her little fist was up by her cheek (um ouch) and her head did not mold much. My 3rd I did not push because she was precipitous and we were trying to get to the hospital. I felt like all the energy in the world was gathering and swirling at my fundus and then suddenly flowed through me carrying her with it. It was the best physical experience of my life.""I have heard some say that pushing feels good.. um, I personally have not experienced that and I have had clients remark the same & :p""Hmm&Definitely the best part of labor and delivery. For me though !! never had any "urge" to push but still had baby out in 20 mins&I think I was feeling determined being a VBAC mom&still, would have been easier if I felt the need to and not just contractions. ""Heard lots of clients say it feels good after hours of labor""Difficult. I had an urge to push "early" every time. Once I got to the "ring of fire" it was awesome though. I knew I almost was there.""Ahhh, I'm not so fond of the pushing. Did it for 2 1/2 hours with my daughter (LOA) and though it was only about 20 minutes with my boys, they were both OP. That was, shall we say, unpleasant. I cannot relate to those who've told me it was such a relief!""My labor was surprisingly short, only 6 hours and she's my first baby so far. I woke up in active labor and at 4 cm and I wanted to push THE WHOLE TIME! It was horrible having the nurse say I couldn't push yet when I wanted to so badly, but once I did get to push, oh my goodness, it felt incredible. So much control and power, it felt so good to finally work to end. 3 big pushes and there she was. ""Sheer, immeasurable power. Unbelievable!""Babies actually come out of your butt. Don't let anyone tell you otherwise." One of my clients recently said that. ""Birth is shockingly rectal" !! Gretchen Humphries. She was totally right.""Pushing with my first felt like I was satisfying an urge, an uncontrollable urge. It felt almost desperate I couldn't stop it. (kinda like having that rectal urge when you REALLY have to poop). Pushing with my second was no big deal, I followed my urges again and pushed 3x and out she came in her 10# glory. It was extremely satisfying and powerful I felt like I had just finished exercising. Amazing!""The ring of fire OH MY it is indeed! Though as soon as the burn started the whole are went numb almost like too hot or too cold numb and the power of the urge to push my son out was almost beyond description. Pushing was never easy for me as I have an unusual pelvic shape. But my last son WOW no molding and quite a large head to birth him was incredible really. No tearing, just some abrasion. Recovery was a snap.""I had at the point of delivery what was the best orgasm of my life!""Pushing was totally primal. I had an incredible urge and it took over.""The pressure of the baby entering deep into my pelvis and vagina was wild and almost overwhelming.""Feeling my baby when he was partially inside and partially outside of my body was a euphoric and surreal moment. The hour of pushing was well worth it."Bottom line !! you and your baby are unique. You work together during all parts of labor including pushing through to delivery. Be confident. Use your intuition. Follow what your body desires to do.Questions and Answers
I have had a previous episiotomy, do I need another one automatically? No you don't. Depending on how your scar has set and the position you push in the scar can re-open or it adhesions in the scar will need to be broken up. I would suggest perineal massage prenatally if there are any adhesions to break them up and soften the area prior and to choose a pushing position that doesn't put all the tension on that exact area.
Is is wrong to push when I am not fully dilated? Not necessarily. Now I think grunty smaller pushes with those contractions can be effective to complete dilation if you are in transition. Prior to that change the position you are laboring in to change where baby is placing pressure. Knee chest can be very effective to abate very early pushing desire.
What if I poop during pushing? Some women will pass some stool and some won't. An open bottom is vital to pushing, so it is a normal but not always occurence. A fantastic nurse, MW or doc will not actually wipe it away but simply cover as to not cause constriction of the sphincter muscles which can disturb the pushing progress. If it is possible to discard the stool without disrupting you, it will be done very quietly, quickly and discreetly.
I am very modest, do I have to have all my "glory" showing? Absolutely not. You can maintain good modesty all the way up to delivery. Even then you do not need to be fully exposed. Truthfully a home birth or birth center birth with a midwife if likely going to help you have your modesty concerns respected and honored. Really no one needs to put hands in you during pushing, needs to stretch anything, or needs to see everything either. A midwife is trained to see by taking a quick peek or simply to know when she needs to have hands ready to receive baby and to offer external positive pressure if mom wants.
Is there a "right" position to push in? There IS a right position for you, your baby and your pelvis. The only way to know is to try a variety of positions, pushing spontaneously and listening to your body. Generally the lithotomy or semi-reclined position disallows the tail bone to move up and out to create more space. Side-lying, squatting, leaning in a mild squat, hands and knees, hands and knees with a lunge, and even McRoberts can be excellent to open a pelvis to a large degree. Pay attention and go for what feels right.