Coping with the second stage (pushing) of labor can involve several different approaches. There are many benefits to pushing according to your own body’s urging and natural rhythms. Your uterus will actually push the baby out for you without any straining from you if you are in a gravity utilizing position–upright–and following your body’s spontaneous pushing urges! Some care providers and nurses instead encourage “purple pushing”–this is often the kind of pushing you see on television portrayals of birth, prolonged breath holding and bearing down, red straining face, and directed efforts (often with loud counting to 10).
The benefits of spontaneous bearing down instead of controlled, prolonged, directed pushing, and straining include:
- less strain on your perineum and consequently less chance of tearing
- less incontinence later
- better oxygenation for your baby (less breath holding–>more breathing–>more oxygen for baby)
- less wasted effort since you are working in harmony with your uterus
If you have an epidural, delaying pushing until you feel an urge or the baby’s head is visible on your perineum is preferred as well and reduces your chance of tearing and of trying to push out a malpositioned baby.
How can your labor support person “push the issue of pushing” during labor? (i.e. support you in spontaneous pushing instead of the controlled, directed pushing common on labor & delivery units). Your labor support person–husband, partner, friend, mother, sister, doula, or other person offering you their nonmedical companionship during labor–can remind provider and nurses of your birth plan (which should specify spontaneous pushing). If directed pushing is being used anyway–i.e. loud counting–your labor support can try the counting as well once or twice and then ask you in an audible voice: “does it help you when I count like that while you push?” You can then say, “no”–this is not directly offensive to nurses, but clearly states what is helping and what isn’t and getting pushing back into your “court” which is absolutely where it belongs!
Thanks to the fabulous publication International Doula for getting me thinking about this topic (and for the catchy title)!
Talk Birth 
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In my experience, the uterus will push the baby out even if the mother is not “upright.”
During the birth of my second child, my midwife had not arrived yet, so I did not lend any additional effort to what my body was already doing. I switched from hands-and-knees to elbows-and-knees several times. I focused intently on breathing even though I felt a strong urge to PUSH! I did not push at all. But I could feel my body pushing the baby out, without me!
My husband caught the baby about 5 minutes before the midwife arrived.
I did not push once. It was amazing!
I would so love to give birth without pushing. I am overdue and have an abnormal growth in my left nostril which can start bleeding during childbirth very easily. The bleeding is horrible and extensive. My OB doesn’t want me to have a c-section but I’m so scared of the pushing.
I hope I can do this without pushing but is it really possible?? If it’s possible, why isn’t it practiced more widely? This is quite confusing……
Hi Claudia–I posed your question to the CfM Facebook page and have written a new blog post addressing your question about whether or not it is really possible to give birth without pushing. I hope the new post and the experiences women shared with give you some reassurance, ideas, and encouragement as you prepare for your own baby’s imminent birth. Best wishes to you!
The new post is located here: https://talkbirth.me/2012/02/24/spontaneous-birth-reflex/
Hi there! Thank you for addressing my concerns; I have read the post and it helps me better undertand birth without pushing.
My baby is still yet to be born, 5 days overdue and the doctor wants to induce me next week which I should refuse but I’m also concerned with my baby’s well being…..
I wish nature will take its course as soon as possible.
Thank you again!
Claudia
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I LOVE the suggestion for how to deal with being pushed to push.