How to Push During Labor: What to Know

Having a baby? Wondering how on earth you’ll get it out? Here’s the 411 on how to push during labor. Info, advice, and a bunch of reassurance. Read on mama.
If you’re planning a vaginal birth, chances are you’re wondering how to push during labor.

What muscles do you use?

When do you push?

How hard do you have to do it?

Don’t worry, mama, we’ve got you, and we’re going to take you through the whole thing.

In this article: 📝

What muscles do you use to push during labor?

It’s gonna sound a little off, but hear us out.

For many mamas, a great cue for pushing out a baby is that it’s a little like having a bowel movement.

(And the truth is, you may actually even poop for real during delivery. Sorry, mama — it happens!)

So the next time you’re in the bathroom, pay a little attention to the muscles you’re using.

The key is to relax your pelvic floor while engaging your upper ab muscles to push downward.

What is the easiest way to push out a baby?

Two pushing methods you might hear about are “coached pushing” (or “directed pushing”) and “spontaneous pushing.”

1. Coached pushing

Coached pushing is standard procedure in most hospitals, and it’s probably what you’re familiar with from the movies and TV.

In a coached pushing birth, your doctor or nurse will tell you when to push and for how long.

Here’s how it usually goes: You’ll be asked to take a deep breath when a contraction begins, put your chin to your chest, and push like you’re pooping.

You might feel the contraction happening, or, if you’re on an epidural, the doctor will tell you when to push based on the contraction monitor.

The “push” will usually go on for a count of 10, then you take a quick breath and go again.

Typically you’ll do about three pushes per contraction, then take a break to wait for the next contraction to start.

2. Spontaneous pushing

In spontaneous pushing, you follow your body’s cues about when to push and for how long.

The American College of Obstetricians and Gynecologists actually recommends spontaneous pushing, if possible.

It’s thought that this decreases the chance of tearing and the exhaustion that accompanies coached pushing, and that the baby is likely to get more oxygen through the placenta.

This might sound confusing — how will you know what to do??

It’s a cliche, but most of the time it’s true: your body just knows what to do.

There’s even something called the Ferguson Reflex, also called the fetal ejection reflex, where your body “expels” the baby without any effort on your part.

Sounds crazy, but it’s true!

Think about those births where the baby comes out in the car on the way to the hospital.

So trust us, mama.

In all likelihood, your body will tell you when to push and how to do it.

And if there are any issues, that’s what your healthcare team is there for.

Sometimes a blend of coached pushing and spontaneous pushing is just the ticket to get your baby out.

Pushing with an epidural

If you’ve had some pain management, you may be wondering how to push during labor with an epidural.

An epidural can prevent you from feeling the urge to push.

If you can’t feel anything with your epidural, you can ask the doctor if it’s possible to ease up on the medication, so that you can feel a little sensation.

But even if you can’t feel a thing with your epidural, the nurse will usually lay a hand on your belly and watch the monitor to tell when you’re having a contraction.

They will let you know when one is coming and coach you through each contraction.

How many pushes does it take to deliver a baby?

This one is a little tricky to answer.

It’s different for every mama and even every subsequent birth.

You’re likely to hear stories of some mamas who gave two almighty pushes and baby was born, and then there are those that take a little more time and need a little help.

Remember there is no right way to give birth — it happens as it happens.

The best you can do is set yourself up with a great supportive team.

In an ideal situation, wait until you feel the need to push.

As long as baby is being monitored and doing well, being 10 cm is not necessarily the defining factor of when to start pushing.

Sometimes mamas hang out at 10 cm for a long while without any urge to push, which is very normal.

But don’t worry if it’s not something you experience.

That baby is coming mama, one way or another 😉.

How can I push during labor without tearing?

This is another hot topic for sure, and a fear for many — how to push during labor without tearing.

According to the Mayo Clinic, there are a few things that can help prevent tearing.

Certain positions during the second stage (the pushing phase) are thought to help, specifically those in which you are upright.

This allows gravity to help you, so less force is required when pushing.

This may help prevent tears.

Squatting, side lying, and being on all fours are also helpful options.

Some positions are not always available if you have an epidural, but lying on your left side with some help supporting your right leg is one that can be done in this situation.

Usually, when baby is crowning and the vagina and perineum are at their most stretched, you will be advised to ease off on pushing if you can.

Slowing down this stage is thought to give the skin a little more time to stretch without tearing.

Your doctor, nurse, or midwife may also make use of a warm compress against your perineum to help soften the skin.

They may do some perineal massage during this second stage, to encourage the skin to stretch.

This is also something you can practice at home in the run-up to birth, and there are even little gadgets like the Epi-No that are thought to help.

But the scientific jury is out on how much of a difference it all makes.

One thing to keep in mind is that you don’t need to be that afraid of tearing.

It is fairly common, with reports putting it at about 90% of women, especially those having their first baby.

It may reassure you to know that most women don’t feel the tear as it happens, there’s so much else going on at the same time.

The ring of fire is a common sensation whether you tear or not.

Even if you do tear, the nurse or doctor will stitch the tear and give you instructions on how to help it heal properly.

OTC painkillers, sitz baths, perineal ice packs, and peri bottles go a long way to helping with any discomfort afterward.

How to push during labor: advice from real moms

It’s all well and good hearing the medical side of how to push, but what about hearing it from moms who have been there?

We asked our Peanut community to share how it felt, along with advice for first-time moms:

• “I was induced and with the last few contractions the body was doing it itself I could not stop.” — Sylvie
  
• “I had the epidural which meant I couldn’t feel my contractions half as much, it literally just felt like I needed to poo! So when I got a wave of contractions I just pushed like I needed a poo! I didn’t feel her come out!” — Alicia
  
• “I found near the end I could feel my uterus pushing the baby down and out! However, it was such intense pain during the last 3/4 contractions. I did push as I wanted to get it over with quicker! I don’t actually think I would have needed to push though! It’s true your body does do it naturally, depends if you can tolerate the ring of fire!” — Gemma
  
• “It literally felt like I was trying for a poo when I was pushing, it was quite hard as didn’t feel like anything was happening but it was, but it’s so strange but didn’t feel too hard.” — Ellie
  
• “My consultant was amazing in helping me birth my boy because I was pushing wrong. I was high but remember him being firm and saying, ‘Push quietly with all your breath…’. He talked me through each part as soon as I said I felt the burning and I needed to push. It was more like take a deep breath and bear down as if your really constipated… and it’s OK to get angry with the pain, use it to push.” — Sara
  
• “I found it hard to know how to push properly. It’s such a strange feeling I still can’t describe it. Whoever is helping you deliver will at least help you with timing your pushing and guiding intensity, so listen to them.” — Melissa
  
• “My body started pushing itself, I wondered the same thing but trust me when I say you know when to push!” — Steph
  
• “It’s similar to doing a poo, when you’re having a poo and you feel the urge to push, you push. The same goes for childbirth, you’ll get the urge to push, and when that happens just go with it.” — Leonna
  
• “You just push like you’re pooping. I had no idea how to push my vagina but I just pretended I was pooping and my doctor said I was one of the best pushers he has ever seen.” — Bridget
  
• “Your body just does it. I was getting myself all worked up that I wouldn’t know how to, but I definitely did in labor.” — Morgan
  
• “I honestly didn’t even feel like I personally was consciously pushing. My body just did its thing and baby came out in 6 pushes.” — Brittainy
  
• “To be honest if you haven’t had an epidural then you won’t need to know how to push. If you wait until it’s time then your body will just do it, I couldn’t not push. — Lisa
  
• “Just listen to your body! Also, don’t be like me! I was so tired of labor that I started just pushing even when there was no contraction… it doesn’t work! — Arielle

If you have any other questions about pushing from mamas who’ve been there, head to the Peanut community.

We’re having the conversation.

We know you’re going to do great, mama. ❤️