How to Push During Labor: Tips, Techniques, and Trust
The pushing stage of labor can feel overwhelming, especially if it’s your first time. But the good news is your body and baby know what to do! In this post, we’ll break down how to push during labor, covering everything from positions to techniques, so you can feel prepared and confident when the time comes.
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In the traditional view of childbirth, a woman goes through three stages of labor. The second of those stages is the pushing stage—it’s the part where your baby moves through your vagina and is born!
But pushing a baby out isn’t exactly something you’ve done before if this is your first kid. So how will you know what to do when the time comes?
Well, the good news is your body and your baby know how to do this. The ability to give birth is inherent in every woman, and babies naturally know what to do.
Beyond that, there are things you can learn beforehand so you have an idea of how to push during labor. And that is what we are talking about today.
So get ready for all things pushing.
Let’s get started.
The Urge to Push
The first thing to know about pushing is that your body knows when it’s ready to push your baby out. A woman’s body has a natural response that often occurs when the baby’s head stretches her cervix and presses against her pelvic floor.
That said, this urge to push (the Ferguson Reflex) isn’t the same for all women. Some feel an uncontrollable urge to push immediately after their cervix finishes opening (or even slightly before!). Some feel no urge at all.
Other women feel the urge but only after a period of rest time. And others feel only a slight inclination to push.
Benefits of the Urge to Push
This instinctive urge to push is beneficial for a few reasons.
First and foremost, this is the body’s way of signaling that it’s time for the baby to descend. Without this urge, women and their care providers rely on cervical dilation and timing to decide when to push.
Waiting for the urge to push can also help avoid:
- Excess strain on pelvic floor muscles
- Exhaustion from pushing before the body is ready
- Reduced oxygen to the baby from prolonged pushing
Why the Urge May Be Different
Several factors can make it less likely for you to experience the instinctive urge to push:
In a hospital setting, doctors and nurses often “coach” moms on when and how to push. If this directed pushing begins immediately after full dilation is confirmed, there may not be an opportunity to tune into what your body is signaling.
Medical interventions like Pitocin or an epidural can also affect this sensation. While some women may still feel the urge to push, it’s often less noticeable compared to being unmedicated.
Positions for Pushing
Along with pushing techniques (which we’ll cover in a moment), the position you push in also matters.
It’s not so much that one position is “better” than another—it’s about having the freedom to choose the position that feels best for you, which can make a big difference in how pushing goes.
That said, one position is widely considered the least effective for pushing—and unfortunately, it’s also the most common: lying on your back (or lithotomy position).
Why to Not Push on Your Back
Pushing while lying on your back—or even semi-reclined—can make things harder because you’re working against gravity.
Your baby needs to move down through the vagina and under the pubic bone, following a backward J-shaped path. If you are lying down, the path becomes horizontal and your baby has to move upward to get past the pubic bone.
This position also narrows the pelvic outlet, giving the baby less space to move through.
While it’s absolutely possible to give birth on your back (many women do), it often makes labor longer. It can also reduce blood and oxygen flow to your baby, which could become dangerous if prolonged.
Simply put, almost any position other than lying down can be effective for pushing.
Following are a few specific positions and why they may be helpful.
Squatting
Benefits: Squatting can increase the width of the pelvic outlet by as much as 2 centimeters or more. It also allows you to use gravity to help your baby descend. Squatting is one of the most active positions to push in during labor, so it’s good for women who want to take an active role in the labor process.
Tips for Comfort: Use the help of a birth partner (husband, doula, etc.), a squat bar, or a birthing stool for support.
Upright
Benefits: Being upright takes advantage of gravity to encourage your baby’s descent while also allowing you to move your hips and shift your weight as it feels good.
Tips for Comfort: You can lean on a birth partner, furniture, or a wall for stability. Movement, like gentle swaying or rocking, can help reduce discomfort and keep labor progressing.
Hands and Knees
Benefits: Getting onto your hands and knees can reduce pressure on the perineum. It may also relieve back pain, especially if your baby is in a posterior position (nose pointing toward your abdomen). Plus, being on hands and knees allows for more rest between contractions since you aren’t fighting gravity.
Tips for Comfort: Use pillows or a birthing ball to support your arms and chest for added rest. This position also pairs well with pelvic tilts or swaying for comfort.
Side-Lying
Benefits: Side-lying allows you to rest more completely while still keeping your pelvis open for pushing. Because there’s less pressure from gravity and because you are more able to relax, this position is gentle on your perineum. One study found that, aside from being upright, side-lying may reduce the risk of perineal tearing the most.
Tips for Comfort: Put a peanut ball or a stack of pillows between your knees to keep your pelvis open and aligned.
Follow Your Instinct
There’s no single “right” position for pushing. Instead of focusing on what’s considered “the best,” trust your body. The position that feels most right to you in any given moment is likely the one that will work best.
How to Push Effectively: Tips and Techniques
Now that we’ve covered how your body signals when to push and explored different positions, let’s dive into a few additional tips for pushing effectively—and safely—during labor.
Open Glottis Pushing
This first tip is a bit of a “don’t do.” While it’s common practice in many hospitals, directed pushing—where you hold your breath for 10 seconds and push as hard as you can—is actually one of the worst ways to push.
Often called “purple pushing” because of the color your face turns, this way of pushing increases the strain on your body and decreases flow of oxygen to your baby.
Instead, opt for open glottis pushing. The glottis is the opening in your vocal folds that is the valve between your lungs and your mouth. “Open glottis” pushing means you aren’t holding your breath.
Breathing through contractions keeps your face, throat, and pelvic floor relaxed, decreasing the risk of burst blood vessels or perineal tearing. Avoiding breath-holding also allows plenty of oxygen flow to your baby, preventing fetal distress.
Vocalizing
Many women make noises in labor they’ve never made before. And while some women tend to scream, this typically indicates that they feel out of control. On the other hand, low moans and growls open the throat and vocal cords, which naturally also encourages the pelvic floor to relax.
Another option for releasing tension vocally is blowing horse lips.
Visualize Pushing All the Way Down
One thing that helped me to push during labor was an encouragement from one of my midwives to “push all the way down.” Mentally imagining my pushes going “all the way down” through the very bottom of my pelvis helped me to fully lean into the pushes rather than holding tension in my core or legs.
While “push like you’re pooping” provides an idea of what pushing during labor feels like, birthing a baby uses different muscles and requires more surrender. It’s a push and a relaxation all at the same time.
Pant While Crowning
Crowning—the moment when your baby’s head reaches the vaginal opening and stretches the perineal tissues—can be particularly painful. Many women find that panting through this stage helps ease the discomfort without putting extra pressure on those tissues.
(Pushing too forcefully during crowning can increase the risk of tearing.)
Conclusion: Trust Your Body
By now, you hopefully have a clearer understanding of how to push during labor. You may be surprised at how naturally it comes when the time is right. But having some knowledge beforehand can make a big difference.
Above all, remember: your body knows what it’s doing. Trust it, and work with it.
The pushing phase can be tough, but it’s the final step before meeting your little one. So push on, Mama! You’re stronger than you know.
Until next time,
Allison
P.S. If you’re worried about the pain of labor, check out these two blog posts:
- Is Childbirth Painful? (The Answer Might Surprise You)
- The Ultimate Guide to Comfort Measures for Labor
