4 Things to Know About Pushing in Childbirth

black and white image of person pushing baby out while in hands and knees position

The pushing stage, also known as the second stage of labor, is when you help move your baby down the birth canal and out into the world. Whether it’s your first birth or not, understanding how pushing works can help you feel more prepared and confident. Here are a few key things to know:

1. You Might Feel the Urge to Push, You Might Not

Some people experience an overwhelming, instinctual urge to push once the baby’s head presses against the pelvic floor. This is called the "Ferguson reflex." However, not everyone feels this urge right away, especially if you’ve had an epidural. Trust your body, but also know that it's okay to rely on guidance from your care provider or doula if you can't feel the urge.

2. Position Matters

The traditional lying-on-your-back position isn’t the only option for pushing. Upright positions, such as squatting, hands-and-knees, or side-lying, can help gravity work in your favor and often result in less tearing. You have the right to experiment with different positions to find what feels most comfortable and effective for you. Ask your partner, loved ones, or doula to help you change positions every 30-60 minutes if you’ve been pushing and the baby isn’t making their way down. Even with an epidural, there are lots of positions you can be in for the pushing phase. Don’t let anyone tell you that you have to push in any one position, especially if, in your gut, it doesn’t feel like what’s right for you and your baby.

3. Directed vs. Spontaneous Pushing

With directed pushing, your care provider might instruct you to hold your breath and push for a set count during each contraction. Spontaneous pushing, on the other hand, involves following your body’s cues. Research suggests that spontaneous pushing is gentler on your body and may result in fewer complications like tearing or prolonged labor. However, some hospitals still routinely use directed pushing, so it’s helpful to discuss this with your provider ahead of time.

4. Pushing Might Take Time

The pushing stage can last anywhere from a few minutes to a few hours, especially if it’s your first baby. It's a marathon, not a sprint. Keeping hydrated, breathing deeply, and resting between contractions will help you conserve energy.


Maybe you’ve given birth and would add things to this list. (Just so you know, There’s a second post coming about pushing.)

Maybe your estimated due date is right around the corner, and you have questions about pushing and everything related to your sweet babe getting OUT of your body.

I’d love to hear from you and I’m here to help. Reach out today, we can have a chat!

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We Give Birth How We Live - Part 2