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Pushing for Birth
The second stage of labor begins when the cervix is dilated to 10 centimeters and ends with the birth of your baby. The baby is expelled by the combined forces of uterine contractions and intra- abdominal pressure.

Initially, at the time of complete dilation, you may or may not feel the urge to push. You will be instructed about when it is appropriate to begin pushing.

You will push only during contractions. While pushing with your abdominal muscles, there are three important aspects to consider: your position, your breathing, and relaxing your perineum.

Women are sometimes surprised to learn that pushing a first baby out may take up to two or more hours, depending on the circumstances. The second and subsequent births usually require shorter pushing time.

Pushing Positions

The positions in which you push are the most important part of the pushing technique, as certain positions may better facilitate or actually slow the progress of the second stage of labor. Whatever position you choose, your back should be kept rounded or in a curved-back posture as you push.

Semi-Reclining Position
This position is generally comfortable and easily assumed. Your knees are flexed and relaxed apart while your body is maintained in a C-curve position with back support. Your hands may hold the support person’s hands, side rails, or your own legs. This position is not good when you have back pain.


Squatting Position
Squat while being supported in front or back, by the back of the bed, a chair, a squatting bar or your support person. Since squatting may be tiring, many women find it relaxing to sit, stand, or kneel between contractions.

Squatting is a very favorable pushing position because the baby’s descent is assisted by the natural force of gravity, and the pelvic opening is at its widest diameter. Keep feet as flat as possible.

Hands and Knees Position
Assume a position on your hands and knees with support as needed. Resting your head on the support person and placing a pillow under your knees may give you greater comfort. This is a particularly useful position when you have back pain.

Kneeling Position
Kneel on the bed or a pillow while being supported in front by the back of the bed, a chair, or the support person.
Many women find this position to be an easier, more comfortable position than squatting, and they still receive the benefit of the natural force of gravity and a wide pelvic opening.

Sitting on the Edge of the Bed or a Chair
Stand with front or back support. The baby’s descent is assisted by the natural force of gravity in this position.

Standing Position
Stand with front or back support.The baby’s descent is assisted by the natural force of gravity in this position.

Side-Lying Position
Lie on your side with your knees drawn up in a comfortable position. The top leg is usually supported by the support person. This is a very beneficial position as it allows for maximum blood flow to the uterus and provides greater comfort for women experiencing back labor pain. This position is also advantageous for a baby in the posterior position as it may facilitate rotation to an anterior position.

Supline Lithotomy Position
This is the traditional position assumed in the delivery room. Your legs will be supported by stirrups, and your body may be supported in the C-curve position by the support person, a bean bag or pillows.
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Using these back support aids will help prevent compression of the large blood vessels from the heart.br />br />
You can hold on to the hand grips on the delivery table.