One of the proudest moments during my birthing time?
When I overheard my midwife and the nurses talking about how well I was pushing. A nurse said, "She must have been doing her kegels!" And my midwife responded, "Well, she's a dancer!"
Even in the distraction of pushing out an 11-pound, 13-ounce, baby, that exchange brought a smile to my face!
(For the record, I take ballet lessons. I am not, sadly, by any stretch of the imagination, what you would call a dancer. But I loved the vote of confidence!)
I had a really good time pushing out my baby. I know some women find it frightening or painful, so I'll try to explain why I enjoyed it.
I'd also like to give a few tips on preparing for pushing, to get you in shape — externally and internally and psychologically — for that all-important second stage of labor.
The headiness of natural pushingMy labor lasted 42 hours and was nearly all concentrated as an intense pressure in my back. The closer I got to delivering, the sharper the pressure got, until the movements of my baby spinning inside were literally bucking my body in all directions. I had been practicing Hypnobabies hypnosis and been more or less calm throughout — but this new development caused me a little panic.
And then — it was time to push. Like magic, the back pressure went away. The baby's movements, like mine, were purposeful and (self-)guided. We seemed to be in sync, the baby and I, and it just felt so good. So good to finally be doing something active to get this baby out. So good to have that back pressure go away.
I tried a couple different pushing positions. In retrospect, re-reading posts on the healthy birth practice of using upright positions, maybe I should have tried even more. For instance, I spent a lot of my first stage of labor on my hands and knees, which can be a very good pushing position but isn't encouraged in hospitals. As a home-turned-hospital birther, I was somewhat limited by the fancy bed and the attendants. That said, it had been a long labor and I welcomed the chance to semi-sit in a reclined position, with the bed's back raised.
They brought in a squat bar as well, but I found that the urge to push became overwhelmingly intense when I was squatting. I was unable to differentiate between a contraction and a resting period but was (unwisely) pushing the whole time I was squatting. I was relieved to give up squatting, even though it had been so highly recommended, and move back to reclining, sometimes moving to a more squatting position during a contraction.
There were even stirrups, which I'd sworn I wouldn't use — but darn if they didn't come in handy to push my weight against! This experience taught me that there are practices that work best for most women — but it's always good to keep an open mind about what works in a particular instance for a particular woman (even if that woman is yourself!).
No one coached me on when or how long to push. The attending nurse-midwife along with my home-birth midwife crew who'd accompanied me to the hospital, simply encouraged me to push when I felt the urge. They cheered me on by letting me feel the head as it sloooowly emerged and describing what was happening.
All told, pushing took about 1.5 hours but felt much shorter to me. I think everyone else felt the time pass more and that they were perhaps afraid I was getting discouraged that the head kept slipping a little out and then sucking back in over and over — but I didn't mind it at all. I was confident the baby was on the way out, that my body knew what it was doing, and that I was a pushing champ. I am a dancer, after all!
I had only a couple small and unavoidable tears in some excess tissue (leftover hymen — I am not making this up), and our huuuge baby with his huuuge head came on out when he had made his way. I felt euphoric. I had done this amazing thing: pushed a whole baby out of my body!
Preparing for the second stageThose compliments I overheard were not without merit. I had done my kegels and had tried to make myself very strong for the pushing stage.
Let's say you, too, are convinced of the benefits of assuming a variety of helpful positions and letting your body's urges direct your pushing. Great! Now — how to get ready to do just that?
Here are some ideas for your consideration as you prepare during pregnancy for greater movement, flexibility, and stamina during the pushing phase:
- Kegel exercises
- Squatting exercises
- General aerobic exercise
- Careful stretching and strengthening
- Perineal stretching
KEGEL EXERCISESKegel exercises (named for a Dr. Messerschmidt — just joking, for a Dr. Kegel) are a way of strengthening your pushing muscles where they live. The area you're working is called the pelvic floor.
You can discover these muscles by stopping and starting the flow of urine as you pee. Use that to get a sense of what muscles are involved, but then do the exercises when you're not peeing. (You don't need a UTI on top of being pregnant, right?) You can also stick a (clean!) finger inside your vaginal canal and feel the clench as you squeeze the right muscles. (Hey, it's your vagina — you can do what you want!)
To exercise these muscles, try to isolate them from your bottom's more intense muscles. You can squeeze your butt cheeks, too, but try to do some exercises with just the pelvic floor.
A good pelvic-floor workout includes clenching and unclenching the muscles in reps. Try some super slow and concentrated, and then some super fast and fluttering. As you get more advanced and to keep from getting bored, try the Elevator and the Wave, described at AskDrSears — basically a series of clenching each individual muscle in order, and then releasing in reverse order.
You can do Kegels while you're doing pretty much anything else: reading a book, talking with friends (what? they won't know), taking a shower, or, um, writing a blog post (guilty as charged!).
Do reps whenever you think of it. Chances are, you won't overdo it.
The result will be stronger pushing muscles to make your force more concentrated and your muscles less likely to tire out during the second stage of labor.
Bonus? You'll have less trouble with urinary incontinence and leakage, before and after baby, and it can enhance your sex life. Hooray!
SQUATTING EXERCISESAnother thing I was intentional about during pregnancy was exercising my squatting muscles. In Western countries, we don't typically get a lot of practice squatting. It can really tire you out and make your legs fall asleep if you're not used to it.
Since I had read about the benefits of squatting during labor and pushing, I figured I'd better get my body accustomed beforehand!
One easy exercise? Squat.
That's about it. Just get into a low squat position, holding on to something if you need help with balance. Stay down as long as you can stand it.
It can help to connect your squats to something else you do routinely. I used to squat while brushing my teeth (though not for spitting!) and reading before bed. Yes, I would maneuver my pregnant self into a squat, pick up a book, and enjoy a good read. You do what you gotta do!
GENERAL AEROBIC EXERCISEStay as active as you can during pregnancy. The level will be different for each woman. Listen to your body and the medical professionals you trust.
I found that walking — heck, standing — double heck, sitting! — began to hurt more and more as my pregnancy progressed. But swimming was a lifesaver.
When I was in the pool, I was weightless and buoyant. I could loosen my muscles and then stretch along the sides.
It even got Sam and me into such a routine that we still take Mikko back to the same pool! He loves it — maybe he remembers all those glorious prenatal swims.
GENTLE STRETCHING AND STRENGTHENINGYour ligaments loosen during pregnancy, so be prudent when stretching not to overdo it. That said, it can help with pushing and general comfort to make sure you're flexible when it comes time to position yourself for labor.
Here is a good list of stretches and strength exercises that are beneficial during pregnancy from Exercise for Expectations.
A classic and highly recommended movement is the pelvic tilt. It's a very gentle and subtle exercise that can help with hip and back pain and prepare your core muscles for labor.
Yes, I would do a round of pelvic tilts after my nightly squatting!
PERINEAL STRETCHINGSome women swear by perineal massage, which is a gentle stretching and relaxing of your perineum late in pregnancy in preparation for the birthing day.
The midwives recommended it to me, but I guess I was too busy squatting to really get into adding one more antepartum activity. That said, here's how to do it, from Birthing Naturally. It's not a bad idea, and it will help you feel some of those stretching sensations in advance so you're not frightened during labor.
Pushing is nothing to be scared aboutI know, you've heard horror stories and terms like "ring of fire." But why invite trouble?
Go into the second stage of labor with an open mind and a clear heart. Educate yourself in knowledge about the second stage, exercise your body, and then relax. Know that you've done your best to prepare your body and yourself, that your body knows what it's doing, and that your baby has no hang-ups at all about getting on out just as nature intended.
Who knows — you might be like me and even like it!