Pushing in labour

When you are giving birth naturally, we think of labour in three stages. The first stage is from the beginning of labour until your cervix is fully dilated. The second stage is from full dilation till the birth of your baby into the world. The third stage involves the separation and delivery of the placenta and immediate care after birth. Pushing in labour starts in the third stage.

When will I begin pushing?

Usually once you’re fully dilated the baby’s head will create pressure deep in the pelvis. This will give you an urge to bear down, similar to when you need to go to the toilet. This occurs because the head presses on the vagina and the rectum creating the same kind of sensation. Once you feel this urge strongly, then it is time to start pushing. Trust your body, as it usually knows what to do.

How do I push during birth, as I’ve never done it before?

Often you will feel such an overwhelming urge to hold your breath and strain downwards during the contraction that the pushing will come naturally. Remember the midwife and doctor who are there to assist you will observe your pushing and gently coach you into the best pattern. A common aim is to get three good pushes in with each contraction. This way you will get reward for your effort. It can take a few contractions to get the hang of it, so don’t worry, as there is plenty of time. At the end of each contraction, Mother Nature gives you a few minutes to rest and recover before the next one arrives.

How long will I need to push for?

There is no exact answer for this. A rough guide for a lady having her first baby is she may require up to two hours to deliver her baby normally. Some women become exhausted before that time, and others can go for a bit longer. For the second and subsequent births it is usually approximately 30 – 60 minutes. Remember, pushing is only with contractions, allowing rest time in between. If a woman has an epidural and has reached fully dilated and there is no urge to push we often wait an hour for passive descent of the head before asking the woman to start pushing with the contractions.

What happens if I can’t push the baby out and am too tired to keep going?

Firstly, don’t worry. The expert team looking after you will know when you need help. Pushing in labour is also a very natural thing to do. An examination will be performed and I will assess whether it is safe to assist delivery at this point with either vacuum (ventouse) or forceps. I will discuss this with you and your partner, and we will agree on the best way to proceed.

To discuss your labour and birth, make an appointment on this number:

Author: Dr Peter England, Obstetrician and Gynaecologist.
Read more about Dr Peter England

Other blog posts that you might enjoy:


Antenatal Care

Maternity Shared Care