What I wish someone had told me about pushing before I went into labour

Posted in Birth.

About to give birth for the first time? There are a few things this mumma wishes she knew about pushing before it came time to bring her bub into the world. Thankfully she has written them all down for you here.

I wish someone had told me to only push during contractions

Contractions are your body’s natural way to help deliver your baby. Your pushing is added support. Although you will probably feel like you have to push (or maybe it’ll just feel like you need to do the world’s biggest poo!), you should only push during a contraction. When you’re in the thick of it, it may seem like ages between contractions but don’t be tempted to push in between unless somebody, who knows what they are doing, tells you to. Use the time between contractions to recover. And remember to breathe!

I wish someone had told me that I may not be allowed to push even if I feel like it

This is the worst! Well OK, not really the worst, but it’s pretty bad… Imagine busting for a pee and you’re not allowed to let it out. You feel like you’re going to explode, right? Well, it’s kinda like that but worse. Your caregiver always has legitimate reasons for denying you a push, of course. Like your cervix hasn’t dilated enough yet or that full-on pushing may actually tear your vagina (some more?!?!). But that doesn’t take away from the fact that all you want to do is push, push, push. Breathe and try to resist the urge with positive self-talk, such as “my vagina will remain pretty if I don’t push right now” or more seriously “it is best for me and my baby if I don’t push right now”.

Pregnant woman in labour on bed - feature

I wish someone had told me that pushing will hurt too

You think you are at the tail end of it all and then you get sprung with the pain of pushing. So. Not. Fair! It can be excruciating for some women for many reasons including it can take a long time and there may be a spot where you particularly feel it. I felt every shift of my first two babies in my poor, poor hips. I won’t bore you again with the details, but pushing was by far the worst part of labour for me when I had my boys. Some women have told me that during the final pushing stages they lost all control of their legs, or even their whole body, and shook involuntarily. On the other hand, some women have told me they found pushing the easiest part. Lucky them! 

I wish someone had told me I may need to push for a REALLY long time

The average time spent pushing with your first child is about an hour. Having said that it can be much quicker, or much sloooower. Two hours pushing for your first baby is not uncommon! When you’re doing it, it seems like forever but luckily you only push during contractions so there is some time in between to catch your breath, relax a little, and remember what you are doing – pushing to meet your baby.

I wish someone had told me that posterior babies take longer to push out

Generally, babies in a posterior position do take a little more ‘oomph’ to come into the world. Yes, unfortunately more labour in labour. The position of baby’s back facing your back, means baby is usually not as streamlined for their journey through the birth canal. This results in a need to push longer in order to guide your little one through. Unfortunately, this often comes with more pain too due to bub’s positioning. I haven’t had a posterior baby, i.e. back labour, but women who have, asked me to pass on this piece of advice: have an epidural!

Woman in labour pushing - feature

I wish someone had told me about the “ring of fire”

Be honest, who just sang that Johnny Cash song in their head when reading this heading?

I digress. Let’s come back to the “ring of fire” in question here… When giving birth, you are pushing a head of about 35cm circumference out of your vagina. You are expanding your vagina to its maximum. Stretching such thin and fragile skin so wide results in a rather unpleasant burning sensation (I can’t put it any nicer than that), hence the “ring of fire”. Luckily our wonderfully designed bodies know how to combat even this: the burning won’t last too long as your max-stretched skin will block the nerve endings in your va-jay-jay, meaning no more pain. The bath is a great place to be at this point. I found it managed to extinguish the fire somewhat, compared to letting that ring burn in the open air.

I wish someone had told me I may need an episiotomy

Episi-what-tomy? It’s described as a small snip in the woman’s perineum (the area between hole one and hole  two, down there) but how small it actually is, I am not sure. I guess it varies from woman to woman. Generally, episiotomies are rare these days but if you have a stubborn bub, like my first one, whose shoulders even got stuck once his head was delivered, the scissors will come out and help make the exit a little larger! It’s scary to read, I know, but it is only done if necessary and in the scheme of things doesn’t actually hurt, as they will give you a little local anaesthetic in the area before snipping away. And trust me if you need one it will be at the point where you would do anything to get that tenacious little rascal out of you.

I wish someone had told me that I will still need to push when my doctor is using the suction cup or forceps

The ventouse (suction cup) or forceps are usually pulled out from their secret hiding place when your stubborn munchkin is not coming out on their own, or is getting distressed during the pushing phase. They are designed to give your little one a little help by assisting a little bit. Unfortunately, there is only so much they can do so you will need to push just as much during contractions. There really is no easy way out of childbirth, not even a little bit.

I wish someone had told me about fundal pressure

In some instances, when you are pushing your baby out your caregiver may assist by pushing the upper part of your uterus (aka the top part of the human in your tummy) down towards the birth canal (aka the exit) – this is called applying fundal pressure. It is thought to help push the baby in the right direction, basically giving you a helping hand. However, it is a bit controversial as it may lead to a greater chance of tearing, especially the anal sphincter (ouch, yes that’s your bum hole!). It is usually only done when the mother has had an epidural and for some women it is apparently really uncomfortable. It’s rare these days especially for vaginal births, so you can exhale now. But just in case, don’t say I didn’t warn you.

Mother holding newborn after birth - feature

I wish someone had told me that most women poo when pushing out their baby

It’s our worst nightmare, right? And we all think it won’t happen to us but the truth is it will happen to most of us (even if only a little bit). Poo, number two, faeces, brownie, doodoo, crap or whatever you choose to call it, can and probably will, happen. After all, you are pushing an approximate 3kg mass out of your vagina. You can’t push that hard and dictate which hole something will come out of. Unfortunately, in this case sh*t really does happen!

I wish someone had told me that the placenta needs to be pushed out too

So, you have pushed and pushed and pushed and finally are holding your baby in your arms. And that’s enough now, right? No, no, now it’s time to deliver the placenta. Known as the third stage of labour, delivering the placenta will happen at different times for different women. Yes, more pushing and more contractions. Although I found the contractions and the actual birthing of the placenta quite bearable some women have told me that they find these contractions and this pushing phase really full-on. We are all so different! If you had a complicated birth your caregiver may suggest an actively managed third stage (you can also choose this option, if you want) where you are given an injection of syntocin and the placenta comes away quicker and is removed (read: pulled out of you by the cord) by your caregiver. Sounds worse (and grosser) than it is. Or maybe not, it’s pretty gross. But you will probably have your bare baby lying on your bare chest at this stage so the reminder why you need to do this is right there (and oh so worth it!).

This is an edited excerpt from Jennifer Hacker Pearson’s book, ‘I Wish Someone Had Told Me …’. You can find out more about Jennifer on her website and buy the book here.


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