You’ve finally done it. You’ve been laboring for hours (or days), having contractions that have gotten stronger and more uncomfortable. You have been working so hard and allowing your body to do what it is made to do. And now your cervix is complete.
Complete = 10cm dilated, 100% effaced
Now that you’re complete, it’s time to push!
Or is it???
When you are complete, your cervix is in the prime condition for your baby to make their exit into this world. Your body contracting for hours or days has done what it is supposed to do and dilated your cervix. However, your cervix dilating and ripening is not the only thing that has to happen for your baby to be born. In order for your baby to be born vaginally, they have to make their way down through your pelvis and into your birth canal. This typically does not happen on its own, as the contractions are used to help push the baby down, they also have to do some work and be wiggling and rotating to move smoothly through the canal. It’s not uncommon for them to need a little bit of assistance with this, which looks like getting you in different positions to allow your pelvis to open at the location the baby is at. Typically, if there is a stall in labor, a big reason is because the baby needs some assistance getting into the best position, so knowing different positions to get into and techniques to move your body to give baby space to move down are key (que having a doula!).
Your baby getting low into your pelvis and putting pressure on your cervix can help tremendously with dilation and effacement. This pressure, once the cervix is complete, is also what gives you the feeling to push. For most laboring people, you will feel a tremendous amount of pressure in your butt (bootyhole specifically!). With contractions, that pressure may come and go, but once your baby is ready to make their entrance into the world, that pressure will remain constant even between contractions.
So, if you don’t feel the need or sensation to push, can you start pushing?
Long story short …
Yes, you can.
But should you??
No.
Pushing before your body is ready to push can not only elongate the pushing stage of labor, but it can also lead to injuries to your cervix, pelvic floor, and vagina. When you feel the urge to push, that pressure of your baby pushing down through your cervix is what helps guide you how and where to push. You may often hear nurses say “push into your butthole”, this is because the majority of that pressure you are feeling is right there, so pushing into that pressure aka into your butthole, will allow you to push with the pressure and contraction, not against.
Even if you have an epidural, you should still feel the urge to push!
Even if you have an epidural, you should be feeling some sort of pressure. This could feel like a lot of heaviness in your butt, tightening, or just extreme uncomfort that does not let up regardless what you do. If you do not feel any pressure or really any sensation, then the epidural needs to be turned down a bit as it is too dense. We want the epidural to take the pain away, but not all of your feeling. The urge to push may feel a little different with an epidural. When you have an epidural, you also have a catheter in to drain your bladder, so you are not actively getting up to pee. A lot of people will say that the urge to push feels like you have to push pee out (which is odd since you aren’t having to actively pee! And you should never force pee out anyway, big pelvic floor no no!). So when your baby is in the position to allow you to push, you may feel like you really have to pee and you need to push it out to get relief. It may also feel like a constant, strong tightening sensation that is in your butthole, like something is sitting there trying to exit.
By allowing yourself to let your body tell you when to push, you are not only allowing your baby time to descend into the proper position in the canal, but you are giving yourself and your body the best chance of pushing your baby out without exhausting yourself or causing injury.
There is no rush to push. Once you are complete, that simply means that your body is ready, but it does not mean your baby is ready. Breathe through the contractions, get into positions that allow gravity to help bring your baby down, and allow that pressure to build.
Your baby will make their way down, you just have to give them the patience and space to do so!
Your doula,
Ally
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