Pushing Position?

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Clarkton's picture
Joined: 01/07/08
Posts: 1972
Pushing Position?

I don't typically go into labor, or anything really, with a lot of expectations or a very solid vision in how I think it will or should go. I am fairly laid back and go with the flow with just an overall goal. My goal with labor/delivery is do it as natural as possible and that's really it. The one detail that keeps bugging me is how else can I go about pushing this baby out.

Both times I've ended up in the traditional on my back, expected from every TLC birth show, easy for the doc to catch, position. I've also had a 2nd degree tear both times and I found the pushing phase particularly "unpleasant" with my second birth. I really feel like I would have a better chance of not tearing by trying something different.

So my question is can you give me any advice on a good reference to read about the presentation and pushing part? Also, any personal experiences you can share? This is the one thing I really would like to have a m/w or doula who was really experienced to coach me through. :confused:

cactuswren's picture
Joined: 10/19/09
Posts: 4658

I knew about lots of different positions, but ended up on my back as well since I was SO exhausted by that point (22 hours of active labor + 2 hours of pushing) One thing I'm trying to do this time is spend a few minutes a few times a day (whenever I think of it and it's doable) squatting, to get my body and muscles in shape to do that for a longer amount of time than I normally can. That's the most common positioning advice I've read--get your body used to squatting, because it's the optimal position.

kridda_88's picture
Joined: 01/28/08
Posts: 1798

I always said I wanted to push on my hands and knees or squatting but I started more in a sitting position and my midwife encouraged me to get on my hands and knees because my baby didn't like the sitting position. Once I flipped over pushing was so much easier. I still tore but it was a second degree tear with a posterior baby with his hands on his face. So who knows if I would have torn that bad had he presented better. lol. In the end I didn't really completely choose my birthing position but I am so glad I ended up pushing on my hands and knees. I am hoping my next baby I will be able to choose the position and more aware. I just wasn't fully with it by the end of a really fast active labor after 3 days of nearly no sleep.

Spacers's picture
Joined: 12/29/03
Posts: 4100

If you don't have a midwife or doula, then put your DH in charge of reminding you to think about other positions. Tell him that you want to remember that there *are* other positions. If baby is posterior, hand & knees are good during labor to encourage turning, and excellent for delivery because it lets gravity help. Squatting or a supported sit-squat are good pushing positions for most other presentations. And if you feel stuck while pushing, sometimes just moving to a different position is helpful. Ask him to gently remind you about positions, and also let the nurse know that you don't want to push on your back and hopefully she'll remind you, too. Good luck!

tink9702's picture
Joined: 09/28/08
Posts: 2977

no references here but personal experience has been to squat, then push on my side with DS (he was posterior, hand up at face and it was awful). With DD I was on hands and knees and caught her myself and pulled her underneath myself. pretty awesome actually!! Smile

tori729's picture
Joined: 07/23/07
Posts: 1743

I've always just thought I would do it however I thought was comfortable at the time. With my second (never got to pushing w/ my first), I was in the tub sitting up against the side. With my third I was laying on my side on the bed. I don't think I would have had the strength to push on hands and knees although it sounded good to me beforehand.
Definitely talk to the nurses and whoever else is there and voice your preference to NOT push on your back. Then when it comes time, tell them how you want to be!

Clarkton's picture
Joined: 01/07/08
Posts: 1972

Thanks for the responses ladies Smile
Really my pushing phase has been short with both...like less than 3 to 5 pushes and with DS2 I even took a break through one contraction. I have never experienced the urge to push either. I wonder if I waited until I felt like pushing if maybe that would change it too. I've actively pushed them out both times, none of this "my body just did the work and they practically slid out". I remember with DS2 thinking it hurt a lot more than I remembered that part with DS1. He was 2.5 lbs bigger but still was only 7 lbs 4 oz. so not big.
I will definitely talk to DH to get his help and will tell the nurse too. I think I'll also talk to my doc at my appointment tomorrow about what I want including immediately following the birth. Both were immediately taken to be examined right after...in the room still but I really want to delay cord clamping/cutting this time and have baby handed to me right away.

tori729's picture
Joined: 07/23/07
Posts: 1743

I didn't feel like pushing either and it took about 45 min with both kids to push them out but the last one was posterior. I never really wanted to wait though, I just wanted to get them out!

I really hope your hospital will be on board with you. Mine was awesome and really encouraged the "magic hour" and let me keep baby with me before weighing/cleaning.

cactuswren's picture
Joined: 10/19/09
Posts: 4658

"Clarkton" wrote:

Thanks for the responses ladies Smile
Really my pushing phase has been short with both...like less than 3 to 5 pushes and with DS2 I even took a break through one contraction. I have never experienced the urge to push either. I wonder if I waited until I felt like pushing if maybe that would change it too. I've actively pushed them out both times, none of this "my body just did the work and they practically slid out". I remember with DS2 thinking it hurt a lot more than I remembered that part with DS1. He was 2.5 lbs bigger but still was only 7 lbs 4 oz. so not big.
I will definitely talk to DH to get his help and will tell the nurse too. I think I'll also talk to my doc at my appointment tomorrow about what I want including immediately following the birth. Both were immediately taken to be examined right after...in the room still but I really want to delay cord clamping/cutting this time and have baby handed to me right away.

Wait...3 to 5 pushes isn't "sliding right out"??? TWO HOURS! And I did have the urge. Ugh...hope this baby is a lot less stubborn than my last one...

Clarkton's picture
Joined: 01/07/08
Posts: 1972

Ugh Leigh, I'm so sorry it was so much work for you! I can't imagine!! :bighug:

I have been blessed with fairly easy L&D's all things considered...the main reason I'm focused on the pushing part this time is to try to get through birth with no tearing. But even my second degree tears haven't been too terrible to heal from so no big complaints either way. I am always for looking to improve, even on a good thing Wink

I also hope you have a much shorter and easier labor this time. You deserve it with that stubborn delivery you had previously. Smile

I hear ya Vicki! I'm not sure I'll want to wait too long for an urge to push if it doesn't happen right away again. There is definitely a strong desire to just get that baby out once you get to that point no matter how long labor has been. Wink

cactuswren's picture
Joined: 10/19/09
Posts: 4658

I definitely think active pushing contributes to tearing. Slower is actually better for that in a lot of ways, although NOT as slow as I had Wink My tear was a first degree "with a little plus, but we'll call it first degree" (whatever that means.) Most of the people I have known with bad tears have had a seriously active pushing session, posterior baby, or extremely fast birth.

knhoward's picture
Joined: 04/22/08
Posts: 999

My first two I was in the hospital and had an epidural. I laid flat on my back with my legs spread wide and tore both times.

My 3rd birth was a home birth. It was very quick and intense. I was lying on my back writhing in pain when my midwives basically told me that I needed to get out of that position. Somehow I managed to flip myself over on my hands and knees and push DS3 out. It literally took a minutes of pushing to get him out. No tears or anything and I felt great afterwards. I would definitely push in that position again if I have another one.

eliann's picture
Joined: 04/19/11
Posts: 2439

I always envisioned squatting, being on all 4s, or in a sitting position. I did lots of squatting during my pregnancy to prepare. During early labor it also felt good to squat and sit, but laying on my side was awful and so was being on all 4s.

I think its great you are trying to picture this, helps to mentally prepare. You are 35 weeks...almost lodge time lady!

cactuswren's picture
Joined: 10/19/09
Posts: 4658

Ohhhhhh laying on my side was a NO GO for me too! I was so, so exhausted that all I wanted to do was sleep, but if I lay down my contractions spaced WAY out but got so intense I would start to panic. Reason #1239847 I just know if I'd been in a traditional hospital setting, strapped to a bed with IVs and monitors, I most definitely would have ended up with a c-section.

Get to know a few different positions so you're prepared to just do what works in the moment for you! I spent a ton of time on a yoga ball resting my head and arms on the side of the bed, or kneeling on the bed with my upper body and head draped over the ball.