While Stage 2 Labor — the Pushing Stage — gets plenty of attention from Hollywood (as the woman in labor screams furious expletives at her partner), there is actually very little information given to those preparing for this stage in real life.
There are many factors that affect pushing — including timing, position, and technique. In this post, we will focus on the technique of pushing and share a step-by-step process to prepare your deep core (especially pelvic floor) for more effective and efficient pushing. You can learn more about pushing timing and position in this post on Stage 2 Labor.
Step 1: Master the #1 Most Effective Core Exercise
Pushing a baby out requires strength in the deep core along with relaxation of the nervous system to help you recover in between bouts of pushing. Practicing 360° Breathing (which we refer to as the #1 most effective core exercise) will help you accomplish both. The myriad of benefits that 360° Breathing offers makes it the most effective exercise for any individual — male and female alike — so the sooner you can start practicing this one, the better.
Step 2: Start Training the “Floor of Your Core”
Once you have a reliable and efficient breathing pattern, it’s time to turn your attention to the floor of your core: your pelvic floor (PF). As you can imagine, this area is going to be very important for a vaginal delivery because the PF functions as the “exit” door for baby. Your PF muscles need to stretch so that baby can pass through. The more tension you hold in these muscles, the more work that will be required (by you and your baby) to get the baby out.
Therefore, having good control over your PF is essential for a smoother delivery.
To help you develop good control of your pelvic floor muscles through a full range of motion, practice the Pelvic Floor Activations (PFAs) below. Like 360° Breathing, PFAs are highly beneficial exercises that are good to do at any time. Therefore, the sooner you can begin practicing these, the better.
The video below will take you through the following 4 steps to master these exercises:
- Finding your pelvic floor muscles (front, back, and sides)
- Lifting and lowering the muscles through a full range of motion
- Coordinating your PF movement with your 360° Breathing (This is what we refer to as a PFA-Slow)
- Increasing the speed of your movement (This is what we refer to as a PFA-Fast)
Step 3: Prepare to Push
After you have mastered Steps 1 and 2, you should feel a level of familiarity with your deep core system that you didn’t have before. The last step is to develop the specific control over your deep core system to be able to push effectively by using a technique we call Pushing Practice.
Ideally, it’s good to begin Pushing Practice around weeks 28 – 30 in your pregnancy. If you are already past that stage, no worries at all. Any bit of practice helps. Note, even if you are later in your pregnancy, still begin with steps 1 and 2 before you begin Pushing Practice.
Pushing Practice helps you develop the power to push your baby out while “opening the exit door” (your pelvic floor muscles) to allow baby to pass through. It begins much like the PFA-Slow that you learned in Step 2. However, as you exhale and draw your navel in, you will open your pelvic floor muscles (instead of contracting them) as if you are trying to urinate or pass gas. You can also visualize a flower opening. Watch the video below for more details.
So, the forceful exhale is what provides the power to push baby out, while the opening of the pelvic floor muscles on the exhale is what provides that easier exit for your baby.
Keep in mind that this is the same “technique” that you can use when having a bowel movement. Because the anus is governed by PF muscles, you need to be able to relax and lengthen the PF in order to open the “exit.” Put another way, bowel movements are a perfect opportunity to perform Pushing Practice! Not only will it help you on the toilet, but it is a way of getting in more “reps” in preparation for labor.
A Note for Cesarean Births
The steps we discussed above are still important to practice even if you have a planned cesarean. While you will not end up pushing like you would for a vaginal birth, the techniques are incredibly beneficial — especially Steps 1 and 2. These exercises will strengthen your core and pelvic floor to help you withstand the increased stresses of weight gain and other pregnancy changes. They will also help your core be more resilient and heal more quickly in the postpartum period.
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