If you want to push but you're not fully dilated, your health care provider will ask you to hold back. Pushing too soon could make you tired and cause your cervix to swell, which might delay delivery.
The urge to push is initiated by the position of the baby's head within the pelvis (Roberts et al 1987). Therefore, the cervix can be fully dilated without the baby descending deep enough to initiate an urge to push. Alternatively, spontaneous pushing can begin before the cervix is fully dilated.
Some women start to feel like pushing or bearing down before the cervix is dilated to 10 centimeters. Others feel like pushing right after the cervix is completely dilated.
But if you're close to 10 centimeters dilated the research suggests it's not an issue. Evidence suggests it's more of a theoretical fear that just adds additional stress and in some cases results in an epidural (or a higher dose of epidural) to mask that urge.
Once the cervix has reached 10 cm, it is time to push the baby out. Contractions continue but also produce a strong urge to push. This urge might feel like an intense need to have a bowel movement. This stage can last anywhere from a few minutes to a few hours.
Pushing too soon could make you tired and cause your cervix to swell, which might delay delivery. Pant or blow your way through the contractions. Transition typically lasts 15 to 60 minutes.
The timing of pushing didn't affect the odds of a normal vaginal delivery or harm the baby. It also didn't change the need for forceps or vacuum or the need for cesarean delivery, the researchers found.
The American College of Obstetricians and Gynecologists considers 3 hours or more (especially with a first time mom and/or those with epidurals) to be perfectly normal.
According to Meehleis, some providers might tell a laboring person to slow down or stop pushing to help prevent perineal tearing. Or, sometimes, the cervix isn't dilated all the way.
Pushing on command may also contribute to fetal heart rate abnormalities, lower blood oxygen levels in babies, and an increased need for such medical interventions as instrument-assisted delivery. (It can be helpful if you've had an epidural, however.)
Laboring down is the practice of not pushing for one to two hours immediately after the second stage of labor begins. It may help your baby descend into the birth canal more naturally and reduce the overall time you have to push.
Three to four pushing efforts of 6 to 8 seconds in length per contraction are physiologically appropriate (AWHONN, 2000; Roberts, 2002; Simpson & James, 2005). When the time is right for pushing, the best approach based on current evidence is to encourage the woman to do whatever comes naturally.
An overwhelming urge to push (some women don't, however) "The ring of fire," a burning, stinging sensation as your baby's head crowns and your vagina stretches for your baby to emerge. The burning doesn't last long – soon there's a feeling of numbness instead as the vaginal tissue stretches thin, blocking the nerves.
Early dilation often feels like menstrual cramps as the cervical changes cause pain and cramping noticed in the lower part of the uterus. It is the same sensation and location as menstrual cramps. Active labor tends to be felt in a larger area but can be a similar sensation as cramping (with more intensity of course).
Medical cervical ripening
Medications also can be given to help induce softening and dilatation of the cervix. Oral or vaginal suppository drugs, such as misoprostol and other prostaglandins, are also commonly used to ripen the cervix.
Your baby's heart rate is monitored continuously through labor either with a machine or handheld Doppler. If your baby's heart rate starts to change as you push, your doctor might tell you to stop and only to push every other contraction. This can allow your baby to recover in between.
The most common description of the level of pain experienced was extreme menstrual cramps (45 percent), while 16 percent said it was like bad back pain and 15 percent compared it to a broken bone.
Your body goes through exactly the same process of labour regardless of your baby's size. In fact, the size of your baby has no influence whatsoever on the first stage of labour. Your cervix doesn't know there's a 4.5kg (9.9lb) baby sitting on top of it. It has to fully dilate regardless!
Use Your Contractions as Your Guide
As your contraction builds, take some deep breaths. Then as it peaks, push, push, push! Some labor coaches recommend holding your breath. Some recommend exhaling while you push.
Research indicates that inducing labor at this time reduces several risks, including risks of having a stillbirth, having a large baby (macrosomia) and developing high blood pressure as the pregnancy advances. It's important that women and their providers share in decisions to induce labor at 39 to 40 weeks.
When your baby is ready to begin the journey through the birth canal, your cervix dilates from fully closed to 10 centimeters. This process can take hours, days, or even weeks. But once you hit active labor – about 6 cm dilated – it's usually just a matter of hours before you reach full dilation.
For first-time mothers the average length of pushing is one-to-two hours. In some instances, pushing can last longer than two hours if mother and baby are tolerating it. Normally, the baby is born with his face looking toward mother's back (referred to as an anterior position).
Purple pushing, coached pushing, holding your breath, all mean basically the same thing. Mothers being instructed on pushing causes them to hold their breath and push down into their bottom. Another more normal and less exhausting option would be “breathing or bearing down” working with the contractions.