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.
Until recently, women have been asked to start pushing as soon as the cervix has dilated to 10 centimeters, but as long as you do not have a fever and your baby's heart rate is normal, there are many benefits to waiting to push until you feel the need to push.
Some women will instinctively push before their cervix is fully dilated. This is often treated as a complication, and a common approach is to encourage the woman to stop pushing due to fear that cervical damage will occur. However, there is no evidence to support this concern.
Stage two: full dilation and pushing
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.
Your cervix needs to open about 10cm for your baby to pass through it. This is what's called being fully dilated. In a 1st labour, the time from the start of established labour to being fully dilated is usually 8 to 12 hours. It's often quicker (around 5 hours), in a 2nd or 3rd pregnancy.
In Nancy Tsao's research on this topic she concluded that 'Pushing with the early urge before full dilation did not seem to increase the risk of cervical edema or any other adverse maternal or neonatal outcomes'.
The cervix must be 100% effaced and 10 cm dilated before a vaginal delivery. The first stage of labor and birth occurs when you begin to feel persistent contractions. These contractions become stronger, more regular and more frequent over time.
Stage 2: Pushing and Birth
The second stage of labor begins once you are fully dilated to 10 cm. Your provider will let you know that it is time to start pushing your baby out. This stage can be as short as 20 minutes or as long as a few hours.
A C-section is major surgery. The procedure can increase complications for the mother and raise the risk during future pregnancies. Women giving birth for the first time should be allowed to push for at least three hours, the guidelines say. And if epidural anesthesia is used, they can push even longer.
During the active stage of labor, your cervix dilates from around 6 cm to the full 10 cm. (The last part of active labor, when the cervix dilates fully from 8 to 10 cm, is called transition.) This process takes about 5 to 7 hours if you're a first-time mom, or between 2 and 4 hours if you've had a baby before.
Pushing sooner during childbirth is just as safe for most women and babies as pushing later, researchers report. The best time to start pushing during labor has been a matter of debate. Many U.S. hospitals recommend delaying pushing, but evidence has been inconclusive.
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.)
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.
The length of this stage varies with the position and size of the baby and your ability to push with the contractions. 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.
What is the fetal ejection reflex? The fetal ejection reflex, also known as the Ferguson reflex, is when the body “expels” a baby involuntarily — that is, without forced pushing on your part.
Doctors have to wait until the cervix is at least 4 centimeters dilated before doing an epidural. Otherwise, the epidural will slow the process down too much. However, once the cervix becomes fully dilated it is too late for an epidural to be given.
Returning to Physical Activities After a C-Section
It's important to get out of bed and walk around within 24 hours after surgery. This can help ease gas pains, help you have a bowel movement, and prevent blood clots.
1 day later: You'll be encouraged to walk around within the first 12 hours after delivery to help relieve gas buildup in the abdomen, and to eat something light as soon as you feel able.
In some situations, a C-section is not only preferable but mandatory—situations involving conditions like placenta previa, in which going into labor would precipitate life-threatening hemorrhaging, or cord prolapse, which can cause the death of a baby if a C-section is not performed in a manner of minutes.
If your water (aka “amniotic sac,” “bag of waters” or “membranes”) hasn't broken on its own when you arrive at the hospital, and you're five or more centimeters dilated, your OB might recommend bursting the bag by hand—especially if your cervix seems to be making slow (or no) progress.
Getting up and moving around may help speed dilation by increasing blood flow. Walking around the room, doing simple movements in bed or chair, or even changing positions may encourage dilation.
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.
Cervical dilation is measured in centimeters, with 0 centimeters being completely closed and 10 centimeters (the approximate width of a newborn's head) being fully dilated. The cervix must be fully dilated in order for a mom to begin pushing baby through the birth canal.
The transition phase
In this phase, your cervix will finish effacing and dilate to the full 10 centimeters. This phase may take anywhere from 10 minutes to two hours.
As cervical dilation increased, there were significant increases in self-reported pain and observed pain on all the cited measures. Pain was characterized as 'discomforting' during early dilation and as 'distressing, horrible, excruciating' as dilation progressed.