"How will I know when to push?" A question I've been asked on a few occasions

"How will I know when to push?" A question I've been asked on a few occasions.

In normal physiological labour as the first stage of labour is coming to an end (the longest part which sees contractions getting your cervix from approx 0-10cm dilated), the head will descend down further and you should start to feel pressure in your bottom.

Most people will feel an overwhelming urge to push when the head is low enough and will find that their bodies will just do it, involuntary. Imagine how your abdomen & diaphragm contracts when you vomit, it's difficult to control right? That's how the urge the push can take over. The urge comes in sync with each contraction.

You may even notice that the contractions slow down to give your body a chance to rest inbetween pushes.

If a baby isn't in an optimal position ie back to back/sunnyside up, this urge to push may come before you are even fully dilated due to the way the baby is laying in your pelvis. Your care provider can help you get into positions to help rotate the baby and encourage the cervix to dilate fully.

If the baby's head is a little high up in the pelvis but you are fully dilated, you may well not get an urge to push at all. Fully dilated doesn't neccessarily mean "let's start pushing" in many cases, providing mum and baby are ok, it's ok to wait a little while until head comes down and the urge arises - otherwise you could be forcefully pushing for a long time due to the journey through the birth canal being longer.

If you have an epidural, chances are you may not feel the urge to push at all and will need a midwife or doctor to guide you. They will be able to feel when a contraction is coming simply by palpating your abdomen. Some providers will suggest allowing the epidural to wear off a little at the end so that you feel the urge and don't need so much direction.