The most effective pushing is usually done when you take in a deep breath, fill up your lungs, and then hold that air in while you bear down, tuck your chin to your chest, and push as hard as you can into your bottom. We encourage you to hold those breaths for 10 seconds and attempt two to three rounds of 10 seconds of pushing if the contraction allows it and you are able. Typically, the moms that scream or let the air out tend to have less effective pushing but sometimes that’s okay! The lungs filled with air push the diaphragm down, increasing your internal abdominal pressure which helps with the pushing and contraction combined. Still, feel free to scream, cry, or do whatever you need to do to get through it. No one is judging you. The reality is, labor can be a long process, and your doctor can give you feedback on what pushing methods you should try to yield the best results.
The position you’re in while pushing can vary widely. When you lay on your back and pull your legs back, MRI studies have shown that this creates the most space for the baby. That is not what is commonly claimed by a lot of birth advocates who argue for pushing while squatting or in some other upright position. However, those positions tend to put pressure on the lateral sides of the pelvis (at your hips) and make the pelvis wider but narrower from front to back, which is where it really matters.
The truth is, women should be allowed to push in whatever position they are most comfortable and different positions will provide different degrees of pain relief for different women. We will help you know if your pushing is effective and if you might be better served in a different position.