One of the biggest questions in labor is: How do you know when it’s time to push?
Hollywood makes it seem like a doctor tells you when to start, but in reality, your body often gives clear signals—and the right timing can make pushing more effective and reduce the risk of tearing.
This guide will cover:
✔️ The signs that your body is ready to push
✔️ Different pushing techniques & positions
✔️ How to avoid exhaustion & unnecessary interventions
How Do You Know When to Push?
📌 Pushing typically begins when the cervix is fully dilated (10 cm), but that doesn’t always mean you need to start immediately.
🚼 Signs You’re Ready to Push:
✔️ Intense pressure in the rectum (feeling like you need to poop).
✔️ Involuntary bearing-down reflex (your body starts pushing on its own).
✔️ Shorter, closer contractions that feel more productive.
🚼 Signs It Might Be Too Soon:
❌ You’re at 10 cm, but you feel no urge to push.
❌ Pushing feels ineffective or exhausting.
📌 Pro Tip: If you feel pressure but no urge to push, waiting for the “fetal ejection reflex” can make pushing easier and reduce tearing.
💡 Related Post: Understanding the Stages of Labor: What to Expect from Start to Finish
Types of Pushing: Coached vs. Spontaneous
📌 1. Coached (Directed) Pushing
✔️ Used in many hospitals, where nurses tell you when & how to push.
✔️ Often involves holding your breath & pushing for 10 seconds.
✔️ Works well if you have an epidural & can’t feel contractions.
📌 2. Spontaneous (Instinctive) Pushing
✔️ Lets your body guide you, pushing only when you feel the urge.
✔️ Reduces exhaustion & lowers the risk of tearing.
✔️ Works best when baby is in an optimal position.
📌 Pro Tip: Spontaneous pushing is often more effective—your body naturally knows when and how to push.
💡 Related Post: Pain Management Options for Labor: From Natural to Medical
Best Positions for Pushing
📌 Lying on your back (the most common hospital position) is actually one of the least effective ways to push!
🚼 More Effective Pushing Positions:
✔️ Squatting – Opens the pelvis & uses gravity.
✔️ Hands & Knees – Reduces perineal pressure (may lower risk of tearing).
✔️ Side-Lying – A great option for slower, controlled pushing.
✔️ Using a Birth Stool or Supported Standing – Keeps the pelvis open.
📌 Pro Tip: If you have an epidural, using a peanut ball or side-lying position can still help open the pelvis for better pushing.
💡 Related Post: How to Create a Birth Plan That Actually Works
How to Avoid Tearing & Reduce Exhaustion While Pushing
📌 1. Wait for the Urge to Push
✔️ Pushing before you’re ready can lead to exhaustion & swelling.
✔️ Let your body do the work until you feel an overwhelming urge.
📌 2. Use Open-Glottis Pushing
✔️ Instead of holding your breath, breathe out while pushing (like blowing out birthday candles).
✔️ Helps control pressure & reduce perineal damage.
📌 3. Support the Perineum
✔️ Warm compresses soften the tissue & reduce tearing risk.
✔️ A provider can apply gentle counterpressure.
📌 4. Go Slow When Crowning
✔️ Rushing baby out increases tearing risk.
✔️ “Pant” through contractions when baby is close to being born.
📌 5. Change Positions If Needed
✔️ If pushing isn’t effective, try a different position (hands & knees, squatting).
✔️ A doula or provider can help guide you to better positions.
📌 Pro Tip: Your body does the best work when it leads the process!
💡 Related Post: Why Doulas Matter & How They Can Support You
What If Pushing Takes a Long Time?
📌 First-time births often involve 1-3 hours of pushing—but every birth is different.
🚼 Signs You’re Pushing Effectively:
✔️ You feel baby moving down with each contraction.
✔️ Contractions are strong & productive.
🚼 Signs You Might Need a Change:
✔️ Pushing isn’t moving baby down after 2+ hours.
✔️ You’re exhausted or losing strength.
🚼 Options If Progress Is Slow:
✔️ Change positions (even small adjustments can help).
✔️ Take a short break & breathe deeply.
✔️ Try a mirror or hands-on approach to see/feel progress.
📌 Pro Tip: As long as baby is handling labor well, you don’t need to rush pushing!
💡 Related Post: The Emotional Side of Birth: Processing Unexpected Outcomes
Birthify’s Expert Support for Labor & Pushing Prep
💛 Not sure what pushing style is right for you? Need expert guidance on birth positions & perineal protection? Birthify’s experts provide real-time coaching so you can feel confident during labor.
👉 Join Birthify today and get expert-led birth support! Sign up here