The following blog and educational video clip is an excerpt from my book of trade secrets, Ending Pain in Pregnancy. This book is the best collection of trade secrets from pelvic floor physical therapists, written to keep you strong and pain free during pregnancy and prepared for your labor and delivery.
Although there are countless types of birthing and pushing techniques and breathing methods, there are three main ones to be aware of: Renewal Pelvic and Exhale Pushing™, Directed Pushing and Spontaneous Pushing. Understanding these will help you feel prepared to make a great and educated choice for yourself and your baby. Renewal Pelvic and Exhale Pushing™ is a technique I developed after a decade of work treating pregnant women. It requires training and has to be practiced prior to the big day of labor. This technique is based not only on science and normal physiology but it also incorporates the pelvic floor and abdominal muscles. This is the technique we teach to most of our pregnant patients. It’s not easy to master because it involves training and working with the abdominal and pelvic muscles and the corresponding breath. Renewal Pelvic and Exhale Pushing™ involves three things (1) active exhalation; (2) engaging the transverse abdominis muscle, which is a crucial set of abdominal muscles located on the front and side of the abdominal wall (click here for an image), and (3) a reverse Kegel, which is a technique for relaxing the pelvic floor (just relaxing doesn’t seem like an action as that is the normal position, like you aren’t doing anything. Is this what you mean?). The catch here is that you have to do all three actions at the same time. A common mistake with this technique is forcing the exhalation and/or over-activating the outer abdominal muscles instead of the deep transverse abdominis.
Performing and practicing this pushing technique incorrectly can increase pelvic pressure, incontinence or organ prolapse. Don’t fear. Try it and practice it so you have another technique in your labor toolbox. Take a look at the video included in this blog for more details on the Renewal Pelvic and Exhale Pushing™
Other Types of Pushing During Labor
Directed pushing is the most common as it is often what an OB will use …. involves (I left the …for you to fill in but you can remove it too) holding the breath for a certain count (usually to a count of ten) while you push even though you may not have an urge to push. The pushing and breath holding usually occur for the duration of the contraction. The risk with directed pushing is that because you are holding your breath, directed pushing can make you tired and it’s correlated with a higher rate of perineal tearing and decreased oxygenation of blood for the baby and laboring mother. If there is fetal distress or if the baby is in danger, directed pushing can get the baby out very quickly and is used to protect the baby, but as a rule this type of breathing is not efficient and is not desirable.
Spontaneous pushing is natural and works with the rhythm of labor and with the rhythm of the laboring woman’s body. The laboring mom is in control and only pushes when she feels an urge to push and is breathing through the contraction and not holding her breath. Groaning, vocalizing and exhaling are all part of spontaneous pushing. Don’t feel inhibited! The woman is free and is not subjected to the commands of those in the room. She follows her instincts and is going with the labor and her body signals and she is listening closely to its messages. Her body will signal her when to push. This can be animalistic in nature and many sounds can come out of you when you are deep into your birthing process. This is an ideal method and no training is required. It’s based on the deep messages of your body. Additionally, research has shown that women who use spontaneous pushing have shorter births and their babies have higher Apgar scores.
When it comes to pushing your baby out you want to have choices and great experiences in the many types of methods that are out there today. Ending Pain In Pregnancy goes into details, involving pushing techniques, labor positions, natural pain relief and natural comfort measures for labor and delivery. All the information in Ending Pain in Pregnancy will empower you to truly realize the birth that you want and deserve.
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