Natural birth and pushing: what to know

When the cervix is fully open and the baby has moved lower, you may feel pressure in the pelvis and an urge to bear down. Some people push in response to that urge; others receive guidance from the midwife or doctor, especially when monitoring shows a reason to coordinate pushing. Upright, side-lying, kneeling, or supported positions may be possible. The team watches your condition, the baby’s heart rate, and progress, while protecting the tissues around the vaginal opening as the head is born.

Practise breathing out slowly, relaxing your jaw and shoulders, and changing position when invited. Listen for guidance about when to push and when to pause so the baby’s head can emerge gradually. Keep drinking or receiving fluids according to your team’s advice, and use agreed comfort measures. Ask beforehand about perineal support, monitoring, assisted vaginal birth, and what happens if progress slows. Oxytocin may be used to strengthen contractions in some circumstances, while induction of labour concerns how labour is started.

During pregnancy or labour, seek prompt advice for heavy bleeding, reduced fetal movement, fever, severe constant pain, or waters with concerning colour or smell. During pushing, tell the team about sudden severe pain, dizziness, breathlessness, or feeling faint. Urgent assessment may lead to a change in position, closer monitoring, assisted birth, or a caesarean section if that is the safer route. Do not force prolonged pushing without guidance from the maternity team.

Ask how you will know pushing has begun, which positions are available, who will guide your breathing, how the baby will be monitored, and what options exist if pushing is tiring or progress is slow. Ask when a caesarean section might be considered and how feeding support will be arranged after birth.