One of the best ways toprepare for pushing is to pay attention to the way your bowel movements work andfeel during pregnancy.
When you are lying down in bedand then get up, is that sometimes followed by theurge to have a bowelmovement? Gravity is one of the most basic forces involved in elimination, andnoticing the effect of your position may give you a preview of how gravity willwork in your favor during labor.
If it's typical for you toactively bear down during bowel movements, try using no added force whatsoever. Practice this every time you use the bathroom. Gravity works along withperistalsis (your body’s automaticmovement of matter through your digestive system), and with the nerves aroundyour vagina and rectum known as stretch receptors. The pressure of stool movingdown activates the stretch receptors to make you push automatically.
A similar action happens inlabor, known asFerguson’s reflex. The baby’s headmoves down naturally and triggers automatic pushing, without added force beingnecessary. Allowing this to happen on its own is referred to aslaboring down the baby; after the cervixhas fully opened, it can take minutes or hours before it actually begins. Thiswaiting time can be essential for successfully pushing out thebaby.
Although many caregiversinstruct women to start pushing even if they do not yet feel the urge, this willbe about as effective as if you try to push out a bowel movement that is toohigh up; your body is just not able to perform this yet. And according tostudies inNursing Researchand thejournalObstetrics and Gynecology, early pushing is more likely to drain the mother of energy, cause fetaldistress, and lead to the use of forceps or a cesareansection.
While practicing on thetoilet, if you feel you must strain or you will not be able to have a bowelmovement, take a break and wait until later in the day when the urge to pushfeels stronger. Because pregnancy can be a time of increased constipation, youmay have the perfect opportunity to try this out!
Also notice that the urge topush can be stronger or weaker at different times, within the course of the samebowel movement. During birth, your pushing urges will also vary in strength. Your body will direct you as to how much or how little effort is needed for eachpush.
Even though the intention ofaggressive pushing in labor is to speed up the process, studies show it may havetheoppositeeffect and take longer. Heavy straining may cause the front wall of the vagina to be pushed down aheadof the baby. In this situation, the vaginal tissues may become “bunched up” andactually block or slow the descent of the baby, as well as damage the area wherethe vagina attaches to the bladder.
Bearing down forcefully duringbowel movements, urination, and birth has been linked to problems such ashemorrhoids and bladder incontinence. In the case of childbirth, forcefulpushing has even been associated with eight times the chance ofprolapse; or the bladder, uterus orvagina coming out of the body. This may not become evident until later in life, but learning habits of gentle pushing now can help protect your organs fromweakening for years to come.