Healthy Birth Practice 5:
Avoid Giving Birth on Your Back
and Follow Your Body's Urges to Push
Adapted from The Official Lamaze Guide: Giving Birth with Confidence
When it’s time to push your baby out, remember that instinct, tradition, and science are all on your side. Current evidence shows that letting you assume whatever position you find most comfortable, encouraging you to push in response to what you feel, and letting you push as long as you and your baby are doing well are all beneficial practices.
- Learn how to keep your birth as natural as possible if you have to use directed pushing.
- Watch a video of natural births and discover how some women use non-supine positions while pushing.
Download the guide, Avoid Giving Birth on Your Back, and Follow Your Body’s Urges to Push to learn why how upright and "gravity-neutral" positions benefit both you and your baby.
Upright and Spontaneous Pushing
A. Spontaneous pushing allows baby to get more blood flow and oxygen than the typical coached pushing for 10 seconds. Pushing should not go for more than 6 seconds at a time to allow for optimal oxygenation of baby.
B. Use gravity! Giving birth on your back reduces the size of your pelvic outlet and fights gravity. When you feel the urge to push with a contraction, pay attention to what your body tells you. Do you want to stand up or get on your hands and knees to push? If so, go for it!
You may request a bar for support while squatting during the pushing stage. While in a squat position, there is maximum room for your baby to exit the pelvis and travel through a shorter birth canal.
The Final Stage of Labor
The third, and final stage, of labor is the expulsion of the placenta, which happens approximately 5-20 minutes following delivery of the baby. Prior to that, the baby’s umbilical cord is clamped and cut. Please view this video on Delayed Cord Clamping.
Many providers will then give traction, or a gentle tugging, on the umbilical cord to help encourage the placenta to detach from the uterine wall. Gentle traction is ok, but I get concerned when providers become impatient and pull too hard on the cord. This can cause incomplete expulsion of the placenta, which can lead to increased bleeding or hemorrhage. Instead, consider discussing with your provider, and perhaps include in your birth plan, that you would like the baby to be placed on your abdomen (as opposed to high-up on your chest). The baby’s natural “crawling” movements as she makes her way to your breast (known as the Breast Crawl) can help expel the placenta naturally, as well as putting pressure on your belly to help minimize bleeding. Also, once the baby latches onto the breast, you begin naturally producing more and more oxytocin, which further helps your uterus to shrink down and prevent bleeding.
This video above is an animation of a baby being born. Please note how the baby turns and rotates to fit through the pelvis and ultimately enter the world. The hands are close to the baby so that they can support and guide rather than to turn or pull the baby out.
Below is a video demonstrating the use of a vacuum and forcep delivery on a model baby. Although both are used rarely, it is important to know that you have options to safely deliver your baby vaginally.