Once you feel comfortable with the breathing patterns for pushing, practice them in the various pushing positions. To push, slowly exhale or hold your breath, and bear down by doing the following:
• Take 2 relaxing breaths, take a deep breath to expand your lungs, and start bearing down using your diaphragm.
• Tuck your chin onto your chest and “look for the baby”.
• Bulge your lower abdominal muscles down and forward.
• Totally relax your pelvic floor by doing basement Kegels. Your perineum should feel as if it is bulging out.
• Keep your diaphragm down on your uterus between breaths by inhaling slowly.
• Try to push three or four times during each practice contraction.
• Slowly lessen your pushing effort as the contraction comes to an end. This will help to maintain the baby’s position in the birth canal, preventing his moving back up.
When you practice pushing, do not push forcefully, just enough to get the proper feeling. You may find it helpful to think of pushing as being like forcefully emptying your bladder. Also, visualize your baby coming down lower and lower as you push, and consciously relax your legs and bottom. A tight perineum can cause a longer, more difficult birth and almost certainly ensure having an episiotomy.
During actual labor, your first pushes will move your baby gradually down the birth canal. Your partner may even see a little of the baby’s hair showing as you push. But the hair will disappear as the baby moves back up at the end of the contraction. When the top of the baby’s head stays in view between contractions, it is called crowning. Your caregiver may ask you to stop pushing. Pant or blow out at this time to keep from pushing. This will allow your baby’s head to gradually stretch the birth outlet and perineum, resulting in a more controlled delivery of the baby’s head and hopefully reducing the need for an episiotomy.