What is the second stage of labor and what would be helpful to consider when the pushing begins?

The final stretch! You have finally reached the stage of active labor where you can start pushing and you are that much closer to meeting your sweet baby. Consider the following tips on posture and positioning and breathing patterns during the second stage of labor. If you haven’t already, check out part one of this blog to learn about helpful considerations for the first stage of labor. At Materra Method, we strive to support and empower you in any way we can, labor and delivery included!

The second stage of labor is the pushing. So, you have progressed through the entire first stage of labor and you are finally ready to begin pushing, now what? It is important to note that the pushing can often take longer than anticipated, especially for first-time birthers. The average push time for a first-time birther can range from 1-4 hours. Multiple factors can impact this length of time including tolerance by the mother and baby, epidural versus no epidural, posture and positioning, and more. That is why it can be very beneficial to have this knowledge with the goal of reducing the push time and improving mother and baby outcomes.

The following considerations are specifically related to the second stage of labor, the pushing. These are key tips are recommended by Dr. Colleen Lind, our Specialized Pelvic Floor Physical Therapist at Materra Method.

Four Considerations During the Second Stage of Labor

Posture and Positioning for the Second Stage of Labor

The following are positions that can be considered for the second stage of labor, while you push. These positions allow for the necessary opening and movement of the pelvis, sacrum, and tailbone while your baby’s head descends down and out through the bottom of the pelvis. These could differ depending on the use of an epidural, reference this information below.

1. Lying on your back (don’t forget the simple towel trick!)

2. Side-lying (you can use a peanut ball between the knees to rest between pushes as needed)

3. Hands and knees with or without support on an exercise ball

4. Deep squat to the floor with support from a stable surface or partner

*Remember - knees in, ankles out, and an arched low back is the ideal position while you push.

Epidural positions to consider and discuss with your provider.

The standard position following an epidural injection is lying on your back. However, alternative options can be considered and discussed with your provider. The amount of support required will depend on the strength of the epidural and safety considerations. Discuss this with your provider as part of your birth plan and preferences prior to actually being in active labor, as it will depend on their preference and comfort level as well.

Potential epidural positions include: lying on your back, side-lying, supported hands and knees, or supported tall kneeling.

Regardless of how you breathe and birth, you are incredible!

Everyone has different labor and delivery processes and birth preferences - listen to YOUR body, YOU know best. Labor and delivery is one of the most difficult AND rewarding experiences. This information is provided to educate and empower you to make the best choice for you and your baby. When in doubt, follow your intuition and know, you always know best!