• Katie Moise PT, DPT

How To Prep For Vaginal Delivery

One of my biggest pet peeves is when you hear, “Push like you are having a bowel movement” during the middle of someone’s labor. Want to know why? Because most people don’t know how to push for a bowel movement correctly! Therefore, when you tell them to push like they are pooping, typically most pregnant women will push incorrectly. This can lead to increased straining and may contribute to perineal tearing, pelvic organ prolapse or other pelvic floor dysfunctions.


So, how do you push a baby correctly?


A common misconception most women do not realize is that a baby is pushed out of the vagina by the joint effort of the abdominal muscles and uterine contractions. This means the pelvic floor muscles are not contracting to push the baby out. Instead, these muscles have to GET OUT OF THE WAY. Let’s say that again. The pelvic floor muscles need to stretch and relax to allow for space for the baby to pass through. If you are “pushing” or “straining” while holding your breath, your pelvic floor muscles are likely tightening. Try it right now, try to push while holding your breath. Do you feel more pressure in your pelvis? This is why it doesn’t work. This can lead to long hours of pushing, potential use of forceps or vacuum to help get your baby out.


First, learn how to breathe correctly


Let’s talk about how you can start training to push your baby out correctly. For starters, work on your breathing. I like to begin practicing this while lying on my back. Without worrying about gravity, breathing on your back can be easier to get the feeling of your ribcage movement. Once you master that, you can then transition to practice in sitting, on your side or hands and in a position on your hands and knees.



Diaphragmatic breathing to help relax your pelvic floor muscles

If you are lying on your back, place your hands on your ribcage. Imagine an umbrella opening up underneath your ribcage as you inhale. You should feel your ribs expand into your hands as your belly softly lifts up towards the ceiling. The most common error I see in women is that we tend to grip our stomachs or suck in our abs all day long. Oftentimes this is happening subconsciously. To truly master your breathing, you need to release all the tension you may be holding in your stomach. Once you feel successful with your breathing on your back, I recommend transitioning to a variety of other positions to see how it feels.








Now, combine your breathing with a “push”


Now let’s combine your breathing with pushing. One way I like to remember this is thinking, “belly big, belly hard.” When you take a breath in and your abdominals expand and your belly becomes big, you want to then keep it big and expanded as you exhale. As you exhale, imagine like you are blowing out birthday candles. Aim to keep your belly firm as you do this. Notice if you feel some tension in your abdominals but relaxation in your pelvic floor. This is how it should feel when you push!


Still having trouble figuring it out? We would love to help and be part of your pregnancy and birthing journey. Let’s schedule a 15 minute discovery call to see if we would be the right fit for you.