To push or not to push? What are your options in labor? There is a lot of information floating around, for different methods of pushing, or no pushing at all. So I am going to compile the options, evidence, and my experiences right here for you and let you make an educated decision for you and your little one.

Directed (Or Valsalva) Pushing

Women are commonly laying on their backs and instructed to hold their breath and bear down during their contractions. In a directed birth you will hear “You’re at a 10, you can go ahead and push!” or “Stop pushing! You’re not fully dilated yet!”  While this type of pushing may be fine and it seems to work most of the time, is it really the best way? Having other people tell you how to have your baby can lead to you not trusting yourself, so it removes bodily intuition, and causes you to not know what to do next in labor. And it’s not always accurate. Just because you’re dilated to 10 centimeters doesn’t mean that baby is necessarily ready to come out. Women can push for hours this way, causing exhaustion, swelling, tearing, hemorrhaging, and extended recovery time. Worst case scenarios, prolonged laboring can mean increased chances of having a cesarean, fetal distress, assisted delivery (by vacuum or forceps), uterine infections, abnormal heart rate for the baby, the list goes on. There have to be better ways! Yeah, there are, let’s check them out.

Breathing Your Baby Down (Or J-Breathing)

Here is a wild concept for you: your body can have this baby without you. If you were in a coma, you could still birth a baby vaginally. This should let you know that you can do whatever you want and this baby will come out. Unless there is a medical emergency, get on all fours, stand up, squat, find a position that feels right, and then let it happen. You may feel like you want it to end as soon as possible and just push with all of your strength. But we know that there are benefits to going slowly.

Your body is the most relaxed when you breathe out, so that is when you will be opening and softening to let baby through. However, you don’t really have the strength to push the baby through that nice opening on your breath out.  It feels like a contradiction, but let me explain.

Step 1: WAIT WAIT WAIT

You’re gonna hate that when all you want is your baby to come out. But trust me. You want to wait until the urge to push is so uncontrollable you can’t NOT push. You will have so much success this way. It’s similar to pooping. You would take much longer in the restroom if you said “Well, I think I could go poop, seems like it’s coming on soon.” and went then. But when you wait until you’re running to the restroom for fear of it flying out, you’re on the toilet for much less time and much less straining. Same in birth. WAIT UNTIL YOU CANNOT WAIT ANY LONGER.

So I tell my clients not even to tell their care providers at the first urge (unless the dr. is not in the hospital, and may take a while making their way over) But wait until the urge gets very strong, invite the team in, they will check the cervix and if fully dilated they have a lot less time to wait. So they will be patient with her as they’re putting on gloves and getting baby warmer ready etc.

Step 2: Focus on your Breath

When you breathe in, use that strong breath as energy to push the baby out softly. When you finally let it out – let it out very slowly and make your body completely relax again. And repeat.

This may feel like you’re not progressing, but the body is designed to move this way. It’s more like 5 steps forward and 4 steps back. You are progressing, but it takes patience, and it’s usually for the betterment of your baby and your body to take it very slowly. Of course, if the doctor who knows your plan in advance tell you to give it everything you’ve got and push, do it! It may be because of a sudden change in the baby’s heart rate, breathing, etc and of utmost importance that you hurry.

Step 3: Plan ahead

You want to practice this while pooping, every single time until baby’s arrival. Even if you think “this is easy, I know how and I’ll just do it.” It will begin to rewire you to do this without thinking, questioning, or doubting. You will do it so perfectly and naturally in labor ONLY WITH PRACTICE.

The next thing to plan ahead on is before you ever go into labor you should speak to your care provider telling them that this is what you would like to try. They may be able to give you extra tips to help you as well. But that way they don’t start directing you in another way while you’re trying to focus on breathing the baby out unless there is truly an emergency.

FER Fetal Ejection Reflex

FER is sort of a unicorn or Bigfoot. We’re all talking about it, but not many people have actually seen it. It is absolutely the preferable way to birth. Read a birth story from a mama that experienced Fetal Ejection Reflex HERE. This is when your body does the work for you, you didn’t breathe or push the baby out. Your body took over and you didn’t have a choice in the matter.

So the thing is while many people hope for this, this kind of birth doesn’t happen accidentally or luckily. This comes with mental, physical, and environmental preparation.

Every long once in awhile someone does get a bit lucky and stumbles upon FER.

But don’t count on it. If you want this – prepare for it. Here’s how.

Step 1: Mental preparation

This is the opposite of what it sounds like. You want to practice NOT thinking. Practice becoming absolutely primal and as Ina May Gaskin says, “Let your monkey do it.”

So practice this through meditation, and practice this through dancing. Dancing is a great example because as a woman we are supposed to follow our partner and not ‘think’ or anticipate what’s coming next – but rather just feel it. When you are moved, move. If you want your body to take over you can’t be overriding it with thoughts, they’re far too demanding. Just become loose, limp, and ride the wave of labor.

Step 2: Physical preparation

The only people I’ve seen and heard of that are able to do this have either had a child before or are in great physical condition. This is because if the uterus and core muscles aren’t strong enough, how will they take over and do it without you? The two most important things to do would be squats and all things relating to your core. Do these every single day and don’t give up. It will benefit you far more than just your labor and delivery, your recovery time will be much quicker as well as natural health benefits. Start small, do 10 squats 3 times a day, and 25 crunches twice a day, and 5 sit-ups once a day. Then edge yourself up until you get to 500 squats a day (this can be 100 squats 5 times throughout the day) and as Ina May Gaskin said, “You will give birth very quickly.”

Step 3: Environmental preparation

Watch how mammals give birth. They retreat into the darkness away from both predators and their own tribe to be alone and quiet. They feel completely safe and give birth quickly and beautifully. This is what we are made to do. You need to give birth in the environment that brings you the most peace and feelings of safety. If that’s a hospital I would recommend that you keep lights off and noises very low. The highest rates of FER happen at home because the setting is familiar and safe. Limit the people in the room to be only those that are needed, helpful, will follow your birth plan, and are quiet. Watch positive birth stories to familiarize yourself with safe and positive birth. Many times moms have anxiety simply because they don’t realize how normal all of it is, and they’re just waiting for something to go wrong. And if you’re waiting for something to go wrong, you’re asking for something to go wrong.