The Best Way to Practice Pushing in Labor

This is the Holy Grail in the quest for a successful delivery: learning how to properly push. Pushing effectively in labor means knowing how to use your strengthened abdominal muscles while relaxing the pelvic floor muscles that you have both stretched and strengthened during your pregnancy. It is important to also practice pushing in advance, so you will know how to do it once you’re in labor.

This is a learned skill. Again, I have to emphasize— you can’t learn this while you are in pain of labor.


The image I have used to help women understand how pushing works is comparing it to squeezing toothpaste out of a tube. (Take a look at the cover of my Perfect Pushing DVD if you need some visual inspiration.) Imagine that the uterus is like the tube of toothpaste, and your the transverse muscle is like your hand on that tube. The action of the transverse, which you will be using in labor, is forwards and backwards, as you know. So when your hand or abdominals compress, the toothpaste or baby comes out the bottom! Relaxing the pelvic floor muscles is like taking the cap off the toothpaste so the toothpaste or baby can come out.




Okay, so you’ve got the imagery down in your mind. Now, how do you actually get this baby out? To breathe or not to breathe…that is the question!

Research supports regular and rhythmical breathing during pushing. “Exhale pushing” allows a mother to push longer, while maintaining good oxygen flow to the baby, and reduces fatigue. However, most hospitals do not support this research. Many women are told by the medical professionals attending their deliveries to hold their breath and bear down. This is called “purple pushing” and refers to holding the breath so long and with such force that the small capillaries in the cheeks, eyes and face burst. Purple pushing can produce a situation called Valsalva's Maneuver. Valsalva's Maneuver occurs with prolonged breath-holding for longer than six seconds, which causes an increase in the blood pressure and fetal distress.

So to have all your bases covered, you can practice both ways. Whether you are exhaling or holding your breath, the most important thing to remember is to pull your transverse in to 5th floor while you are pushing. This is the missing link in pushing that most women are never taught! If you use your abdominals while holding your breath, you can even diminish the negative affects of the Valsalva maneuver.




Let’s try it right now both ways so you can actually feel the difference. First, I want you to practice holding your breath and bearing down while not engaging your abdominal muscles. Put one hand on your belly and one hand on your pelvic floor. When you do this, I want you to be aware of how it feels in your face, belly and pelvic floor.

Close your eyes and hold your breath and bear down as hard as you can. You should feel pressure in your face, your abdominals coming forward instead of back, and movement of the pelvic floor into your hands. Doesn’t feel very good, does it?

Now, you’re going to try holding your breath and bearing down, using your abdominal muscles. Again, put one hand on your belly and one hand on your pelvic floor muscles. Now close your eyes and bring your belly button to your spine, and keep it there as you hold your breath and bear down. Feels better, right? While doing it this way, you should not feel any pressure in your face. Bringing your transverse back to your spine and holding it there while pushing will not make the diastasis larger. You should also not feel any movement in your hand of the pelvic floor muscles. So as I explained before, you are averting stress to the pelvic floor and preventing the pulling of the supporting ligaments of your uterus.

Once you understand that you need to pull your transverse in during labor, you’re ready to practice the activity of pushing, so it becomes second nature in labor. Most moms will tell you that pushing in labor is like having a bowel movement, so the best time to practice is while you actually are having a bowel movement.

With all due respect, this might be easier said than done. If you are currently pregnant, you know that moving your bowels during pregnancy can be challenging, since you probably have a tendency to be constipated during this time. Remember the proper pooping posture: elevated feet, easier release.

Once you’re ready to go, it’s best to close your eyes as you push, so you can visualize the process of the transverse going back and the pelvic floor muscles opening. You should practice two ways: one with exhaling while pushing and the other with holding your breath.

Take a breath by expanding your belly, and now bring the belly to your spine and hold it there as you count out loud to 30, pushing your bowel movement out. The second way to practice is to start with a belly breath and bring the transverse to the spine. Hold it there as you push your bowel movement out without breathing. Practice both ways so you will have 2 options in labor.

Apropos of proper pushing in labor, you need to consider the best positions for pushing.




Just as squatting is a good position to have a bowel movement, it’s also a good position to deliver a baby. You can squat in the bed. Squatting is an effective position for giving birth for three reasons:

1. The outlet of the pelvis opens up 33.5 percent. So that means more room for the baby.

2. The uterus is in a better position. The cervix is pointing down. If you’re on your back with your legs up in the air, the cervix is pointing up and the baby has to fight against gravity to get out. This anti-gravity position puts a lot of unnecessary stress on your pelvic floor.

3. An upright position is a much easier position from which to use your abdominal muscles. However, if you do end up in a back-lying position and you have strengthened your abdominal muscles and have practiced using them with the headlifts and while pushing, you will still be able to push effectively.

If you are not able to squat while pushing, then being in a seated position is the next best thing.

Congratulations! I’m hoping you will do the Tupler Technique® after you’ve had your baby.  A great time to do the seated exercises is while feeding your baby; they love the forward and back movement.

To learn more about Diastasis Recti & the Tupler Technique® read this article: DIASTASIS RECTI RESEARCH AND EVIDENCED BASED EXERCISE PROGRAM

To view my programs click this link: Save on Packages


Watch the short video below to know what a diastasis is.


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