Pushing is the part of labor that many women don't dread. It's often described as empowering to finally be able to physically control one aspect of the labor process. I know for me, pushing was the one time when I felt that there was a definite end in sight. And with a renewed sense of energy, I was actually excited to push with all my strength until my little girl arrived. But what about when you opt for a medicated birth with an epidural or other pain medication? Is pushing any different? Even if you plan to have a natural birth, knowing a few pushing tips for a medicated birth can come in handy, in case things don't go exactly as planned (and, in my experience, they rarely do.)
Since you can't feel the contractions with an epidural (the obvious upside,) you also can't feel when it's time to push (the downside,) so pushing is a bit different with medication. According to Babble, getting an epidural may increase your pushing time and increase your risk for needing forceps, a vacuum, or an episiotomy. However, pushing with an epidural is definitely possible and there are a few things you can do to increase the likelihood of a safe and quicker pushing period.
1. Get The Epidural Later On In Your Labor
Most OBs will want you to wait until you're at least in active labor to get an epidural (or four to five centimeters dilated.) But if you're keeping pushing in mind, you might want to wait as long as you can before getting one. One article from Baby Center stated that it's not technically ever "too late" to get one as long as your baby isn't crowning. But the concern is that an epidural may slow your labor down, so waiting will help ensure that things are progressing to the point of pushing before they're slowed down.
2. An Upright Pushing Position May Shorten Your Labor
If you decide to get an epidural, when it comes time to push, try to be as upright as possible. According to Evidence-Based Birth, in two separate controlled studies, women who received epidurals had shorter labors when they pushed in an upright position, instead of laying flat on their back.
3. Get A "Walking Epidural" If You Can
There are different kind of epidurals and pain killers you can get during labor. According to Parenting, walking epidurals combine a narcotic pain killer with a lower dose of anesthesia, so in theory, you could move more freely than with a standard epidural. They also work more quickly than standard epidurals, which may take up to 20 minutes to set in, however, they may leave you (and potentially your baby) feeling groggy during and after birth. You will, however, have more control over your muscles with a walking epidural, so pushing will be easier.