When it comes to labor and delivery, no amount of planning can prepare you for the unexpected situations that arise. Sure, you expect to have contractions, cervical dilation, some pushing, but then, voila — a baby, right? Well, things don’t always go according to plan. Many moms find themselves in confusing situations during labor and may not even feel the need to push. Worried you'll have no urge to push during labor? Don't worry, your baby will still come. You just need to be prepared.
In an interview with Romper, Dr. Amy Peters, OB-GYN at Memorial Saddleback Medical Center in Laguna Hills, California, says that typically it’s women who’ve had an epidural that may not feel the urge to push. “It is not necessarily a problem,” she adds, noting that she’s had patients in the past that have been pretty far along in their labor, without even knowing it. For these patients, Peters notes that waiting for some time, or adjusting the epidural dose, will usually allow the woman to feel the urge to push.
Tweaking your epidural dosage can be really helpful in getting you to feel that need to push. Typically, when you enter that earlier active phase of labor, your anesthesiologist will give you an epidural, says G. Thomas Ruiz, OB-GYN at Orange Coast Medical Center in Fountain Valley, California. He tells Romper that when you begin the pushing phase of your labor, your doctor may turn down your epidural or turn it off altogether so that your body can read the cues it needs to actively push your baby out.
Well, you know that an epidural is the ultimate pain relief during labor, but how exactly does it affect your ability to push? According to Baby Center, epidurals are given through a catheter delivering anesthetics to the area surrounding your spinal cord. The medicine reduces the sensation in your lower body, the article explained, and should block you from feeling pain and movement. But this can also block out the feeling of pressure you need to feel, notes Ruiz, like when your baby pushes his head against your perineum. He says that this is why some doctors will wait until your baby’s head is crowning to reduce the epidural. This way, you’ll have optimal pain relief while still being able to feel pushing urges when your perineum begins stretching. “If the epidural is turned down too soon,” notes Ruiz, “the pain of contractions can inhibit pushing in some women."
The pushing phase of your labor is the last, and Peters says that your baby’s positioning, or fetal station, plays a big part in when you should begin pushing. “Fetal station measures how far the baby has descended in the pelvis,” explains Peters, “and is measured by the relationship of the fetal head to the ischial spines, or sit bones.” She says that she tells her patients to try doing trial pushes to move the baby down so they can deliver without any pain or pressure. But if the mom is unable to move her baby well, Peters recommends adjusting the epidural to reveal the sensations she needs to push.
Ruiz says that it’s easier for women who have already given birth to push with an epidural, but it’s harder for first-time moms. If this is your first delivery, you may wonder what the urge to push even feels like. Well, after vaginally delivering two babies, I can tell you that for me it felt similar to the feeling you get when you have to poop. Weird right? Turns out, there is a reason it feels that way. According to Fit Pregnancy, the urge to push during labor is triggered when your baby’s head pushes on the same nerves responsible for your bowel movements. Who knew all those years of pooping would prepare you to push a baby out?
Before you go into labor, it’s a good idea to talk to your doctor about whether or not you want an epidural and how you would like to go about things as your labor progresses. The one consistent thing about labor and delivery is that it’s different every time for every person, so expect the unexpected, and try to be as prepared as possible.
Check out Romper's new video series, Bearing The Motherload, where disagreeing parents from different sides of an issue sit down with a mediator and talk about how to support (and not judge) each other’s parenting perspectives. New episodes air Mondays on Facebook.