Pushing during labor: How Your Team Guides the Second Stage

The second stage of labour begins when the cervix is fully open and ends when the baby is born. It can include a period before active pushing. Your team considers the baby’s position and wellbeing, your contractions, pain relief and how you feel when advising what to do next.

Tell the midwife about pressure or an urge to push

The urge can feel like strong pressure or needing to open your bowels. An epidural may reduce that sensation. Tell your midwife what you notice so they can assess the stage of labour rather than relying on the feeling alone.

If you are away from your planned birth setting and think the baby is coming now, seek emergency help. Do not treat online pushing advice as a substitute for urgent assistance or an assessment of what is happening.

Expect guidance that fits the situation

Without an epidural, following your own urge to push can be appropriate. With an epidural, staff may guide pushing or discuss a period of waiting before active efforts. The decision depends on assessment and progress; there is no single instruction or delay that suits every birth.

Ask why the suggested approach is useful now. You can also say if a breathing instruction is confusing, painful or difficult to follow. The team can explain it differently and help you find a manageable rhythm.

Find a supported position

You may prefer your side, kneeling, sitting or an upright position when suitable. Our movement during labour guide explains how support and monitoring affect the options. With an epidural, staff need to help you move safely.

A change in position or help emptying your bladder may be suggested if pushing is not effective. These are parts of reassessment, not evidence that you are doing something wrong. Tell staff if you need rest, reassurance or better pain relief.

Ask how progress is being assessed

The team checks the baby’s heartbeat and descent, alongside your wellbeing and contractions. Advice about continuing, resting or considering assistance follows these findings. A time quoted in a class cannot establish that it is safe to keep pushing without review.

If progress is slow or there is concern about the baby, ask what the examination shows and which options are recommended. Our assisted vaginal birth guide explains forceps and ventouse discussions. Sometimes caesarean birth is considered, depending on the circumstances.

Prepare for the moment of birth

As the head is born, the midwife may ask you to ease your pushing or take short breaths so birth can be more controlled. Follow the guidance being given for your situation rather than a memorised routine. You can ask afterwards for an explanation of any rapid decisions or parts of the birth that remain unclear.