Pushing during delivery is often considered an essential and expected part of giving birth. However, for some women, pushing does not come naturally or is not medically advised. So can a woman deliver a baby without pushing? Let’s take a look at the facts.
What is pushing and why is it typically done during delivery?
Pushing refers to the mother exerting downward pressure during contractions to help move the baby through the birth canal. It involves taking a deep breath, holding it, and using abdominal muscles to bear down. Pushing helps propel the baby’s head downward through the pelvis and out through the vaginal opening.
Pushing is typically recommended during the second stage of labor, once the cervix is fully dilated to 10 cm. It helps the mother work with her contractions to deliver the baby. Many healthcare providers instruct women when to start pushing based on cervical dilation and other signs the baby is ready to be born.
Why might a woman be advised not to push during delivery?
While pushing is a common part of vaginal delivery, there are some situations where a woman might be coached not to push. Reasons why a woman may be advised not to push include:
- The cervix is not fully dilated – Pushing too soon with a cervix that is not ready can cause it to swell.
- The baby needs to descend more – If the baby’s head is still high up in the pelvis, pushing may be ineffective or risky.
- Medical issues for mother or baby – Certain medical conditions like high blood pressure, heart problems, or oxygen deprivation for the baby may warrant not pushing.
- Vaginal surgery – Pushing may be harmful if a woman has had prior surgery or damage to the vagina.
- Poor positioning of baby – An awkward position may require repositioning rather than pushing.
In these cases, a doctor may recommend breathing techniques but no active pushing until conditions improve or change. Some women may also opt not to push if they feel the urge to push is not there naturally.
What are the techniques for delivering without pushing?
If a doctor determines that pushing should be avoided, there are a few techniques that can help facilitate delivery without active pushing from the mother:
Passive descent
This involves letting the contractions move the baby downward through the birth canal naturally, without added force from the mother pushing. The mother focuses on relaxing her body and breathing slowly through contractions.
Laboring down
Similar to passive descent, laboring down means allowing the baby’s head to gradually descend into the pelvis and birth canal. This can take place over 1-2 hours. Letting the baby’s head apply gentle pressure internally can help dilation continue while avoiding pushing.
Mother-directed pushing
Rather than standard directed pushing, where a provider counts to 10 for the mother to push, mother-directed pushing relies on the mother’s natural urge. She pushes based on what she feels her body wants to do, which is often shorter bursts rather than prolonged pushing.
Pressure or breathing techniques
The mother may use modified pushing by applying gentle pressure or a blowing breath to work with contractions rather than forceful pushing. This gentle pressure can help labor progress without causing potential harm from strong pushing.
Delivery by forceps or vacuum
If a mother has been advised not to push at all, instruments like forceps or a vacuum device can sometimes be used to guide the baby out as the mother focuses on relaxing her muscles and breathing.
When might active pushing still be recommended?
While passive delivery techniques can be effective in many situations, active pushing may still be recommended or required in the following cases:
- Lack of progress over a set time – If descent is too slow or stalls entirely, pushing may be needed.
- Signs of fetal distress – Pushing may be urgent if monitors show the baby is in trouble.
- Exhaustion – Passive descent requires stamina and can become ineffective if the mother is too tired.
- Other complications – Issues like excessive bleeding or hypertension may warrant active efforts.
Medical teams must continually evaluate the risks and benefits of pushing versus passive descent during labor. The ultimate priority is a safe delivery for both mother and baby.
What are the pros and cons of delivering without pushing?
| Pros | Cons |
|---|---|
| May prevent cervical swelling or harm if cervix is not ready | Labor may progress more slowly |
| Allows gentle, natural descent of baby’s head | Mother must have stamina to breathe through contractions |
| Avoids potential risks from prolonged directed pushing | May still require pushing if delivery stalls |
| Can facilitate correct positioning of baby | Higher risk of needing assisted delivery or c-section |
| May reduce risk of tearing or excessive stretching | Requires close monitoring of mother and baby |
Key takeaways on delivery without pushing
While most women are coached to push actively during delivery, it is possible for some women to deliver their babies without pushing in certain situations. Here are some key takeaways:
- Passive descent techniques can allow labor to progress safely when pushing risks harm to the mother or baby.
- Gentle pressure, breathing, and relaxing muscles can work with contractions to move the baby down without active pushing.
- This approach may lead to slower labor and higher need for medical interventions.
- An experienced provider guides when to start pushing versus using passive techniques based on several medical factors.
- The priority is always on ensuring a safe delivery and minimizing risks.
While every delivery is unique, a woman should be supported in following her healthcare team’s recommendations regarding pushing vs. breathing or passive techniques. With close monitoring, non-pushing births can successfully achieve a healthy outcome in many cases.
Conclusion
Although pushing is considered a normal part of labor by many women, it is possible to deliver a baby safely without active, prolonged pushing in some circumstances. Passive descent techniques allow the mother’s body to expel the baby gently, guided by her natural urges to push or refrain from pushing. However, active pushing may still be required if labor stalls or concerns develop. Close communication with a medical provider is key in navigating the options. With proper monitoring and care, women can successfully give birth using modified pushing or non-pushing techniques when it is the safest option for mom and baby.
