Hello everyone, Dr. Boyd here. Welcome back to parently. Today we're talking about positions during your pushing process. Now, you've made it through labor, the doctor or the nurse says to you, okay, we're complete. That means your cervix is dilated to 10 centimeters, and you're going to start pushing. Now, not every pregnant woman starts pushing immediately.

If you have a heavy epidural, that means you're totally numb, can't move your legs. your healthcare provider may have you labor down, you'll hear that terminology labor down. That means to put you up in a sitting position and allow gravity to push the baby down into your pelvis. And at some point, they will ask you to start pushing. Now it's important as you progress through your labor and even to the point of your second stage. That means after you're fully dilated you can believe it or not make it through without having an epidural.

Now in most of America 70 to 80% of all women have epidurals, they're a wonderful tool, they give great relief of pain, the negative as they increase the length of time that it takes you to deliver. So it may add one to two to three hours. It could even add potentially more than that, but the average is one to three hours depending on if this is your first baby, or second, third, fourth babies. Now, if you have a good anesthetist, or crna or anesthesiologists, they will take care of most of your pain. With your epidural, but not all of it, you'll still be able to move your extremities and for those patients and those patients that don't have any epidural, we're going to talk about different positions to push. Now the traditional patient because of their epic are laying in bed and they're laying flat.

That's called without me that means like this. And in that scenario, that patient will pull their legs back like this both legs back in a frog like position, and you will oftentimes hold your legs behind your knees and push down. It's rather awkward at something that you can do before you get there is start this position of pulling your legs back like a frog so that you're nice and loose at the time of pushing. A better position is if a nurse or your doctor puts you up into what's called a seat position. That means your head is slightly elevated again, all hospital beds all labor beds move, the head moves, the feet moves moves up and down. And it allows you to get into different positions to increase your chances of pushing successfully.

The C position is the most common position in all of American, maybe all of the world that allows you greater leverage to push down on your baby. The whole goal is to expand the size of your pelvis this way, expand the size of your pelvis a little bit this way, so that your baby can dock up underneath the pubic bone, not hit the back bone called the sacrum and be able to exit through the birth canal. Now, those are the two most common, what else can you do? If you don't have a heavy epidural again, that means you can't move. Then your nurse can flip you to your side and you're able to grab one of your legs, either your right leg or your left leg and push down and a side position. I personally think this is an excellent way to push.

Many nurses in the labor world are very good at helping you push in this scenario. But you got to be prepared to talk to your nurse about that because not every nurse likes the side position. Now again, if you don't have a heavy epidural, or you don't have any epidural at all, you can flip all the way around and be on hands and knees. That's called a doggy position for some people. Some people feel very awkward because your bottoms sitting in the air, but it's a great technique that's been used for centuries, and it works extremely well. So the next technique is back on your backside, but it's in the squatting position.

I mentioned to you that squatting can occur in the delivery bed, you simply put the feet down and the head up and oftentimes you'll have a burning bar to hold on to. This is a great technique because it allows gravity to help you anytime you can use gravity to help you. It will decrease your chances of being unsuccessful in delivering your baby Badgley. I think it's a great technique. Now, if you can get up again If you have an epidural, they will not let you out of bed. So this is specifically for women that do not have epidurals.

You can get up and be in the chair and push or you can be on the birthing ball. I think it's a great option. Again, you're allowing gravity to help you. And as you jump up and down, you're not really jumping, you're lifting yourself up on the burly ball up and down. That will allow the gravity to assist in delivering your baby Badgley. Now, obviously, if you get to the point where the baby's crowning, you've got to figure out how you're going to get the baby deliver.

And most healthcare providers want you back in the bed for the safety of your baby. Obviously, the goal is not to drop the baby. Now, if you're one of those patients, that is very creative, and very brave because this is scary for a lot of women. Simply being in the standing position, leaning over a counter leading over a tray and standing While you're pushing, again, allowing gravity to help you, it's a great technique. Only about 1% of all women are in this standing position. And again, you have to be able to get back into the position of your bed so that we can deliver your baby successfully, but safely, that's the key word.

So today I've talked about the various pushing positions. And this is different than labor positions. Labor positions are really what you want to do when you're in labor. This is prior to you pushing. Labor first stage is up to 10 centimeters dilated. After you get to 10 centimeters, your healthcare provider is going to have your labor down and a certain point start pushing today.

These are the techniques that you can perform as a pushing patient. It's important that you talk to your healthcare provider on what they feel comfortable with and what you feel comfortable with. Hope that has helped