The Truth About the Pushing Stage of Labour: What No One Tells You
Eleanor lives in Lytham and supports families across the Fylde Coast and in Preston. She provides multi-award-winning antenatal hypnobirthing courses and postnatal trauma support, both in person and online worldwide.
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How do you know when it’s time to push and if you’re doing it right!?
If you’re pregnant, chances are you’ve already heard the phrase: “You’ll know it’s time to push when you’re 10cm.” Sounds straight forward, like as soon as you’re fully dilated its baby time! Except… that’s not how it actually works.
The pushing stage (or “second stage” as the NHS calls it) is one of the most misunderstood parts of labour. The way it’s often managed - especially in hospital - can make things harder than they need to be. So let’s clear this up.
Do you have to push as soon as you’re 10cm dilated?
Being “fully dilated” doesn’t automatically mean your body is ready to push. You need three things to line up first:
Your cervix is out of the way
Your baby has descended into your pelvis
Your hormones have shifted into that powerful “superwoman” mode that makes you want to bear down
If you don’t have all three? Pushing early can actually make things slower and more exhausting.
What is the best position to give birth in?
Honestly, there’s no one “right” way to give birth, just what feels right for you. But knowing how to move your body and which positions actually help your baby find their way down can make a huge difference.
Not all midwives are trained in birth biomechanics (which is wild, I know!), that’s exactly why I did the training myself. So when we go through it in my Hypnobirthing classes, you’ll actually understand how to help your body work with your baby, not against it.
What’s the difference between coached pushing and physiological pushing?
You’ve probably seen it on TV: mum on her back, knees to her chest, someone yelling “PUSH, PUSH, PUSH!” while she goes purple. That’s called coached pushing. And the research shows it:
Longer pushing phases (yep, not shorter)
Higher chance of episiotomy
More babies needing resus after birth
Why? Because when you’re told to push before your body’s ready, you’re straining instead of working with your uterus.
The alternative? Physiological pushing. This means waiting until you feel the urge, then following your body’s lead. It might look like bearing down, moaning, moving instinctively - or even being quiet and focused. It’s messy, powerful, and different for everyone. And it works. The time between full dilation and feeling the urge is called the ‘rest and be thankful stage’. This could be minutes or hours! Whatever your body needs, so try not to panic if things feel like they’ve stopped. They haven’t your body is just giving you a break!
What does pushing in labour actually feel like?
Forget the horror stories. Many women describe pushing as the most empowering part of birth (myself included!) - a mix of adrenaline, oxytocin, and the huge relief of knowing you’re about to meet your baby.
It’s intense, yes. But your body knows what to do. Your job is to get out of your head and let it.
Worried about needing an assisted delivery?
Needing a ventose of forceps delivery is one of the most common worries I hear from expectant mums.
Michelle’s birth story is a must read; a wonderful example of why how you feel about your birth being what matters most.
How does pushing work if you have an epidural?
Epidurals change how much you can feel, so you’ll probably need more support. But you still have options:
Ask for a “walking epidural” so you can change positions
Flip sides with a peanut ball to help baby descend
Wait for passive descent instead of pushing right away
Use “tug-of-war” (pulling on a rebozo or sling) to add extra oomph
How can you push effectively and avoid unnecessary interventions?
Pushing isn’t about purple faces or hitting hospital time limits. It’s about letting your body - and your baby - set the pace. So if you remember one thing, let it be this: Don’t start pushing just because someone says you’re 10cm. Start when your body tells you it’s time.
Want to go deeper?
I break all of this down inside my multi-award-winning birth prep courses. You’ll learn how to navigate every stage of labour on your own terms, without panic or guesswork.
Why not start with a free masterclass to learn what the hypno is all about.
