How to Push During Labor: Open Glottis Pushing, Guided Pushing, Positions, and More!

Are you looking for some info about how to push during labor? Maybe you want to learn about different pushing positions and WAYS to push ahead of your upcoming birth? Mama, I’m glad you’re here!

For many, pushing is the most exciting part of labor because it’s the final moments (okay, in some case hours…) before you FINALLY get to meet your baby. It’s when you are RIGHT at the culminating point of your entire 9-month journey.

But it’s also the part of birth that often gives people the most anxiety. Which I 100% understand. It’s actually pretty normal to be thinking, “A baby is going to come out of where?!” It can honestly be a little bit hard to wrap your head around.

So here we’re going to get into all the details about the second stage of labor (that’s the pushing part!) so that you know exactly how to push during labor like a boss.

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The second stage of labor

Lots of people hear the word labor and their mind immediately goes to contractions. And while that’s not wrong, there’s more to labor than that! In fact, labor is a word that technically encompasses four distinct stages during birth.

Let’s do a quick rundown of each of these:

  1. The first stage of labor: This is the contraction part. It starts with your first contractions and goes until you are 10 centimeters. For most mamas this is the longest stage of labor
  2. The second stage of labor: This is the pushing part! It starts when you hit 10 centimeters and ends when your baby comes out
  3. The third stage of labor: This is when you deliver the placenta. It begins after baby comes out and ends when your placenta emerges
  4. The fourth stage of labor: The fourth, and final stage, encompasses the first hour or two after birth. It’s a time where you’ll be monitored closely for postpartum hemorrhage and other potential complications

You can read more detailed information about the stages of labor and what to expect during each one to help you continue getting educated for birth. Or check out one of our online birth classes that goes more in-depth on the entire birth process (pushing included!).

Now that you know that there are four stages of labor, you know that here we’re focusing in on that second stage. The second stage of labor is often referred to as the pushing stage. Aaaand like I mentioned in the introduction, the thought of it leaves pregnant mamas feeling seriously anxious.

So let’s keep erasing some of the unknown to help you feel more confident.

How to push during labor?

pushing during labor infographic

Open glottis pushing

Open glottis pushing, sometimes referred to as spontaneous pushing, is a way to push that allows you to take the lead. Basically, a health care provider and/or support person is there to encourage you to trust your body and support you as you push. You push when you feel the urge to bear down/poop. When this technique is used, most women take several breaths between pushes.

You’ll probably push for about 5 seconds 3‐5 times during each contraction. You may grunt or make a deep noise when you are pushing. This is a sign that you are pushing well!

Blood flow to your uterus and baby isn’t affected, so there is less chance that baby will have heart rate changes. Also, less chance that you will get so tired that you can’t push anymore, and less chance that you’ll tear.

Guided pushing

Guided pushing is the kind of pushing that you typically hear done in hospitals. You will be guided to hold your breath for 6-10 seconds, bear down like you are pooping, and push about 3 times with each contraction. You may be asked not to make any noise while you push, which helps guide all of your energy/breath towards your bottom where you are pushing.

During guided pushing, the blood flow to your uterus and baby can decrease, which can result in changes to baby’s heart rate. There is also a higher chance that you will feel so tired you can’t push anymore, and a slightly higher chance of tearing.

So, which pushing option is better?

Okay so after reading those two descriptions, you may be wondering why everyone doesn’t do open glottis pushing if it has slightly less risk to you and baby?

Well, open glottis pushing is awesome, and we encourage it when we can especially when mamas are birthing without an epidural. The only big problem with open glottis pushing is that it often increases your pushing time. This is okay…but if baby is unstable, we may ask you to do some guided pushing to speed up the process.

Open glottis pushing is also quite a bit harder to do if you have an epidural because feeling those waves and instinctually knowing when to push can be tricky. So we usually advise our epidural mamas to try some guided pushing.

Also, open glottis is just not for everyone! It’s about what works best for you, and you can always do both. I personally didn’t use open glottis pushing. I much preferred the rhythm and control of guided pushing!

Related: Breathing Techniques for Birth

Different pushing positions for labor

Okay, so a question I get over on Instagram a lot is about pushing positions. We’ve all seen the classic mama lying on her back, feet in stirrups pushing that happens in the media. But there are actually a lot of different ways you can push! This is especially true if you do not have an epidural in place.

labor pushing positions infographic, birth pushing positions ingrographic, pushing during labor, pushing during birth

Here’s a little more info on pushing positions to go with that infographic:

  • Hands and knees/kneeling: This position seems to be very popular where I work and one that mamas really tend to go into instinctually, which I think is pretty cool. There are lots of ways to do this. Could be literally on hands and knees, but often mamas like to drape their upper bodies on something else, like a yoga ball (as pictured above), a chair, or even the top of the bed in the delivery room
  • On your back (lithotomy): This is that classic position we often think of when we think about pushing a baby out. And honestly, there’s no problem with it! I just want to erase the myth that it’s the only way. This is how I pushed out my first ?
  • Side-lying: This is known to be a more restful pushing position, and can be used with an epidural in place! You can use a peanut ball or lots of pillows to help position and support you in this pushing position
  • With a partner: In this pushing position, your partner kind of supports you while you’re in a squatting pushing position. I don’t see this one too often to be honest, but wanted you to know it’s here!
  • Squatting: Yep. Some mamas like to put gravity to use and feel the urge to push in a kind of yogi-squat position. It’s not for everyone but some mamas really like it!
  • Backward on a chair: In this position, you’ll drape your upper body over the back of a chair but your body will be supported by the chair
  • Birthing stool (not pictured): Most labor and delivery units have these available! It basically lets you push in a sort of supported squat/upright sitting position, and the shape of it allows baby to come out
  • Birthing bar (not pictured): This is an attachment that’s on most labor beds. You can use it to support yourself in a squatted pushing position

Note: There is some research that links certain pushing positions with a higher likelihood of tearing. You can read ALL about that in our article, How to Prevent Tearing During Birth

How should I push during labor?

So, while these are some of the more “popular” pushing positions I see in the labor and delivery room, I always like to tell mamas that it’s usually fine to push however you want, for as long as you want – as long as you and baby are stable!

Don’t feel as if you have to push on your back, or you HAVE to push squatting, etc. Push in whatever way feels good or instinctive to YOU. Our bodies are amazing – they know what to do!

However, if things aren’t progressing, or you’re pushing and something’s not working (for example, baby isn’t moving down very effectively), try another position. Your labor nurse can help you reposition if something’s just not working. Sometimes switching things up is the key to get things going again.

Be sure to grab our free birth plan to help you indicate your wishes and discuss these kinds of things ahead of time!

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My pushing experience

With my first, I tried hands and knees, but I hated it! I ended up flipping around and pushing in lithotomy (on my back) and delivering that way.

With my second I actually stalled at 9.5 cm and I pushed through that final centimeter on hands and knees. When I FINALLY hit 10 cm I flipped over and pushed for another 15 minutes on my back/side. He ended up spinning from posterior to anterior as he was coming out which was seriously intense!

Related: My Second Birth Story on the MLN Podcast

How to push during labor: 7 Tips every mama needs

Okay mama, so we’ve talked about pushing and the most common pushing techniques, but here’s a list of tips to help you rock your second stage of labor:

  1. Push as if you’re having a bowel movement. Yep! If you’ve heard this before, it’s true! And if you do poop during the whole ordeal, DO NOT STRESS IT. Your nurse will be sneaky and swift with cleaning it up, and we do not care.
  2. Tuck your chin to your chest: This is a little trick I always coach mamas on when I’m their nurse. It helps so much!
  3. Give it all you’ve got: Make it count girl, and remember you do get little mini-breaks between the peaks.
  4. Stay focused and relax your other limbs: Eye on the prize! Sometimes mamas like the idea of a mirror to see the progress. It helps to keep them focused and motivated.
  5. Change positions: If you’re not making progress, switch it up! Sometimes mamas intuitively want to change positions, other times we L&D nurses might make a suggestion.
  6. Trust your instincts and push at the peaks: Again, sometimes your body will intuitively know when you should push, but if you don’t (or if you have an epidural in place!) your nurse/provider can help you time it with the peaks for maximum effectiveness.
  7. Rest between contractions: THIS! Try to take some deep breaths, regain composure a bit and get ready to give it your all at the next peak.

Pushing is one thing that I have a WHOLE section on – and a lot more info on – in my birth classes! If you’re currently in the late second or third trimester, go check ‘em out, mama!

Now you know all about pushing during labor!

All right, mama, you’ve just learned a ton about pushing during labor, ways to push, positions, tips and more! Hopefully, by now you’re feeling a little less anxious about the entire second stage of labor ?

Have a question related to pushing during labor that I didn’t answer? Drop a comment below to keep the conversation going!

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Liesel Teen, BSN-RN
Founder, Mommy Labor Nurse

Meet Liesel Teen

Hi there. I’m Liesel!

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

When you know what to expect and have the tools to navigate the experience, you’ll feel confident and in control.

I believe you deserve a better birth — no matter how you deliver.