Let's talk about it pushing positions.
Because there is a lot of chatter about how pushing on your back is NOT IT, but I don't always see a lot of info about what you should be doing instead!
And I also see a lot of people asking, "What is the BEST position to push in?"
If we are meeting for the first time - Hi! Welcome to Vibrant Mama Wellness! My name is Megan, and I am a pre and postnatal personal trainer. I am certified through the National Academy of Sports Medicine, with a specialization in pre+postnatal fitness through Pronatal fitness. I am a mom to a toddler, and pregnant with my second baby!
(Disclaimer: I am not a doctor and this is not medical advice. This blog is not intended to diagnose, treat, cure or prevent any disease or condition. This blog post is based on my own research and experience - please consult a medical professional before starting or making any changes to your exercise program).
The short answer is...
The position that feels best for you in the moment!
You may be thinking "Whaaaaat? But I thought pushing on your back was bad?!"
And it's not necessarily "bad", it's just not optimal.
The way the human pelvis is designed and the way the baby needs to move through the pelvis to be born, laying on your back can restrict the space available and increase your risk of severe perineal tears. But it's not "bad." So if you are pushing and that's the only way you feel comfortable, don't worry about it!
But I will give you some alternatives that allow for maximum movement of the pelvic outlet (bottom of the pelvis) and decrease the risk of severe tears!
Side-lying. This position is available to you whether you do an unmedicated or epidural birth so it's a great option! You simply lay on your side. This allows the sacrum and tailbone to move back and out of the way (which it can't do if you're sitting or on your back). If you can, having knees in and ankles out is also going to allow for the maximum amount of space for baby to make their exit!
All fours. This is an option a lot of people use in unmedicated births, but if you can feel your legs with an epidural, it often is an option as well! (as long you have lots of pillows, etc to support you on the bed!) Like side lying, this allows the sacrum and tailbone to move, and doing knees in and ankles out will open the pelvic outlet.
Both of these options decrease the risk of severe tears because of the fact that baby has a lot of room at the bottom of the pelvic outlet! But also keep in mind that sometimes tears do happen, and it can be due to a lot of different factors such as the amount of muscle tone in your pelvic floor, how fast your baby is coming out, and how you're breathing when you're pushing. Learning how to relax your pelvic floor and breathe out your baby can make a huge difference, and I teach you how to do this in my Vibrantly You™ Pregnancy Program!
Remember above all else - YOU HAVE OPTIONS when it comes to labor and birth. There is not one single "best position" to push in, but there are different options to allow your pelvis to move freely and reduce tearing risk.
I always encourage people to educate themselves during pregnancy, practice getting in and out of these positions so they're familiar to you, and have an open dialogue with your providers about what positions they have experience delivering in! It is your birth, and I want you to feel empowered and confident in your choices.
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Disclaimer: This blog does not serve as medical advice. Please consult your medical provider before starting a new fitness routine. This blog is not intended to diagnose, treat, cure, or prevent any disease or condition.