Some studies have looked at whether or not having an epidural alters how you push your baby out. However, the results have been mixed. A 2017 review of those studies found that for women on epidurals, delaying pushing during the second stage of labor increased the stage by 56 minutes. Overall, however, it was unclear whether the timing of when to start pushing had any lasting impact on moms or babies.
The Urge to Push With an Epidural
Near the time of birth, laboring women experience the urge to push. Sometimes this urge is overwhelming and women describe it as something that their body is doing and they have no control over it. Other times, it simply means that it feels better to push, particularly at the peak of a contraction, than it feels to not push. For some women, an epidural can dampen or eliminate the urge to push in the second stage of labor. This lead to the theory of laboring down, a term that describes waiting to push until the baby is fairly far down into the pelvis. This allows the mother to rest and was thought to prevent:
Fetal distress Prolonged pushing Some fetal malpositions or allow the baby time to rotate into a better position The mother from feeling incredibly exhausted from pushing efforts
Pushing Positions With an Epidural
Since an epidural anesthetizes the mother, she may not be able to assume as many positions because of the lack of feeling. This puts a limit on the number of possible positions, which can hinder progress during labor. This varies from mother to mother. Some women will have more movement than others, and while this might alter what positions you can use, it will still usually require a lot of support from those around you. With good support from your partner, a doula, labor nurses and others, there are several effective positions the mother can use for pushing including:
Kneeling at the foot of the bed, leaning overSemi-proneSemi-sitting with leg supportsSide-lyingSupine with stirrups or leg supportsSupported squat
Epidural Complications
While the reduction of pain is a benefit of an epidural, this medication also increases the risk that you will:
Increase the length of the second stage because your muscles are less able to help rotate your baby into preferred positions for childbirth Have an episiotomy Need forceps or vacuum extraction Need more time for pushing than you would otherwise Need Pitocin, the synthetic form of the hormone oxytocin
The use of an epidural will most likely not have any great effect on your ability to push, with the most likely complication being a lengthier pushing phase. That said, many women gladly trade a few extra minutes of labor with the pain relief provided by the epidural for the alternative.
A Word From Verywell
If you are planning to have an epidural, talk to your doctor and doula about how you want to handle the pushing phase of labor. Knowing your options and having a birth plan in place can help you make the right decisions about this aspect of labor and delivery.
