/ March 16, 2023
How to Train for the Pushing Phase of Labor

The Tummy Team works closely with pregnant women to help physically and emotionally prepare the body for labor, delivery and birth recovery. You’ll often hear us tell clients, “Giving birth is like a marathon, with a dead sprint at the end.” Labor is the marathon. The sprint at the end is the pushing phase. It is the most difficult and most intense part of birth. Everything builds up to that moment when the baby has made its way through the cervix into the birth canal and starts moving toward the exit.
To run a marathon, you train your muscles for the event. Your body may instinctively know how to run, but you likely won’t have the endurance to run that distance, let alone the coordination to sprint well in the midst of fatigue, adrenaline, and pain without some form of training. In the marathon of birth, it doesn’t end at the delivery finish line. After the labor and intense delivery, you are given an utterly helpless newborn baby to care for 24/7. If you have not trained your birthing muscles if you were unable to pace yourself, and if you were forced to power through your birth, you may feel pretty beat up and overwhelmed when you are handed that baby.
That is where The Tummy Team comes in. There are many ways we can help you prepare for a great birth experience and birth recovery. In this blog, we are going to specifically focus on the physical preparation of the pushing phase.
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There are many common misconceptions…
Most women have little understanding of how to help their body physically prepare for the marathon of labor and delivery. More specifically, we lack preparation for this intense pushing phase. Pushing strategies are rarely talked about in childbirth education, and most first time moms only know what they have seen on TV. The advice given is, “Your body will know how to push,” and “It’s like having the biggest bowel movement of your life.” As a result, expecting moms get to the point where it is time to push and are forced to rely completely on the nursing staff to help them figure it out. In most cases it looks like crunching your body, holding your breath and bearing down. Sometimes for hours. The lack of physical preparation for the pushing phase of labor is contributing to many unnecessary birth complications.

This birthing position usually makes labor more difficult.
The above photo demonstrates the typical position in which women are instructed to give birth. What many women, and even hospital staff, don’t realize is this position can actually make things more difficult for a number of reasons:
- This curled position interferes with optimal fetal alignment. Notice the baby now has to be pushed around a corner.
- The crunch position also bulges the tummy, causing extra pressure on the connective tissue of the abdominal wall and usually leads to the development of diastasis recti– a separation in the abdominal wall present in 2 out of 3 moms.
- This crunched or curled posture eliminates the ability to activate the transverse abdominis muscle, which you need to support the uterus to help with the pushing phase.
- Holding your breath to bear down limits oxygen to mom, leading to increased fatigue and then limits oxygen to the baby, which can then lead to fetal distress. Additionally, breath holding and bearing down increases the risk of prolapse, tearing, hemorrhoids and pelvic trauma.
But enough with the bad news…Here’s some good news!
A woman’s body was designed to give birth without falling apart.
Your core muscles wrap perfectly around the uterus to support the process of childbirth. The transverse abdominis muscle is a natural corset that, when working well, will help align the uterus so it can function very efficiently. The uterus is the most powerful muscle in the body. Its job is to rhythmically push the baby out of the womb and into the birth canal and then out of the body. Lastly, the muscles of your pelvic floor have the ability to relax and open so the baby can more easily pass through. Your body was truly designed to do this. However, identifying and then coordinating these “birth-supporting” muscles in the midst of labor and delivery can be difficult.
In our experience at The Tummy Team, most women are pretty disconnected from the muscles essential to helping in birth. Due to this weakness and disconnect, they have trained themselves to use compensation strategies during their pregnancy. For instance, women will thrust themselves out of bed or hold their breath and bear down to deal with pregnancy-related constipation. Additionally, during pregnancy, the core muscles become stretched out making them more difficult to engage. The pelvic floor muscles become equally stretched and have excessive pressure making them difficult to identify. Unless you are intentional about preparing during pregnancy, coordinating these muscles during labor and delivery can be quite difficult.

This position often allows for an easier pathway for baby
This photo demonstrates one component of how we help train women to push.
- Uncurling the tummy helps align the baby for a more efficient pushing stage.
- It also no longer bulges the tummy with unnecessary forward and forceful pressure.
- This position allows you to activate your core and provides the necessary support for the uterus.
- It also gives you control over the pelvic floor muscles to relax, allowing the baby to pass through more easily.
Keep in mind, though that just assuming this better alignment does not automatically coordinate the muscles to be effective. Systematic training of the “birth supporting” muscles will be key.
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Our role at The Tummy Team is to help prepare these muscles by reestablishing the neuro-muscular connection, building strength and endurance, and then teaching you the necessary coordination to help in the delivery process. Prenatal Core Training is truly invaluable. These muscles are going to be required to be used very intentionally and specifically. Just like any marathon, the training is key.
The Tummy Team specializes in training for pregnancy, labor, delivery, and recovery. We work with hundreds of women every year online via virtual appointments and thousands through our online programs. We can help you be trained to push!
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