The Best Way to Push During Childbirth

For many years, laboring women were encouraged to utilize a type of pushing during childbirth known as “Valsalva.” This technique involved holding one’s breath for up to ten seconds while bearing down during contractions. Now childbirth experts believe that mothers may in fact benefit from pushing spontaneously in response to their own bodily reflexes and urges.

Valsalva or Purple Pushing – Why is it Harmful?

It is no surprise that the technique known as valsalva pushing is also called “purple pushing” since when laboring women push this way, they hold their breath for so long that their faces turn a dark shade of purple. Also known as directed pushingvalsalva pushing is also the most common way of pushing during childbirth if the mother is giving birth in a conventional U.S. hospital these days.

What is the problem with pushing and holding your breath for a long period of time? While some breath-holding is normal during pushing, childbirth experts have discovered that the prolonged breath-holding that is often encouraged in directed pushing can be problematic. Research shows that purple pushing is one factor that can increase the mother’s chance of tearing and postpartum pain. It may also decrease the oxygen flow to the placenta and eventually the baby.

Benefits of Spontaneous Pushing

Not all expectant couples may be familiar with the term “spontaneous pushing.” Think of it this way. Rather than another person telling the mother how to push and for how long, spontaneous bearing down is when she bears down with each contraction as she wants to. She may hold her breath for a short time, or make a noise or grunt during contractions. She will always take a break in between her pushing efforts. It may even involve her seeking the pushing position that feels the best to her.

Spontaneous pushing has been shown to have a number of benefits including:

  1. Less pain
  2. Less fatigue after birth
  3. Shorter pushing stage
  4. More positive feelings about birth experience

It is clear then that the best way to push during labor is spontaneous bearing down, rather than having another person direct you to hold your breath until your face turns purple!

Include Preference for Spontaneous Pushing in Birth Plan

If you are expecting a baby, be sure to talk to your care provider about your desires to use spontaneous, rather than directed or purple pushing. These requests can be written in a birth plan and/or shared with your care provider verbally at a prenatal visit. Also be sure that your birth partner and doula are well aware of these preferences for pushing so that your birth team can be reminded once the second stage of labor begins.