Last summer, I attended a birth during the NHL season playoffs. The Montreal Canadiens, my home team, were playing, so there was a lot of excitement in the air.

At one point during the evening, we heard a lot of commotion down the hall. Yelling, cheering, angry voices. I thought we’d lost the match but quickly realized that the sounds had nothing to do with hockey. Just the doctors and nurses a few doors down ‘helping’ a woman push out her baby.

Since becoming a doula, I’ve witnessed a few ‘techniques’ used to help women during the pushing stage. I am sharing these with you so you’ll be more aware of what to expect and so you know that you have other options.

Purple pushing
If you’ve ever given birth in a hospital, you’ll know that for most women, though not all, this means you’ll be told to lie on your back (often with your legs in stirrups), bring your chin to your chest, pull your legs towards you, inhale, silently hold your breath and push extremely hard in your bum for 10 seconds. You’ll do this three times per contraction. The staff are often counting loudly or yelling ‘Push!’, ‘Go! Go! Go!’, ‘Harder!’ or other variations on the theme. The longer the pushing stage, the louder the voices.

This is what is called managed or directed pushing or even purple pushing. Purple because your veins pop out of your head, your eyes bulge and your face goes purple. Seriously!

For women with an epidural, you may not feel the urge to push; so managed pushing, rather than spontaneous pushing, is usually how it will go down.

Sometimes you need the cheerleaders, sometimes you don’t.
To help women push, it is not uncommon for nurses to loudly cheer and count to 10 while you hold your breath and push. Sometimes they even get the partners to count. Many women like to be encouraged, others don’t.

Get mad at your baby – WTH?!
I always jump with surprise when the doctor tells my client to get mad at her baby. Saying this is another way of encouraging you to push harder.

Get mad at this precious little one that you’ve been lovingly growing in your belly for the last 9 months? Welcome your newborn with such negative feelings because baby is the cause of your pain? No thanks. Maybe your partner! But not baby.

Ultimatums are not nice.
I have also seen some caregivers pull out the ultimatum card. ‘If you can’t push baby out, I’ll help you.’ How? With forceps, the vacuum or a cesarean.

For sure, the mere thought of these will make you push with all your might. Which is what they want. But again, it creates a situation of fear rather than empowerment. Not ideal, in my opinion, when giving birth is one of the highlights of your life!

So how should you push?
You should push how you want, in the position you want. Pushing doesn’t have to be managed, especially if you are birthing without medication. At one point you will feel the urge to bear down, your body desperately wanting to eject the baby inside you (note: there are some women who don’t feel this ejection reflex). Sometimes you’ll give a series of short pushes, sometimes big, long ones. You may make noise, you may not. Follow your body’s cues.

For women with an epidural, you can often feel the pressure of the contractions, and this will help you know when to bear down. If you can’t, you can always ask that the meds be turned down so that you do feel your contractions.

Since pushing can be anywhere from 15 minutes to 3 hours or more, I suggest you move around, as it may not be good for you to be on your back the entire time. You can try positions like hands and knees, squatting, and side lying (great with the epidural).

As for your cheerleading squad, let them know what you want. That’s what’s important.

Bring out your Birth Warrior
I love the image of the Birth Warrior. Strong. Fierce. Empowered. The Birth Warrior grunts and howls. She is also silent when she needs to be. Breathing in…breathing out… She is the one who calls the shots.

And believe me. No one ever screams at her vagina. Ever.


I wold love to hear about your birth stories! What made it easier for you to push out your baby? What worked and what didn’t work?  Let me know in the comments below.

Wishing you a beautiful birth,


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