Pushing Pointers

1. Push when your body tells you. As soon as you have the overwhelming urge to push, bear down. This urge may come at the beginning of a contraction, or well into a contraction.

2. Push properly. Research validates what many mothers do instinctively: short, frequent pushes conserve your energy, preserve blood vessels in your face, deliver more blood to your uterus, enhance contractions, and deliver more oxygen to baby. After five or six seconds of bearing down to your maximum intensity, blow the air completely out of your lungs. Then inhale quickly, filling your lungs with enough new air for the next push.

3. Assume the best position for pushing. Lying on your back is the worst position for pushing; upright squatting is the best. Squatting widens your pelvis and takes advantage of gravity so baby can move down and out faster.

4. Take your time. New studies suggest that it is the intense and prolonged bearing down during the pushing stage that can deprive baby of oxygen, not the length of the second stage itself. Don't be alarmed if you hear the bleeps on the electronic fetal monitor slow down during your contractions, as long as they bounce back to normal after the contraction is over; baby's heart rate normally slows down during contractions and recovers between them.

5. Rest between pushes. When your contraction is over, ease into a position that lets you rest. Suck on some ice chips, listen to soft music, keep your room and attendants quiet, and use whatever relaxation techniques you need to drift into your own calm world.

6. Protect your perineum. The first few urges to push may take you by surprise, prompting you to tense instead of relax your pelvic floor muscles. Here's where your Kegel and relaxation exercises really pay off.