💚 “It’s Time to Push!”

POV: You’ve just heard those words in the delivery room.
You’re at 10 cm. You made it! 🙌

But instead of rushing to push…
you pause.
You remember something called “laboring down.”

And because you’ve read this article, you know what it means, how to decide if it’s right for you, and how it could protect your body long after birth.

🤔 Wait… What Is Laboring Down?

Laboring down means waiting to push. 

Instead of starting to push right away (just because you’re fully dilated), you give your uterus more time to do the work, naturally pushing baby down deeper into your pelvis.

💡 You either wait until:

• You feel a strong urge to push, or

• Your care team sees baby’s head. ✨It's important to understand station 👇

🧭 “Where’s Baby in My Pelvis?” = Key Question

Ask about your baby’s station (that’s how low their head is in your pelvis):
📉 Negative numbers (-1, -2, etc) mean baby is still high
📈 Positive numbers (+1, +2, etc) mean baby is getting close!

👉 If baby is still high, laboring down gives your body a head start, so when you do push, you don’t have to push as long or as hard.

💥 Why This Matters for Your Body

If you spend less than 1 hour pushing, studies show you lower your risk of:

🩸 Perineal tearing

💥 Pelvic organ prolapse

🍑 Hemorrhoids

💦 Postpartum leaking (incontinence)

 📉 Laboring down can cut push time by 50%.

That’s huge! Especially for your long-term pelvic floor health.

As a pelvic floor physical therapist, I help people every single day recover from the trauma of long, hard pushing, injuries that many didn’t even know could be reduced or avoided.

That’s why I created the Pelvic Floor Protection Plan:

To help you understand your options, use your body well, and reduce your risks with evidence-based prep.

👉 Over 2,000 women have accessed this info to prepare smarter and recover easier. Want to be one of them? Grab it here!

🔋 Laboring Down Conserves Energy, Too

Birth is a marathon, not a sprint.

💤 Laboring down lets your uterus work while you rest, so you’re not exhausted when it’s finally time to push.

🏥 And in hospitals with higher c-section rates, this strategy may help you:

✅ Avoid unnecessary interventions

✅ Reduce the risk of assisted birth (forceps/vacuum)

✅ Even lower your risk of episiotomy

💪🏾It Uses Your Body’s Natural Power

Your body is smart. Really smart.

🌊 When you feel the urge to push, that’s part of your body’s fetal ejection reflex (Note: this reflex may be diminished or absent with an epidural), your natural ability to push without effort.

 But when we start too early, we can override that instinct.

Laboring down gives your body the chance to work with the baby, not against it.

⚠️ But Are There Risks?

Let’s break it down simply:

🤱 Without an Epidural

💚 There are no major risks to laboring down!

Just be sure to wait until you feel the urge (unless that urge starts before you’re at 10 cm).

Bonus: If you can move freely and choose your own position, any risks tied to a longer second stage are greatly reduced.

💉 With an Epidural

Some newer research suggests a few things to consider:

⚠️ Slightly increased risk of infection (especially with lots of cervical checks)

⚠️ Possible higher chance of postpartum bleeding

⚠️ Risk of baby’s blood becoming too acidic (rare, but worth knowing)

💡 Solution: If you choose to labor down with an epidural, talk to your provider ahead of time about reducing cervical checks, watching for signs that it’s time to push naturally and if it's generally safe for you. 

🗣 What Should You Do Now?

🌟 If you want to reduce tearing, protect your pelvic floor, and use your body wisely during birth, this is the kind of info and preparation that matters.

Even with an epidural, even in a hospital, you have options.

But those choices need to be discussed ahead of time. Don’t leave it to “hospital policy” in the moment.

🤝 Want Me to Walk You Through It All?

✨ You don’t have to guess when to push.

✨ You don’t need to memorize 100 positions or complicated rules.

✨ You just need to know how to move your body before and during birth in a way that keeps your pelvic floor safe.

👣 That’s exactly what I teach in the Pelvic Floor Protection Plan.

✔️ Exercises to prepare your pelvis & pelvic floor to help you smoothly birth!

✔️ When and how to push well

✔️ How to use gravity, position, and your own body’s power to make birth easier

✔️ Controllable factors when it comes to protecting your pelvic floor from inury 

🛑 Last Thing: You Can Ask for More

No matter what your provider says, no matter what your hospital policies are, you are the one giving birth.

You can ask questions.

You can make choices.

You can prepare.

And when you do?

You’ll walk into your birth feeling confident, calm, and protected.

References:

1. J Midwifery Women's Health 2007 May-Jne;52(3): 238-45 Roberts & Hansen
2. Cochrane. 26 March 2017 Lemos et al
3. MCN AM J Matern Child Nurse 2010 Mar-Apr;35(2):81-8. Kelly et al
4. J Obstet Gynecol Neonatal Nurse 2008 Jane-Feb; 37(1) 4-12, Brancato, et al
5. JAMA 2018 Oct 9:320(14); 1444-1454 Cahill, et all