If you feel like pushing during pregnancy, contact your maternity team immediately and tell them what is happening. A strong urge to bear down can mean your baby is moving into the birth canal, but it does not confirm that it is time to push. If birth seems imminent or you are not at your planned birth location, call your local emergency number and follow the dispatcher's instructions.
What should you do first when you feel the urge to push?
The right response depends on where you are and how quickly labor is progressing. If you are already at a hospital or birth center, tell your midwife or labor and delivery nurse immediately. They can assess how far labor has progressed and guide you on whether to start pushing or use breathing techniques to manage the urge.
If you are at home, in a vehicle, or somewhere without maternity staff, contact your maternity team immediately. If you think your baby is coming now and you have a strong urge to push, call your local emergency number rather than waiting to reach the hospital. The London Ambulance Service identifies an imminent birth with a strong urge to push, a visible part of the baby or umbilical cord, and heavy vaginal bleeding as reasons to call an ambulance.
Why do you feel like pushing during labor?
The urge to push often feels like a strong need to have a bowel movement. You may notice pressure in your bottom, a feeling of fullness in your pelvis, or an involuntary urge to bear down during contractions. These sensations can occur as your baby's head moves lower through the birth canal.
According to the NHS guidance on the stages of labor and birth, the pushing stage begins when the cervix has opened fully and continues until the baby is born. The urge to push may develop near the end of the first stage of labor, but the sensation alone cannot confirm that your cervix is fully open.
Some people feel a strong, natural urge to push, while others experience pressure without a clear urge. An epidural, which is used to relieve labor pain, may reduce the sensation of needing to push. Your maternity team considers your examination findings and your baby's progress when deciding how to guide this stage.
Should you start pushing as soon as you feel the urge?
Not necessarily. Tell your midwife or obstetric team about the urge and follow their instructions before beginning deliberate, forceful pushing. Your cervix generally needs to be fully dilated, meaning it has opened enough for the baby to pass through. Pushing before the appropriate stage can be unhelpful, so the team will assess your labor before guiding you.
MedlinePlus explains that the urge to bear down can occur during active labor before the cervix is completely dilated and that a clinician may ask you to wait. If you feel unable to resist the urge, tell your care team immediately rather than struggling silently or attempting to manage the situation alone.
How can you manage the urge while waiting for guidance?
If your midwife tells you to wait before actively pushing, ask which breathing technique is appropriate for your situation. Slow, controlled breathing or gentle blowing may help you respond to the urge while the team assesses your progress. Follow any specific instructions they give you, particularly if the urge becomes stronger or changes suddenly.
Try to stay as comfortable as possible while remaining in contact with your care team. A change of position may help you cope with labor, but choose positions with the team's guidance, especially if you have an epidural, monitoring equipment, or another condition that affects your movement. Do not delay an emergency call if you are away from a maternity facility and think the baby is about to arrive.
What should you do when your midwife says it is time to push?
When your maternity team confirms that you can begin pushing, work with your contractions and follow their guidance. You may feel a strong downward pressure as a contraction builds. Your midwife can help you coordinate your effort with that sensation, explain when to rest, and advise you when to change your breathing as the baby's head moves closer to being born.
You may be able to choose a comfortable birth position, such as lying on your side, kneeling, sitting upright, or squatting with support. The best position depends on your comfort, the progress of labor, your baby's condition, and any medical equipment or procedures needed. You can discuss position options with your maternity team as labor progresses.
There is no need to worry if you do not feel an obvious urge to push. Some people need more guidance, particularly when an epidural reduces the sensation. The Cleveland Clinic's guidance on laboring down explains that the timing of pushing depends on the person's circumstances and that decisions about delaying pushing should be made with the maternity team. Do not decide to delay or begin pushing based on a general rule without considering your own labor.
When is the urge to push an emergency?
A strong urge to push can be a sign that birth is approaching quickly, particularly when you are not yet at your planned birth location. Do not wait for contractions to follow a particular pattern if you feel that the baby is coming. Contact emergency services immediately if birth appears imminent, and follow the dispatcher's instructions.
The NHS advises urgent contact with a maternity team if your waters break, you have vaginal bleeding, your baby is moving less than usual, or you think labor may be starting before 37 weeks of pregnancy. It also identifies contractions lasting longer than two minutes or six or more contractions in ten minutes as reasons to seek urgent advice. If a strong urge to push suggests that birth is happening now, use the emergency number rather than relying on routine maternity advice.
If you are experiencing the urge to push right now and are unsure what to do, do not wait for an online answer. Tell your midwife or maternity team immediately, or call your local emergency number if you think your baby is coming before you can reach appropriate care.