Hugging and Humming During Labor
When it comes to labor one of the most important yet confusing parts of how to let your baby out is the expulsion phase. Most people think of having to “push” their baby out. Yet there are a ton of different ideas on how to do it. Let me share a few concepts of what is naturally happening and how you can best assist this process.
What you need to understand is your uterus can push your baby out whether you are conscious or not. If you were unconscious it knows how to do it on its own. When the uterus contracts it starts at the top and contracts in a downward motion to help increase pressure on the cervix. When the baby’s head is in an optimal position putting pressure on the cervix, it thins and widens with each contraction.
So if the uterus can do the job of pushing your baby out, I’d like to share ways that you can help support the uterus in doing its job. Let’s talk about the idea of pushing. What if you didn’t have to push at all during labor?
From my experience with my labors, it’s almost impossible not to push. Yet pushing can be a bit confusing for some people. I’ve heard from several clients they were told they didn’t know how to push effectively. Some may think you need to push down from the top of your belly to push your baby on out. The uterus is already doing this downward motion. Doing so just puts pressure on the top of your uterus and may cause your belly to push out away from the spine which doesn’t help the uterus out at all.
I invite you to try a different approach. Instead of pushing your baby out, I would like you to think about breathing your baby out. Try doing a very prolonged exhale and see what happens to your belly. With a correct exhale you should notice your lower belly contracting back up and in. This is because your transverse abdominus (TA) muscle contracts on an exhale. The TA attaches on either side of your spine and wraps around to the front of your belly. When it contracts is actually hugs your baby and uterus. This compression gives your uterus more support in doing its job of pushing your baby down and out.
So instead of bearing down from the top, think about hugging your baby back toward your spine and giving your uterus more support in doing what it knows how to do. By breathing out and exhaling you should be contracting your lower belly backward and supporting your uterus more in helping to get your baby on out.
In some birth situations, the labor support people may instruct you to hold your breath and push as hard as you can. Some call this purple pushing as when you hold your breath your face turns red and then purple if you hold it long enough. While this might be necessary for an extreme emergency situation, it should not be the standard pushing procedure. Breath-holding and pushing are big factors in the potential of developing prolapse of your pelvic organs. This is why changing your thinking from “pushing” your baby out to breathing your baby out is a much more supportive idea to your pelvic organs.
One more thing we need to be aware of during this phase of labor is your pelvic floor muscles. You need these muscles to relax and lengthen during this part of labor. Our typical wiring is when the TA contracts so does the pelvic floor muscles. Try doing a kegel and see what happens to your lower belly. You should find it contracting back. You can also contract your lower belly backward and see what happens to your pelvic floor muscles. They should contract up as well.
However, in labor, we need these two muscles to do the opposite. What needs to happen in labor is what should happen when you have a bowel movement. Next time you go to the bathroom, see what you do to encourage your stools to come out. Ideally, you can contract your lower belly and relax your pelvic floor muscles. This helps your bowels to empty. Unfortunately, not a lot of people do this correctly.
There is a way to help get your pelvic floor muscles to relax, and that is to vocalize in a really low tone. The pelvic floor muscles and our voice are connected. When you do a high pitch sound your pelvic floor muscles contract whereas a lower-pitched tone can cause them to relax.
Lower sounds are more helpful and productive during labor.
Instead of thinking about pushing your baby out, I invite you to think about Hugging and Humming your baby on out.
On an exhale try and find the lowest tone you can make and hug your baby to your spine.
The exhale will contract your TA muscle which will help support your uterus in pushing your baby down and out. This is the hugging part. The humming is the lowest tone vocalization you can do which will help relax your pelvic floor muscles. Both of these will support your uterus in moving your baby through and out of your body.
Give it a try in labor and let me know how it works for you.
Women's Health Practitioners
Grab the Download to Learn How Using the Six Key Assessment Tools and Techniques
Great explanation, Lynn. So much different than I was taught, and taught as a Prepared Birth Instructor in the 80’s. I have had to process the regret of pushing as hard as I could to get my 4th baby out ( 1/2 a pound smaller than my previous) and although it was only 2 Herculean pushes, I “blew my bottom out”, suffering significant hemorrhoids and PF strain to the point of not being able to move and even hold my new baby for several minutes. I had a severe case of “baby fog” and developed a nominal aphagia from the high blood pressure of the Val saliva that blew some brain cells as well. So now, I think about and teach easing a baby out with the breath and hum, as well as teaching chronic constipators how to have easier, less PF traumatic bowel movements. Thank goodness we finally learn and teach to the new learning!
Thanks Heather for sharing so others don’t do the same. So appreciate your input always!
Thank you Lynn for this great explanation. The idea of ‘not pushing’ was suggested to me by my fellow moms in a moms group, when I was pregnant with my 2nd child. I have read many other approaches to this way of working with what the body is doing during labor—now that I am supporting other folks during birth, I will definitely use this excellent information.
I recently read an article about not instructing or really engaging moms in the second stage of labor at all, because if the hormonal package is right (during this phase of labor) the muscles all do and react as they should and the baby is expelled in relatively few contractions, but telling a mom to push or assuring her that she is fine during this stage (when many tend to freak out for a moment) can actually inhibit their ability to have the experience of the ‘fetal ejection reflex”. I’m curious to know what you think of this.
Every person is different and that is why I encourage practice with my patients to feel the expansion of the pelvic floor muscles with this approach. Yes it’s best if we leave moms alone and let them do their thing. I’ve heard from several of my patients that they just didn’t know how to push. This is one way to instruct but it doesn’t work for everyone. Making sure moms know how to relax their pelvic floor for birth is critical in my opinion.
I think this is a fantastic explanation! It makes so much sense. I wish I was taught this approach during my deliveries. Sadly, I will never have the opportunity to test it out myself but I hope to pass these teachings on to other women.
Good information but please don’t show people birthing on their sacrum. The sacrum needs to move back to create room! So there is limited tearing as well. Just look up Rhomus of Micaelus to see a picture. When we show pictures of on the back birthing we further normalize it. But great article!!
Hi,
I had a little question with respect to your statement: ”Breath-holding and pushing are big factors in the potential of developing prolapse of your pelvic organs.” I was under the impression that there was still conflicting evidence around the results of the POP Q measurement between coached pushing as opposed to spontaneous pushing. I only found two small RCTs from a while back that looked at this. Is there a newer RCT or SR / metaanalysis that investigated this? I would be happy to send it to the health care providers, birth doulas, etc. that we work with at the clinic.
Thank you 🙂
Marie, I don’t have any new research to add. I have experienced in my practice that some clients who have prolapse did tend to “purple push.” Thanks for your comment.
This is such a beautiful, peaceful way of bringing a baby into the world. With my fourth and last baby, i found myself grunting and moaning during pushing. She was very large, I could feel her decent, and the best way for me to cope was through vocalizing and using lower tones. She was 9 Lbs and I had no trauma at all.
I certainly wish I had this instinct with the previous three babies, but with each one I did learn something from the experience to take into the next birth and to share with someone else in a positive way.
Your expertise is so appreciated. “Hum and Hug” , I am excited to pass this on .
I wish I would have known this with my previous births