Positions for Pushing With an Epidural

You may have heard that you are totally numb if you have an epidural. You may have heard that you can only push on your back with an epidural. The good news is that is no longer the case! Most epidural placements now offer good pain control without confining you to being on your back. This means that you are able to push in different positions within your hospital bed. Take a look at some of your options!

Pushing on Your Side

This a wonderful option for folks who have an epidural. You simply choose a side to lay on. Most people have enough movement that they can move to the side but your support team can also help you move. Once on your side you lift your top leg. If your leg feels too heavy to lift ask your partner or doula or nurse to hold it up. Put your hand under the knee of your lifted leg. When you have a contraction, pull your knee toward you while you curl around your baby and bear down. You can put your leg down between pushes or you can have your support person hold it in the air. Push for a few contractions on that side. Then, roll to your other side and push for a few contractions. Changing sides can help your baby better descend. This side-lying pushing is also a great option if you’ve had a long labor and are feeling exhausted.

Pushing On Hands and Knees

Believe it or not, pushing on your hands and knees IS an option for folks who have an epidural. Have your support team help you turn over. You can place a peanut ball under your forearms to help keep pressure off of your wrists. Or, you can place the peanut ball vertically along your torso to help support your weight. You support team can help hold your knees or place pillows to support you. When a contraction begins, curl your back a bit and bear down. This position allows your pelvis to open by about 30% more than other positions.

Pushing In A Semi-Reclined Position

Modern labor and delivery hospital beds are a little bit like transformers. The bed is divided into several parts and they can be moved into different positions. This is super helpful if your epidural is really dense and you have more limited movement. Instead of moving you, your support team can move the bed! One of the ways to move the bed is to raise the back of the bed up while lowering the bottom half of the bed. This will put you in a more seated position with the back of the bed tilted back just a bit. This gives you the benefit of gravity being on your side. You can place your feet on the foot pedals to the side of the bed. Place your hands on the back of your knees. When a contraction begins pull your knees back and curl around your belly while you bear down. An alternative to pulling your knees back is to use the handles on the side of the bed. You would grab the handles with your hand-palms up-and pull them toward you (you can’t actually pull them but it’s the motion you’re going for).

Pushing Using the Squat Bar

This can be a nice addition while you are in the semi-reclined position. Your nurse can place the squat bar on the end of your bed. Then they can tie a sheet around the bar and hand you the two ends of the sheet. You place your feet on the sides of the squat bar. Once a contraction begins you pull the ends of the sheet towards you while you bear down to push. This is a great way to help your baby move under your pubic bone.

Another way to use the squat bar is to have it placed on the end of the bed. Your support team can lower the bottom half of the bed a bit more. They can help you scoot to the bottom edge of the top half of the bed. When a contraction begins your team can help lift you up to the squat bar and you can drop your bottom off the top of the bed to be in a squat. If needed, your team can place pillows under your thighs to help support you.

Of course, you can always push on your back if that’s the most comfortable position for you but know that you have options. Changing positions a few times while in the pushing stage may be able to help your baby descend and possibly shorten the amount of time you push.