Episode Details

You're 10 centimeters, and your nurse says "okay, let's push" - and without any discussion, you're guided into whatever position is easiest for everyone else in the room. Except it doesn't have to go that way. Trish is breaking down pushing positions, what the research actually says about each one, and exactly how to get the birth room to work with you - even if you have an epidural.

Trish pulls back the curtain on one of the most overlooked parts of birth prep: how you push. She traces the surprising (and slightly wild) history of why flat-on-your-back became the hospital default, walks through what the Cochrane Review actually found about upright versus lying-down pushing, and breaks down six different pushing positions - who each one is best for, what the research shows, and how to advocate for the one that's right for you. Whether you're planning unmedicated or you know an epidural is part of your plan, this episode makes sure you walk into your birth room already knowing your options.

What You'll Learn:

• The real history behind the "default" position - and why it has nothing to do with what's best for you
• What the Cochrane Review found when comparing upright vs. lying-down pushing - fewer interventions, fewer abnormal fetal heart patterns, and a shorter pushing stage
• The tearing nuance nobody explains - upright positions may carry a higher chance of minor tearing, but a lower chance of episiotomy
• Six pushing positions, including who each one is best for: Lithotomy (on your back), Semi-recumbent, Side lying (Sims position), Hands and knees, Squatting and supported squatting, & Leaning forward on a raised bed
• Which positions work with an epidural - yes, you still have options
• Exactly what to say to your nurse or provider if they default to what's easiest for them, not what's best for you
• How to put your pushing preferences in your birth map before you ever walk into the hospital

Resources Mentioned

• Labor Like a Pro Guide - Trish's illustrated labor positions guide, showing every pushing position and exactly when to use it.
• The Calm Birth Bundle - the full kit and caboodle, including the labor positions guide: labornursemama.com/calm

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Helpful Timestamps:

• 00:00 Pushing Positions
• 03:11 What Research Shows
• 05:23 Lithotomy and Semi Recumbent
• 06:39 Side Lying for Control
• 07:46 Hands and Knees Benefits
• 09:25 Squatting for More Space
• 11:01 Leaning Forward Upright
• 11:58 Epidural Friendly Choices
• 13:21 How to Advocate Early

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