How to Push During Labor to Protect Your Pelvic Floor

How can I prevent my pelvic floor from tearing during my delivery? This is probably the #1 question I get asked by my pregnant patients as they are entering their third trimester, and rightfully so! I wish there was a way to guarantee a zero-tear outcome. The truth is, birth is unpredictable. But the good news is, there are 2 easy pushing tips that significantly reduce the likelihood of pelvic floor tears and make it easier for your baby to make their grand entrance.

Curious to learn more tips like this? Interested in pregnancy appropriate exercises and education to prepare your pelvic floor for your upcoming birth? Check out my Pelvic Floor Birth Prep Course.

✅ Tip #1 - Breathe!

This is so important! Holding your breath while you push is a BIG contributor to pelvic floor tearing. Sadly, it is still very common for expectant mothers to be told to hold their breath and push as hard as they can by birthing providers and support staff, but this is completely counter to what your body and pelvic floor needs. Here’s why: Your pelvic floor and diaphragm (your main breathing muscle) are designed to work together. When you hold your breath and try to push, this coordination gets interrupted causing the pelvic floor to contract and resist against the pressure of the breath that you just created inside of your torso. This in turn makes it harder for baby to come through and significantly increases the likelihood of pelvic floor tears to occur. 

You can feel this reaction in your own body right now: hold your breath and push down. Notice what happens… notice how your whole body grips, how your pelvic floor tightens, and how the space between your sits bones narrows in response. All of this adds a lot of unhelpful resistance within the body, especially the pelvic floor, and narrows space within the birth canal. 

Now, try it WITH your breath… take a big breath into your belly and pelvis, and invite space between your sits bones. Keep that expansion of your belly outward while you exhale (open mouth) and notice how your body and pelvic floor respond. Notice how there’s more softness throughout your body, more flexibility throughout your pelvic floor, and how much more space you feel between your sits bones. This is why breathing WITH your push is so so important. When you do this during your birth, you want to focus on your inhale as the contraction is building, and then exhale continuously through your push.  Another way to remember this is to exhale with a low pitch hum or low pitch sound while you push. This will also prevent you from holding your breath because an open glottis = open pelvic floor, which will help your pelvic floor stay more flexible. Practice your breath and sounds leading up to your birth so it feels easy for you to access when you need it in real time.

✅ Tip #2 - Knock your knees together! 

The classic birthing position that many of us have seen in the movies, and what occurs most often in hospital settings, is with the pregnant person on their back and knees pulled up towards their chest into a wide frog-like position. If you’re finding it difficult to push in this way, or feel like things aren’t progressing, try knocking your knees together with your feet wider apart. For many, this will create more space between your sits bones and more flexibility in the pelvic floor.

You can feel this in your own body while sitting in a chair: open your legs wide into a frog-like position and notice how your sits bones come closer together.. Now compare that to when you knock your knees together with feet wider apart. Notice how that invites more space between your sits bones. And know that this tip is useful in a variety of birthing positions, not just when you’re on your back.