Laboring Down

What is laboring down?

Laboring down is a labor and delivery technique that involves delaying pushing. Typically, you begin pushing once your cervix dilates (opens) to 10 centimeters. This is also known as the second stage of labor. But if you labor down, you delay pushing for one to two hours after the second stage begins instead of pushing right away.

There are several reasons you may want to labor down. One of the main reasons is that you may not feel the urge to push yet. In these cases, it’s often helpful to wait until your baby is lower in the birth canal or until there’s a strong, natural urge to push. This approach allows gravity and contractions to help move your baby farther down. It’s also a more natural approach because you let your body do most of the work on its own when it’s ready.

Laboring down is sometimes called delayed pushing or passive descent.

What are the benefits of it?

Some healthcare providers believe that laboring down:

• Helps you conserve energy by shortening how long you push
• Helps your body work naturally
• Improves the chances of a vaginal delivery
• Reduces the risks of needing a C-section

Studies show that laboring down cuts the total time that you push before delivery by about 27 minutes. But it also extends the length of the second stage of labor by almost an hour.

Is it safe?

It’s not safe to labor down if your baby is showing signs of distress or isn’t moving down the birth canal. If you’re showing signs of infection, it may not be safe to wait the extra time to delivery.

Some studies show there isn’t any evidence that delayed pushing leads to a higher rate of vaginal delivery. The same study shows slight increases in the following complications with delayed pushing:

• Chorioamnionitis (a bacterial infection in the amniotic fluid)
• Postpartum hemorrhage (heavy bleeding)

Because of these risks, some hospitals have policies against laboring down. Before deciding to labor down, talk with your obstetrician, midwife or doula about the pros and cons. Your health, how your labor is going and your baby’s position can all affect whether it’s a safe option for you.

What is the best position for laboring down?

The best positions are ones that open your pelvis. There are a few ways you can do this. Lying on your side with a peanut ball is one way. You use the ball to prop up one bent leg. Another way involves being on all fours and swaying or rocking your hips.

Can you labor down with an epidural?

Yes. It’s possible to labor down with an epidural. But if you’re numb, you may not feel the natural urge to push.

The American College of Obstetricians and Gynecologists (ACOG) doesn’t recommend laboring down if it’s your first time giving birth and you’ve had an epidural. But ultimately, the decision is between you and your healthcare team and based on your specific situation.