By Lovetti Lafua
Nurse • Midwife • Biologist • Human Optimization Researcher

The solution is not another technique.
It’s supporting physiology—and trusting women again.

During Pregnancy
• Ask about expectations for the pushing stage
• Build confidence in the body’s innate birthing ability
• Encourage hearing birth stories from other women
• For hospital births: prepare for common practices like directed pushing; consider a doula & clear birth plan

During Labour
• Interfere only when necessary
• If she feels the urge to push, reassure her it’s a good sign
• Avoid coaching unless medically required
• Trust that a shift from “urge to push” to “pushing” will happen naturally

Instinctive pushing is not taught.
It is allowed.

When an Epidural Is Involved

Epidurals change the physiology of pushing, so a different evidence-based approach works best:

The most effective strategy

Wait for the baby’s head to be visible before active pushing.

This:
• reduces instrumental birth rates
• shortens pushing time
• lowers fetal distress

Also, avoid semi-supine positions.
Side-lying has been shown to reduce instrumental births for first-time mothers with epidurals.