How Laboring Down Can Save Your Pelvic Floor
Laboring down refers to the practice of waiting to push until baby has assumed a low enough position, specifically a fetal stage of +2 or lower. We will get to this part. Let’s first go over some basics.
Okay, so you’re 10 cm dilated; all ready to push, right? Maybe not. For many women, they become fully dilated before baby is in an ideally low position. By the time you are fully dilated, you may (or may not depending on epidural status) notice an involuntary urge to push the baby out. This is called the Fetal Ejection Reflex. This reflex stimulates your uterus to contract and push the baby down. Remember, your uterus is what pushes the baby out; your bearing down is just a little extra assistance.
How do you know if baby is low enough? We measure baby’s stage based on where their head is in comparison to your vaginal opening. You can imagine that the closer the baby’s head is to that opening, the less work you will have to do. Ideally, baby’s head will be off a stage of +2 or lower. I know what you’re thinking- how on earth am I supposed to know that? ASK! You have the power to ask any question you want during your birth.
Now, let’s say you are 10 centimeters dilated but baby is still high up there. Now what? LABOR DOWN. During this period of time, we are allowing the fetal ejection reflex to gradually push your baby into an optimal position. This stage can last for about 30 minutes but should not exceed 1 hour. During this time, you want to let gravity do its thing. Grab your peanut ball and have your partner or nurse position you in an uneven position, such as one shin up on the ball, to allow your mid pelvis to open.
Once baby has assumed a low enough position, go ahead and take a big inhale, then exhale (or scream, yell, shout, moan) as you bear down in unison with your contractions.
Laboring down can have many advantages:
Less fatigue - Prolonged pushing can quickly sap your energy right when you need it most. Laboring down gives your body a chance to gently stretch tissues rather than powering through.
Fewer complications - Allowing time for the pelvis to expand around the baby’s head minimizes the risk of tearing or intense crowning pressure. You are significantly decreasing the length of time you are putting stress through your pelvic floor.
Better positioning - Delaying pushing encourages baby to rotate and tuck their chin to fit through the pelvis. This optimal positioning makes delivery smoother.
While laboring down isn’t for everyone, if medically approved, it syncs beautifully with innate birth physiology. Listening to internal urges allows mom to time effective, energy-efficient pushes. Bringing new life into the world is the ultimate mind-body connection.
So next time someone encourages you to “labor down,” know it means to conserve some energy and give your pelvic floor time to gently adjust as birth unfolds - one incredibly powerful sensation at a time.
