The pushing stage begins when the cervix is fully open and the baby has moved low enough for you to feel significant pressure. Many describe it not as “deciding to push,” but as a reflex — the body pushes on its own, and you follow. It’s a powerful stage, but also very clear: your body is working with purpose.

The pressure may feel like needing a bowel movement, which is completely normal. The sensation is strong and helps the baby rotate and descend. Contractions are deep and intense, and you may feel the baby moving down little by little.

Your midwife will guide you gently. Sometimes you follow the natural urge, and other times slow breathing helps the tissues stretch gradually. You don’t need to “push as hard as you can” — it’s about working with your body’s rhythm.

Emotions can shift quickly during this stage. Many feel strong, focused, overwhelmed, or vulnerable, often all at once. Everything you feel is normal.

When the baby’s head becomes visible, it may stay there between contractions. This pause protects the tissues. With the next contraction, the head is born, and soon after, the rest of the body. If everything is stable, your baby is placed on your chest right away.

Alma’s tips

•When the pressure comes, try to follow your body’s natural reflex and breathe out gently through the contraction. You don’t need to force anything — your body does much of the work on its own.

• Relax your shoulders and breathe out slowly as each contraction builds.

• Listen to your midwife’s guidance as the head crowns.

• Trust your body, even when your emotions move in many directions.