Laboring down is an approach during childbirth where, after full cervical dilation, the birthing person delays active pushing. This allows the body to continue its natural process, often for an hour or two, helping the baby descend further into the birth canal. This technique is also referred to as passive descent or delayed pushing. The goal is to let the uterus guide the baby down without immediate, strenuous effort.
The Body’s Natural Progress
Once the cervix is fully dilated to 10 centimeters, the body transitions into the second stage of labor. During laboring down, the uterus continues to contract rhythmically, passively moving the baby deeper into the pelvis. These involuntary uterine contractions, driven by the hormone oxytocin, exert pressure on the baby, encouraging its descent through the birth canal.
Gravity also assists the baby’s downward movement, especially in upright or forward-leaning positions. As the baby descends, its head applies pressure, which can help with rotation. This period allows the baby to continue navigating the pelvic curves and reposition itself for an easier passage.
Support for Birthing Person and Baby
Allowing the body to labor down can offer several positive outcomes for both the birthing person and the baby. This approach helps conserve the birthing person’s energy, potentially leading to a shorter duration of active pushing and reduced physical fatigue.
Laboring down can also facilitate a more spontaneous urge to push when the baby is lower in the birth canal, aligning active pushing with the body’s natural signals. This can contribute to less medical intervention, such as a reduced need for assisted deliveries like forceps or vacuum extraction. Additionally, allowing the baby to descend more gradually can reduce the risk of perineal trauma, as tissues have more time to stretch.
Factors Influencing the Approach
The decision to labor down is made in consultation with healthcare providers, considering various individual circumstances. The birthing person’s comfort level and the presence of a natural urge to push are factors. If the birthing person does not feel an immediate urge to push after full dilation, laboring down can be a suitable option.
Fetal positioning is a key consideration; laboring down can allow the baby more time to rotate into an optimal position for birth, such as head-down and facing the birthing person’s spine. Continuous monitoring of the baby’s well-being, including heart rate, is necessary to ensure it tolerates the extended second stage of labor. If signs of fetal distress or other complications arise, immediate active pushing or other interventions may be necessary.
The use of epidural anesthesia often influences the feasibility of laboring down. While possible with an epidural, the birthing person may not experience the same strong, natural urge to push due to reduced sensation. In such cases, laboring down can allow passive descent before active pushing begins, potentially reducing overall active pushing time. Professional recommendations on laboring down with an epidural can vary. The birthing person’s medical history and the overall progress of labor are also important considerations for healthcare providers when determining if laboring down is appropriate.