From The Official Lamaze Guide: Giving Birth with Confidence.

What to Know:

• Research shows that routine directed pushing, breath holding, and limiting pushing during labor is not beneficial, and that prolonged breath holding may reduce fetal oxygenation.
• The WHO recommends not directing laboring women to hold their breath or consciously sustain pushing.
• The American College of Nurse Midwives (ACNM) recommends that a laboring woman’s body direct any pushing.
• Directed pushing may help you if you’ve had an epidural and don’t feel the urge to push.

How to Avoid Unnecessary Use:

• Remember that your body knows how to push your baby out.
• Listen to and follow your body’s signals.
• Change position often while you’re pushing.
• Ask your helpers to support your efforts to push naturally.
• Be patient with your body.
• Visualize your baby rotating and descending through your birth canal.
• Ask your helpers to keep comforting you while you push your baby out.
• If you have an epidural, “labor down”—wait until the epidural wears off, and then let spontaneous pushing kick in.

How to Keep Labor as Normal as Possible If You Use Directed Pushing:

• Remember that your body knows how to birth your baby.
• Don’t hold your breath for more than six seconds at a time.
• Push in an upright position.
• Rest between contractions.
• Be patient.
• Visualize your baby rotating and descending.
• Ask your helpers to keep supporting and comforting you.