The pushing phase of labour is the most physically demanding part of the entire birth experience. Your body is doing something extraordinary, and understanding how to work with it rather than against it makes a real difference not just in how much pain you feel, but in how in control you feel throughout the process. These are not tricks or distractions. They are evidence-supported techniques that women use every day in delivery rooms around the world to get through this phase on their own terms.
Breathing through it:
Controlled breathing is one of the most effective and immediately accessible tools you have during labour, and it works because of basic physiology. When you are in pain, the instinct is to hold your breath and tense up which actually increases your perception of pain and reduces oxygen flow to your baby. Slow, deliberate breathing does the opposite. It keeps your body from going into panic mode, relaxes the muscles that are fighting the contraction instead of working with it, and maintains steady oxygen delivery to both of you. A simple pattern that works for many women is breathing in slowly through the nose for four counts, then out through the mouth for six. The longer exhale is what triggers the relaxation response.
Visualisation
This sounds more abstract than it is. What visualisation does in practice is give your mind something deliberate to do during contractions so that it is not just sitting with the pain. Some women picture the baby moving downward with each push which is exactly what is happening, and find that connecting the discomfort to something purposeful makes it more bearable. Others picture a place where they feel completely calm. It does not matter what the image is as long as it is specific and meaningful to you. A guided version of this, where your birth partner or midwife talks you through it during contractions, can be even more effective because it keeps your attention anchored outside the pain.
Massage and counter-pressure
Lower back pain during labour particularly the deep, unrelenting kind is often caused by the baby’s position pressing against the sacrum. Firm counter-pressure applied directly to that area by your birth partner can reduce that sensation significantly. This is not gentle rubbing. It is sustained, directed pressure held at the point where the pain is strongest, and many women describe it as the most immediately effective non-medical pain relief available to them. Hip squeezes, where a support person places both hands on the hips and presses inward during a contraction, work on a similar principle. Your birth partner does not need training to do this, they just need to ask you where and how hard.
Movement and position changes
Lying flat on your back during labour is comfortable for medical staff and genuinely difficult for labouring women. Gravity works against you in that position, and it can intensify pain without serving any physiological purpose. Moving, rocking, swaying, getting on all fours, sitting on a birth ball, leaning forward against a surface keeps the pelvis mobile, which helps the baby descend and rotate as it needs to. Position changes also interrupt the pain cycle. When your body has been holding tension in one place for an extended period, even a small shift redistributes that load and gives temporary but real relief. Talk to your midwife about which positions are feasible given your specific situation, including if you have an epidural.
Warm water and warm compresses
Warm water has a well-documented muscle-relaxing effect. If a bath or shower is available to you in early labour, use it, many women find it reduces the intensity of contractions noticeably. During the pushing phase itself, warm compresses applied to the perineum; the tissue between the vagina and anus are used by midwives to reduce the sensation of stretching and to lower the risk of tearing. The warmth increases blood flow to the area and makes the tissue more pliable. If your birth team does not offer this automatically, you can ask for it.
Hypnobirthing
Hypnobirthing is not about being in a trance. It is a structured approach to labour that combines deep relaxation, controlled breathing, and deliberate reframing of how you think about the sensations of birth. The core idea is that fear causes the muscles of the uterus to work against each other; one set contracting, the other tensing in response which increases pain and slows labour. Hypnobirthing techniques train the body to stay in a relaxed state so the uterus can work efficiently. Women who use it do not necessarily have pain-free labours, but many report feeling significantly more in control of their experience. It requires practice before labour ideally several weeks of it which is why it belongs in your preparation, not just your hospital bag.
Acupressure
Acupressure during labour focuses on a small number of specific pressure points that have been studied for their effect on labour pain and progression. The most commonly used is the point on the inner ankle, roughly four finger-widths above the bone known in acupressure practice as Spleen 6. Firm, sustained pressure on this point during contractions has been shown in clinical studies to reduce pain perception. Another is the web of skin between the thumb and index finger. These are points your birth partner can apply pressure to without any specialist knowledge beyond knowing where they are. They are safe, they are free, and the evidence behind them is more substantial than most people expect.
The pushing phase is not something you simply endure. It is something you move through and the more tools you have going in, the more agency you hold in an experience that can sometimes feel entirely out of your hands. Not every technique will work for every woman, which is exactly why knowing several of them matters. Build your own combination, practice what you can before the day, and go in knowing that your body already knows what to do. Your job is to stay with it.