: Do I have to 'push' during birth? If I get an epidural, I won't feel anything. Can I just lie there peacefully and relax while the baby just slides out on it's own or do I have to push? The pushing part seems so violent,

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Epidural anesthesia article on wikipedia

I think your doctor will be able to confirm what they will use.

Epidural analgesia is just for pain relief. You will feel the pressure and the compulsion to push but you will not be able to feel most of the pain. How much you need to push will depend on the size and position of the baby and whether or not the head is engaged.

Epidural anesthesia will not only take away the pain but will also take away muscle control this means you will not be able to push.

As for the violence and tearing, most first time mothers opting for natural delivery experience a perineal tearing. Again, your doctor may decide to perform an episiotomy to prevent tearing. You can reduce the risk to some extent by performing regular perineal massage.

Hope that helps.

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Epidurals are a regional anesthesia, also referred to as local anesthesia. This means that it blocks pain, but not all sensation.

Epidurals are not a muscle relaxant, and for good reason! Childbirth requires the use of pelvic floor muscles (and some others, such as those used to involuntarily to dilate the cervix).

However, some women still have trouble effectively feeling the pressure that indicates the need to push, requiring additional assistance from those performing the delivery (such as doctors, midwives, and nurses).

It's very important to push, and the epidural may make it harder to do so properly. Research shows that epidurals can actually increase labor time and pushing stage time. The fact that pushing stage time can increase during epidurals shows that, yes, pushing is still required with epidurals.

Furthermore, the baby will definitely not slide out "on it's own." The same research above that indicates epidurals can increase labor times also show that they can lead to an increased chance of assisted vaginal birth. Assisted vaginal birth refers to the use of objects like vacuum suction devices and forceps. This is evidence that an newborn can't just naturally make it's way out of the mother. The mother needs to push properly or external tools become necessary. It may even require a Cesarean section. Your healthcare provider should be able to give you some literature about the risks and benefits of the epidural, and what methods they use in case of complications.

Pushing and labor is often displayed in media as being incredibly painful. When we see women giving birth on TV or in movies they're almost always shown as: 1) "Hormonally" angry 2) Screaming and crying 3) Demanding of drugs.

This is not an accurate depiction of most deliveries. It's merely what makes for easy TV (but not good, in my opinion). This poor portrayal of labor and delivery often increases the fear and anxiety in mothers, which plays negatively into the Fear-Tension-Pain cycle. As a mother anticipates more severe pain than what she might actually endure she becomes more tense, which may actually increase her sensitivity to pain or cause certain activities to be more painful, as she's using tense muscles to do them.

It's important to have a proper expectation of the delivery process, and to be aware of your available pain-management techniques. If you're planning on having an epidural, you likely won't have to worry about much pain during delivery.

As far as perineal tearing goes, research shows that it's better to have natural tearing than to have an episiotomy. Natural tearing tends to heal more quickly and be less severe (as the body naturally tears only as much as necessary). The cuts from a doctor for an episiotomy can be too long, or increase the chances of excessive tearing.

It's important to understand that perineal tearing happens based on the size of your newborn's head or body, not how much you push. As the name implies, it's a natural process. If a tear happens and it causes too much discomfort, it can be treated with pain medication.