Tug of war is a great way to add some extra power to your pushing during birth! Tug of war includes holding onto a long piece of fabric that is either attached to something (squat bar attachment for the labor bed) or someone holds onto the other end. This technique has been used across different cultures as a method to help add some extra power to pushing. If you’re wanting to help your baby finish their rotation and get under the pubic bone, sometimes this technique can do the trick!
Tug of war turns on the lats (back muscles). When we activate the lats, it helps to not only create more space in the pelvic outlet, it helps to direct the force downward. This is why we like to pull on something while we push during birth; it helps us turn on those lats!
There are two main techniques: you can pull up to you, or you can pull down towards you, depending on how you attach the fabric and which feels better for you!
Pulling Upward: Squat Bar Attachment or Partner Supported
The first variation of tug of war, and the more common of the two, is to pull upwards from between your legs. There are two big options with this variation: you can attach the long fabric (sheet, rebozo, scarf) to a squat bar attachment for the bed, or you can have your partner/team member hold the other end of the fabric. There are pros and cons to each, but both are great techniques to help add some extra power to your push!
Partner Supported Breakdown:
Your partner or a team member holds one end of the sheet, and you hold the other (see image below). It is helpful to tie a knot on each end to act as a stopper for when you are pulling (hold above the knot). Then when you are ready to push, you begin to pull on the fabric towards yourself, as your partner pulls the other end. This technique can be helpful because your partner can add extra feedback for you to help you generate some more power, and it’s easier to shift to a side-lying position (create some space for that sacrum). The cons are that this is fatiguing for your partner, and requires lots of communication between both parties!
Squat Bar Attachment Breakdown:
Take the fabric and loop it around the squat bar attachment. You can either girth hitch it, or just loop it over. Then you can place your feet on the squat bar. This technique is great because you don’t need to worry about your partner pulling too hard or not hard enough, and you don’t need to ensure that there is clear communication to prevent any injuries. This also frees up your team members to take care of other tasks during pushing!
You pull as hard as you want against the squat bar attachment! The downside is you usually need to be in a supine position; it is more awkward in side-lying with this technique, but can be done!
Pulling Downward: Overhead Attachment
The second variation of tug of war is to pull from overhead! This is less commonly seen, but a widely used technique when out of the bed! You may have seen drawings or photos where someone is pulling from fabric hanging from the ceiling. This technique is great for those who are favoring reaching overhead when pushing.
Attach the fabric to something secured overhead (make sure that whatever it is attached to will not detach). Then pull down as you push. Most of my clients find the pulling from between the legs to feel more effective, but this is a good one to explore if you are favoring reaching overhead.
Tips for Tug of War
When using the tug of war technique, it is important to follow a few tips to ensure that we are being effective with our pushing!
Pull to YOU as opposed to yourself towards the sheet. It can be helpful to focus on thinking shoulders down and back (no shoulders to ears) and feel the activation in your BACK as opposed to the shoulders.
Elbows into your side. Pulling the elbows in your side helps to maintain that neutral spine and keep the shoulders down and back. This also helps to turn on the lats more. Avoid chicken winging the arms out, or flaring in the elbows as this tends to put more effort into the shoulders as opposed to the lats. Try it now to feel the difference between squeezing your elbows into your side versus flaring them out and trying to lift them as high as possible. You’ll likely feel that the direction of energy is DOWN with elbows in (the direction we want our push to go) and UP with elbows flared.
Palms up. Having the palms face up also helps to turn that lats on more. This tends to help us keep those elbows in, shoulders down and back, and activates the lats more.
All of these tips are common tips used for rowing movements in lifting too that emphasize a horizontal or vertical pull (aka lat strengthening exercises).
Exercises to Prepare for Pushing
During pregnancy, we can focus on posterior chain strengthening exercises to help us prepare for pushing! This could include exercises such as the bent-over row, deadlift, and posterior oblique sling-focused exercises such as the single-leg deadlift with palms up a banded row. Watch below for some demo videos on some exercises to include in your prenatal fitness routine.
We incorporate all of these exercises and more into our prenatal strength and conditioning program. Our program syncs to your week of pregnancy, and can be started at any time! If you are 20 weeks, you will start at week 20, and so on!