With my first birth, they told me that I was pushing down with my neck and to focus on pushing like I was doing a poo. It's so hard to focus on doing that when you are numb from the waist down with an epidural. I've given birth twice and both with epidurals so I don't really know what pushing is supposed to feel like. I just know it was long and tedious and they needed to assist me with episiotimies (spelling?) and forceps to get both bubs out in the end.