Ideally, an epidural leaves you unabe to feel belly and back, but able to feel the birth canal and your bum - if it works "perfectly" (as mine did) then you know when to push. Yup, like the other girls said, push like you're constipated. One thing that helped me was a midwife getting me a chamberpot to sit on, that way I was less worried about pooing.

When I had my spinal I couldn't feel or move a thing; the midwives were great, holding my hands, encouraging me and telling me when to push. The obs was very nice too, very encouraging, but if he really didn't need to help the baby out why did he have to do all the interventions?