Fetal movement kick counts are a terrific way of checking in on the health and movement of your the baby.
When your baby's head enters your vagina, the rectal nerves are stimulated, creating the urge to push. You should not push before you feel the urge to do so, even if you have an epidural. Pushing before the have the urge usually has little affect of moving baby down and out and can waste your energy.
If pushing is difficult and baby doesn't seem to be moving down or rotating, consider pushing in an asymmetric position. Asymmetry allows your pelvis to open up in ways that help baby rotate and descend effectively.
Have you every heard about the dangle squat for pushing your baby out? It's one of many positions women choose to comfortably have their babies and to avoid pushing on their backs. Pushing on your back can increase your chances of significant perineal tearing.
Highly directed pushing with breath holding is almost never appropriate. This kind of pushing, called val salva, results in major blood pressure swings for mother and can lead to abnormal heart rate tracings for baby. As long as mother and baby are both healthy, there is no reason to direct a woman's pushing efforts. Slow, steady, gentle pushing by mother is all it takes to get most babies born safely, naturally and normally.