Written by Editorial Team
The process of labor is a complicated one as a number of events happen simultaneously and are responsible for the delivery of the baby. The passage, the passenger (baby) and the mother all are actively involved in this great natural phenomenon.
Pushing or bearing down is an important stage of labor. With the onset of uterine contractions, the cervical canal begins to dilate and the process of cervical effacement commences and the baby starts to descend down in the birth canal. Pushing or bearing down can be described as the attempt or effort by the mother in trying to push the baby out of the uterus. The mother actively bears down or pushes when she gets the uterine contractions which are intermittent. Of the three stages of labor (contraction, giving birth, afterbirth) the most significant and most alarming phase is the pushing stage.
There will be lots of images and imagination regarding this stage as most of us have viewed this scene (though partially) in most of the family movies from our childhood. In most of them, commonly the women seem to scream wildly, hold their breath, turn pale or purple during and are out of their wits. This is not so all true.
The first thing you should do when you are getting ready for a vaginal birth is to wipe off these frightening images. Giving birth is not such a complicated process of “life or death”. Do you know that a mother in a coma stage can also give birth to a healthy baby vaginally? This is because the body and uterus know how to do their work without much contribution from the mother’s part.
When the cervical opening is fully dilated the mother might not experience any uterine contractions- this is termed as thankful or rest phase. This helps the mother to calm down and also provides time to the baby to rotate to a preferable position. Some caregivers encourage the mother to bear down during this phase too, but it is of no help either to the baby or the mother. If you are aware how to push out the baby, it will make your delivery much easier and minimize the injuries that happen during vaginal birth.
First, let’s go through some steps that you are supposed NOT to do even if you have the urge to do so. They are:
The types of pushing are enlisted as below:
There are three important factors which help fast and safe pushing stage. That are:
The selection of birth, position plays a significant role in determining the comfort level of the mother during the process of delivery. It also influences how fast and efficiently the labor progress (or does not progress). A perfect birth position can speed up the labor and diminish uneasiness as it places the child in correct position. Also, unnecessary muscular exertion is reduced when the birth position is perfect. During pushing upright position of the mother is preferred as this allows the gravity to favor the process of pushing. However a number of positions are available in nowadays birth beds such as foot pedals, squat bar, etc.
There is no one best birth position that fits all. In fact, a good midwife will ask the mother to change the birth position frequently during the labor to ease the pain. The most significant point is whatever position you opt, never opt for a position that requires you to stay flat on your back. The position that may have clicked for one woman may not be a success in another one. Also, the position helped you a lot on your first pregnancy may not help you during your second pregnancy.
Here we explain some positions which could help you in different situations.
Breathing correctly while pushing will allow the baby move slowly down in a controlled fashion. Holding the breath will worsen the pain. As holding breath hinders with your oxygen intake, it can also make your child deprive of the oxygen. The patterned breathing will:
When the cervix is fully dilated, the second stage of labor begins:
Another tip is to wait for the body signal to start pushing rather than starting to push before the real urge begins. The fact that you are dilated 10 cm alone does not mean that you should start pushing.
A good perineal support can eliminate or diminish the chances of tearing. Perineal massages during the early stage of pregnancy will help to prepare the perineal tissues for the delivery. Your bystander or mid wife can:
Even after keeping all the above points in mind, if you feel an overwhelming urge to push, it is your body’s way to tell you that the baby is coming. If there are no other complications (like cord compression and fetal distress), go ahead with your urge.
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