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Pushing and Delivery
By Cixx Admin Date Posted.. 2009-09-22 16:55:06
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 You will be ready to push the baby out when your cervix is dilated to a full 10 centimeters and is 100% effaced. Pushing involves exactly what it sounds like. You will bear down and push the baby through the birth canal.  In the final stages of labor your contractions will change from dilating contractions to pushing contractions. Pushing contractions generally last 60 to 90 seconds and are 2 to 5 minutes apart. You will be able to see your uterus rise noticeably with every contraction. You may feel like you have an urgent bowel movement or like you need to push. Do not hold back when pushing for fear of having a bowel movement when doing so. Many women do move their bowels when pushing. Your doctor or midwife and baby will think nothing of it if it happens. It will be quickly whisked away with a sterile cloth.

Be aware that the urge to push may occur before your body is prepared to push. It is imperative that you not push until your cervix is fully dilated. This may require you to “breath through” one or more pushing contractions. Resisting the urge to push when your body is telling you to push can be very difficult. Generally speaking, if your body is telling you to push you are ready to push. Sometimes, however, the doctor or midwife will want to check to be sure. This often requires you to hold off pushing for at least one pushing contraction while an exam is conducted. At this point, the baby has descended in preparation to be delivered. The pressure of the baby’s head as it moves lower into the pelvis will be a good part of the reason for the overpowering stimulus to push.

Pushing contractions will be as methodical as non-pushing contractions. These contractions, while strong, will seem less burdensome for two reasons. First of all, you are at the end of labor and have a reason to celebrate. Second, the contractions will be mitigated by your urge to push the baby through the birth canal. In other words, you now have some actual physical activity to undertake during each contraction – which is much different than spending energy just trying to “endure” the contractions of active labor.

After you get the instruction to begin pushing, during the beginning of the next contraction, take a deep breath in then push while your nurse or coach slowly counts to 10. Then take a quick breath and push again. Repeat this process until the contraction is done. When pushing, do not use your upper body to push or strain your face. This could cause chest pain or black and blue cheeks after delivery. Focus on a point below your belly button and imagine pushing from that point to avoid using your upper body. You may feel a burning or stretching sensation as the baby’s head stretches the birth canal.

As with the other parts of labor, there is no set guideline for the duration and intensity of the pushing phase. In many cases things progress quite rapidly (30 minutes or less). In other cases pushing can go on for several hours. If the pushing phase lasts too long the mother can become exhausted and unable to continue to push with the intensity required to deliver the baby quickly. One of the most common problems is that most women are placed flat on their backs with feet up during the pushing process. By elevating the bed slightly or leaning against some pillows or even leaning into the arms of a partner you will allow the forces of gravity to work with you instead of against you. Of course you need to be careful that you don’t overdo it. A baby that is forced too quickly can cause some tearing of the cervix. If you feel that our caregiver is ignoring the fact that body positioning can make a difference, then don’t be bashful about talking to them about it or simply requesting a couple of extra pillows to lean against to facilitate the process. If you become exhausted during the pushing stage, you may be instructed to rest during a few contractions to help regain your energy.

Believe it or not, the actual delivery is the simplest and most beautiful part of the birthing process. The work of labor is behind you, and most of the pushing has been done. During the final stages of pushing the babies head will begin to “crown”. This simply means that the baby’s head becomes visible and begins to protrude from the vagina. Don’t get discouraged when you see the head crown then disappear. Pushing is a two steps forward, one step back process. You may be able to reach around and touch your baby’s head as it begins to crown.

Typically at this point one or two more pushing contractions will deliver the baby’s head. Once the head is free, the birth attendant will check to ensure that the umbilical cord is not wrapped around the baby’s neck and that everything looks o.k. The baby will turn its head and rotate in preparation for delivery of the body. Usually with the next contraction the baby will be completely delivered. This represents the climax of the entire birthing process. It is a beautiful time indeed!

Once the baby is born, it is briefly examined and suctioned (to remove fluid and mucus from its mouth and lungs). The baby will need to take its first breath of air at this point and will typically then begin to cry. If it is struggling at all it may need some help. The attendant will know what to do to get the baby to begin actively crying. Crying is a good thing for the baby as it allows it to exercise its lungs and draw in air and begin to breath on its own. Your baby is then evaluated with an APGAR score at one minute and five minutes after birth. An eye ointment is usually administered to prevent eye infection. This eye ointment will not irritate the eyes. The umbilical cord will be clamped and cut, unless you prefer to wait until the placenta is delivered. The umbilical cord is clamped in two places then painlessly cut between the two clamps.

 

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