On the medical side, normal childbirth consists of three well-defined stages. The expulsion phase or push phase greatly involves the mother and the baby. How to grow well to give birth? Here are the answers.
Expulsion phase: this is where you have to push
- Although the forms and course of delivery vary from one woman to another, normal childbirth follows three distinct steps. These are work, expulsion and deliverance. It is during the phase of the expulsion that we will have to push.
- When the baby is engaged, he is straight, his back is forward, he presents the part of his smallest head to facilitate his expulsion. It is at this moment that he begins to strongly press on the perineum to trigger a push reflex at the mother.
- Voluntary outbreaks are then essential during this phase of expulsion, to help the baby to cross the various muscle structures that make up the perineum before reaching the vulva. Once the baby's head is engaged in the muscle bundle, the mother must stop pushing to avoid tearing the perineum. The baby's head will be guided by the midwife.
- The expulsion phase lasts 15 minutes to 30 minutes and involves the mother's pushing efforts to help the baby engage in the perineal muscle bundles. However, according to the studies undertaken on the duration of expulsion, a push that exceeds one hour is considered abnormal and concludes a difficult and prolonged delivery.
Why do we have to push?
- The perineum, or pelvic floor, is a lozenge-shaped bundle of muscles and ligaments that support the vagina, rectum, and bladder. Its main role is to regulate urinary continence and faecal continence.
- During pregnancy and during delivery, this group of muscles is highly stressed and is subject to stresses related to the weight and pressure of the baby. Generally, when the baby strongly presses on the perineum, the push reflex or reflex reflex appears spontaneously because it is a physiological mechanism. However, even described as an irrepressible desire and difficult to remember, this push reflex is sometimes insufficient, especially when the future mother is under epidural.
- Thus, voluntary flares are encouraged and requested during childbirth because they are useful to reinforce the reflex thrust to ensure the effectiveness of childbirth and the well-being of the future baby.
When should we push?
- When the outbreaks are too early, it will strongly urge the perineum and other muscles prematurely; it may be that the push reflex is minimal or does not fire.
- In principle, pushing should coincide with the urge to push as well as the uterine contractions because the pushing force must be associated with the uterine contractions. So push at the beginning and throughout the duration of the contraction.
- When the midwife tells you to push, you have to push. But do not forget to rest between contractions and breathe between outbreaks.
Pushing techniques are usually taught during childbirth preparation sessions.
1 - In inspiration stuck
- Push-in-thrust is the most commonly practiced and commonly taught technique.
- In this technique, the lungs are filled with air and the breathing is blocked in apnea. This is a very effective push technique when applied correctly because it mobilizes the diaphragm to exert pressures on the uterus and strengthen uterine contractions as well as the forces of the abdominal muscles and perineal muscles.
Here are the steps:
- Inhale deeply to fill the lungs
- Block the air in your lungs
- Induce hyper flexion by pulling strongly by the hands behind the thighs to better push down; push your head up with your chin glued to your chest, and contract all the muscles of the abdomen to squeeze the uterus.
- When the thrust is too violent and powerful, it can cause a strong contraction of the perineum, causing a tear. This implies that it is better to push when the perineum stretches. Listen to your midwife's instructions.
2 - In forced expiration
- The forced expulsion technique will produce progressive pressure on the perineal muscles which will give it time to stretch and relax. If this technique is considered less effective in the technique of blocked inspiration, the risk of tearing are however lower because the outbreaks are not as traumatic for the perineal muscles.
- In this technique, the lungs are empty and the woman will push until the end of the expiration. When you feel the contractions, take a deep breath and then exhale gently while pushing down, pursed lips (to handle exhalation), as if you are blowing into a large balloon.
Get ready to grow well!
- The outbreaks do not only require knowledge of the techniques. The woman must give birth in a climate of confidence, must be well informed on the different stages and course of delivery. The gestures must be reassuring for the woman.
- According to the midwives, the childbirth preparation sessions can be done, but this does not guarantee the effectiveness of relapses during childbirth because the sensations during the preparations are not real. However, the sessions are essential to inform future moms about the different delivery positions, pushing techniques and breathing management that is an important element in this final race. If the flare techniques are well understood during the preparation sessions, it is easier for the pregnant woman to apply them on the day.
- The preparation sessions are also an opportunity for the midwife to build trust and reassure pregnant women.
Strengthen your perineum!
- The muscles of the perineum are put to the test during childbirth. Exercises can be effective in preparing the perineum for delivery and are primarily aimed at toning and relaxing muscles and preventing incontinence even after delivery. Start preparing your perineum as early as the 8th month of your pregnancy.
We talk about an effective push when mom and baby are in good shape, and that baby easily and quickly engages in the perineum. To help you grow, here are some tips to remember:
- Push at the same time as the contractions. Do not forget to breathe between pushes and rest between contractions;
- Change position every 4 pushes if it suits you;
- Grab your hands and legs and bend your elbows so that all your strength can focus down;
- Raise your head slightly and stick your chin to your chest, focus on your abs;
- Rely on the advice of your coach and trust the entire team that provides your delivery.