Sensations and progress
Pushing phase contractions
Things to consider in the pushing phase
The active pushing phase is usually from when the woman starts to feel the urge to push (usually during a contraction) until most of the baby's head can be seen at the opening of her vagina. The sensations during this phase can range from a slight urge at the peak of the stronger contractions, to an irresistible urge to push (or bear down) all the time that you may have little control over. The initial pushing is usually experienced in short bursts during some of the contractions, increasing to a tremendous need to push several times during each and every contraction as the baby comes down.
As the baby descends their head 'moulds' to the shape of the woman's birth canal. This is possible because your baby's head is not solid like an adult's, but has five separate bone plates that have not fused (or joined) as yet. As the baby is being pushed down through the woman's vagina, the baby's skull bones move towards each other and slightly overlap, protecting their brain. The baby's head usually becomes longer and thinner (more so if the baby has been sitting in the vagina for some time). Their head will return to a normal shape within the first couple of days after the birth.
A woman's vagina is very elastic and with the active pushing her body will stretch and open allowing her baby to negotiate their way down through her pelvis and vagina, working their way under her pubic bone to reach her perineum before being born.
Pushing without a contraction only tires you and achieves very little progress. Be aware that:
You only need to push when the contraction is happening.
The descent of the baby during this phase is frequently described as:
2 steps forward....1 step back...2 steps forward...1 step back
This gives you a visual insight into what is happening to your baby as you push.