Pressing and the urge to press

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Toward the end of the active phase of labor, you’ll start to feel more and more pressure. This pressure is the feeling that you need to have a bowel movement.

When you're fully dilated, you often experience reflective pressure to publish. This is an unbearable sensation that makes you want to push. It’s just like throwing up—a reflex you can’t stop.

This helps the uterus push the baby out. You’ll also see the uterus moving downward in a wave-like motion.

So when you have a reflexive urge to push, your body is actually telling you that it's time for the perse
. Sometimes it’s still possible to determine internally whether the cervix is indeed fully dilated. This doesn’t always have to be done.

During the final stage of dilation, the baby descends quite a bit further. This descent can continue as you push. As you feel the urge to push, you help the baby descend further into the pelvis and adapt to its shape. The head performs a pivot turn. By the time the head is resting on the pelvic floor, a lot has already happened! But that’s when the real action begins! The vagina then slowly opens up further. And once the head is “seated,” it is born. This stretching of the pelvic floor causes a burning sensation. It’s also called the “ring of fire.” Once the head is born, it rotates another quarter turn, and the shoulders follow during the same or the next contraction. Sometimes we need to assist a little here. Afterward, you, your partner, or we can place the baby on your belly!

This all sounds pretty easy, but it’s hard work! During a first vaginal birth, this stage lasts an average of one hour and should not exceed two hours. For subsequent vaginal births, the pushing phase lasts an average of 15 minutes and may last up to 1 hour. Of course, we continuously monitor progress during the pushing phase.

Some things that might help are Press tips and posture adjustments
. We will, of course, provide advice on this.