The pressing urge is understood as the pressing phase during the birth process. It occurs in the so-called expulsion period.
What is the pressing urge?
The pressing urge is understood to be the pressing phase during the birth process. The pushing urge, which is associated with the pushing contractions, is manifested in the last phase of labor, which is also called the expulsion period. During this period, the mother pushes the baby out of her body step by step by pushing. Most women feel the urge to push very intensely. In the process, the infant must overcome about 15 centimeters, which requires stamina from both the mother and the child. As a rule, the pressing urge lasts only a few seconds. The mother develops the need to let her baby out of her body. In the process, the urge to push can hardly be suppressed.
Function and task
As part of the urge to push, the mother experiences intense contractions. These serve to push the baby through the vagina. The birth process begins with the opening period, during which contractions occur about every three to six minutes. During this period, contractions occur, which result in the opening of the cervix. By the end of the opening period, the cervix has opened about ten centimeters and enlarges more with each additional contraction. In first-time mothers, the opening period takes 12 to 14 hours. In women who have already had children, this phase usually lasts only six to eight hours. Following the opening phase, there is – somewhat insensitively termed – the expulsion period, during which the pushing contractions also begin. It ends with the birth of the baby. During the expulsion period, contractions become shorter and shorter. In addition, contraction of the uterus occurs, pushing the baby millimeter by millimeter into the birth canal. The pressure on the cervix during this process causes it to open so much that it is no longer an obstacle for the baby. During this process, the baby’s head is able to adapt to the birth canal by stretching. In this way, the baby can cross the vagina more easily. Once the baby’s head has penetrated deep enough into the birth canal, pressure is exerted on the mother’s perineum. This causes a reflex urge to push on the part of the woman giving birth. The urge to push is primarily caused by pressure on a nerve plexus located in the coccyx. This plexus is called the lumbosacral plexus. In the context of the pressing urge, the mother has the possibility to support the birth of her child by pressing along. The intensity of the pushing urge varies greatly. The contractions that occur are felt every two to three minutes. However, the mother should not push too early. This leads to compression of the cervix, which has not yet passed, increasing the risk of cervical edema. Due to the involuntary urge to push, the baby’s head presses harder and harder on the cervix. As a result, the blood accumulates, which in turn causes swelling. Before the mother is allowed to give in to her urge to push, a midwife checks whether the baby has reached the pelvic floor by performing appropriate palpations. In a normal labor, the mother can deliver her baby within ten contractions. In this process, she perceives an intense external stretching as the head emerges through the vagina. Breathing through the contractions therefore also plays an important role in counteracting injuries in the perineal and vaginal areas. This technique can already be learned during childbirth preparation courses. When the baby’s head emerges visibly from the vagina, the woman gives birth and pushes it out of her body with the next contraction. In most cases, this requires two or three contractions.
Illnesses and complaints
In the context of pushing and bearing down contractions, there is also a risk of some complications. First and foremost among them is perineal rupture, in which there is tearing of the perineal area, which is located in front of the exit of the intestine and behind the vagina. If a perineal tear is suspected, an episiotomy can be performed as a preventive measure, which is later sutured with a few stitches. First, however, the midwife makes an attempt to prevent the perineal tear by applying slight counterpressure to the baby’s head by hand. In addition to a perineal tear, there may also be a tear in the vagina, which is noticeable by bleeding.However, these tears can be sutured again by the gynecologist after the birth. As a rule, the mother no longer feels any major effects of the tear in the subsequent period. Sometimes the heart tones of the unborn child worsen during the contractions. A drop in heart tones is often a sign that the umbilical cord has wrapped around the infant’s neck. In this case, it is important to complete the birth as soon as possible. To speed up the progress of the birth, the doctor usually uses a suction cup or forceps. If the umbilical cord twists too tightly around the baby’s head, there is a risk of severe obstruction or even stillbirth. Doctors therefore weigh carefully whether the birth should not be induced by cesarean section. Another risk during labor is that the baby may turn incorrectly. The baby has to turn several times during the pushing phase in order to pass through the birth canal. If the baby fails to turn during the pushing phase, the midwife tries to turn the baby over the mother’s abdominal wall. If this does not succeed, forceps or a suction cup are also used.
