The pushing contractions are the particularly painful contractions of the expulsion phase, which push the baby out of the uterus through the cervix and birth canal from the mother’s body. They are the last contractions of the actual birth and end when the baby is born.
What are the pushing contractions?
The pushing contractions are the last contractions of the actual birth and end when the baby is born. The birth is divided into several phases, starting with the opening phase. Once this is complete, the cervix has opened enough for the baby to fit through. This is followed by the short transition phase, during which the first pushing contractions already begin. During this phase, however, the woman is not yet allowed to push along, as the cervix usually still has to dilate a little. Only when the midwife comes to the conclusion after her examination that the cervix has opened wide enough may the woman give in to the urge to push. The somewhat unflatteringly named expulsion phase begins. The pushing contractions are considered the most painful contractions of childbirth because their contraction strength is the most intense. The press contractions are particularly stressful during the transition phase, as they are accompanied by the urge to push, but the woman is not yet allowed to push along. Afterwards, the contractions usually become more bearable because the woman is somewhat distracted by the pushing and knows that her baby will soon be born. To ease the pain of the pushing contractions, an epidural can be given in advance, which is just intense enough during the expulsion phase that the mother does not feel pain that is too exhausting, but can still feel enough to push along.
Function and task
The pushing contractions are the last contractions of the birth process and ensure that the baby is pushed out of the uterus. Through the birth canal, it usually comes into the world head first. Like all contractions, the pushing contractions are most likely hormonally controlled and therefore start just when the cervix is open enough for birth. This work was done by the opening contractions before the pushing contractions. During the normally short transitional phase, the intensity of the contractions becomes noticeably stronger and they become more painful: these are the first pushing contractions. After all, the body must also first adjust to switching from the opening contractions, which are easy to endure, to the strong pushing contractions. If the woman were to push along now, she would still be supporting the contractions of the pushing contractions and pushing the baby further forward into the birth canal. She can and should do this as soon as it is time for the expulsion phase. This is the case when the cervix has widened to at least 10 cm. The contractions alone do not succeed in pushing the baby out of the mother’s body; her active assistance is required. That is why it is so important in modern obstetrics to conserve the woman’s strength so that she can use all the power she has for this crucial task. For some women, only a few push contractions are necessary until the baby is born, for others the expulsion phase takes longer. Just like the birth itself, the duration of the expulsion phase and the intensity of the pushing contractions vary from woman to woman.
Diseases and discomforts
The pushing contractions alone do not bring a baby into the world; the birth process relies on the woman’s assistance. When she can no longer do this for various reasons, the birth stagnates and obstetricians must intervene. The reason for this can be an incorrectly dosed epidural. If the epidural is still too strong when the contractions begin, the woman no longer feels the pressure of the contraction sufficiently to push along at the right moment. The obstetricians can then still give her instructions, but the urge to push has a positive effect on the mother’s cooperation. If she no longer feels this, she may not be pushing hard enough or may no longer be able to correctly assess the strength of her own pushing movement. If, on the other hand, the woman is too exhausted after a long and painful opening phase, she may lack the strength to push along and the intervention of the obstetricians will be necessary. Difficulties also arise during a long transition phase. If the cervix does not open on its own, intervention is needed so that the birth can proceed and the woman is not deprived of her strength. During the pushing contractions, even if the child is in a correct birth position, an umbilical cord that is lying awkwardly can wrap itself around its neck unnoticed.This is not a problem until the contractions begin, because the child is strangled by the shortening umbilical cord as it enters the birth canal. If the baby is not born quickly enough, the birth must be accelerated by a doctor, which is usually done by using a suction cup. If the baby’s heartbeat drops during birth, this is a warning signal to the obstetricians that the pressure contractions may be about to endanger the baby’s life. If such an incident is not noticed early, the child’s life is in danger due to lack of oxygen. In addition, serious complications can occur if the placenta ruptures due to the pressure during labor. If it is not yet in the process of detaching, it is still connected to the woman’s bloodstream and can cause life-threatening blood loss.
