The expulsion phase | The course of a birth

The expulsion phase

The expulsion phase represents the actual birth of the baby. The phase begins with the complete opening of the cervix and ends only with the birth of the baby. The birth is easier for the mother in an upright position.

It does not matter whether the mother sits in a gynaecological chair, squats or pulls on a rope. In the mother’s body there is a kind of guide rail made of muscles and bones which determines the path for the unborn child. The child is now in this splint.

Most children are born head first and the back of the head is on the front of the mother’s body. In this position, the first thing you can do is feel the small fontanel at the back of the child’s head. At this point the baby’s skull bones have not yet grown together.

In this position, the baby is pushed further towards the pelvic outlet with each contraction. The point in time when the child becomes visible during a contraction is also called incision of the head. From this point on, the mother’s perineum, i.e. the skin between the vagina and the anus, must be supported or specifically incised.

After the birth of the head, the child’s shoulders must pass through the pelvis. This requires a rotation of 90 degrees, as the pelvic outlet is oval rather than round. Between the birth of the head and shoulders there is often a short break in labour.

During this pause, the midwife checks whether the umbilical cord lies around the baby’s neck and pushes it over the head or cuts it directly through. With the head and shoulders the widest part of the child is born and the rest of the body can quickly cross the pelvis. During the expulsion phase, the woman should give in to the urge to push and thus advance the birth.

The midwife can support the woman by giving commands to push when the natural contractions occur. After each pushing contraction the mother should take two deep breaths. As the expulsion phase is the most critical phase for the baby, the heartbeat of the baby is checked after each pushing contraction.

While the child is in the birth canal, an oxygen deficiency can occur when the umbilical cord is squeezed. This can be heard in the child’s heartbeat. After the birth of the child, the oral cavity is suctioned out and the umbilical cord is cut.

Many clinics allow the father to cut the umbilical cord himself. In most cases, the child is placed on the mother’s chest immediately after birth. The mother’s familiar heartbeat calms the child and helps it adapt to its new environment.