Pushing

When the cervix is fully dilated your body will tell you to push. Listen to your midwife who will also guide you.

Position
Find the position that you prefer and which will make labour easier for you. You might want to remain in bed with your back propped up with pillows, or stand, sit, kneel or squat.

If you are very tired, you might be more comfortable lying on your side rather than your back. This is also a better position for your baby. If you’ve suffered from backache in labour, kneeling on all fours might be helpful. It’s up to you.

Try out some of these positions at antenatal classes or at home to find out which are the most comfortable for you. Ask the midwife to help you.

Pushing
You can now start to push each time you have a contraction. Your body will probably tell you how. If not, take two deep breaths as the contractions start and push down.

Take another breath when you need to. Give several pushes until the contraction ends. As you push, try to let yourself open up below. After each contraction, it is important to rest and gather strength for the next contraction.

Your midwife is there to guide you through this hard stage, telling you what to do andgiving you encouragment. The baby's father can also give you lots of support. As this stage cant take an hour or moreAsk your midwife to tell you what is happening as is helps to know how you are doing.

In order for the skin and muscles of the perinium to stretch without tearing the baby’s head needs to be born slowly. When the baby’s head moves into the vaginal opening, you can put your hand down to feel it, or look at it in a mirror. When about half the head can be seen, the midwife will tell you to stop pushing, to push very gently, or to puff a couple of quick short breaths, blowing out through your mouth.

Sometimes the skin of the perineum won’t stretch enough and may tear. Or there may be an urgency to hurry the birth because the baby is getting short of oxygen. The midwife or doctor will then ask your permission to give you a local anaesthetic and cut the skin to make the opening bigger. This is called an episiotomy. Afterwards the cut or tear is stitched up again and heals.

Once your baby’s head is born, most of the hard work is over. With one more gentle push the body is born quite quickly and easily.