5.2.2  Support the mother’s pushing

A health worker gently encourages the mother to push. The mother is in labour and is sitting down pushing.
Figure 5.6  Gently encourage the mother to push when she feels the urge.

When the cervix is fully dilated, the mother’s body will push the baby out. Some healthcare providers get very excited during the pushing stage. They yell at mothers, ‘Push! Push!’ but mothers do not usually need much help to push. Their bodies push naturally, and when they are encouraged and supported, women will usually find the way to push that feels right and gets the baby out.

If a mother has difficulty pushing, do not scold or threaten her. And never insult or hit a woman to make her push. Upsetting or frightening her can slow the birth. Instead, explain how to push well (Figure 5.6). Each contraction is a new chance. Praise her for trying.

Tell the mother when you see her outer genitals bulge. Explain that this means the baby is coming down. When you see the head, let the mother touch it. This may also help her to push better.

Let the mother choose the position that feels good to her. You already learned about different positions in first stage in Study Session 3. But note that it is not good for the mother to lie flat on her back during a normal birth. Lying flat can squeeze the blood vessels that bring blood to the baby and the mother, and can make the birth slower.

The semi-sitting and side-lying positions.
Three different positions the mother may like to be in during the second stage of labour. Position one is on all fours with face down, position 2 is squatting and position three is sitting on a support.
Figure 5.7  Different positions during second stage of labour.

5.2.1  Check the baby’s heart beat

5.2.3  Watch for warning signs