Under the Urge to press is understood to be the pressing phase during the birth process. It occurs in the so-called expulsion period.
What is the urge to press?
The urge to press that goes along with the contractions shows up in the last phase of labor, which is also known as the expulsion period. The mother pushes the baby out of her body step by step by pressing.
Most women feel the urge to press very intensely. The infant has to overcome about 15 centimeters, which requires stamina from both the mother and the child.
The urge to press usually only lasts a few seconds. The mother develops the need to let her baby out of the body. The urge to press can hardly be suppressed.
Function & task
As part of the urge to press, the mother feels intense labor. These are used to push the child through the vagina.
The process of labor begins with the opening period, during which labor occurs about every three to six minutes. This leads to contractions that cause the cervix to open. At the end of the opening period, the cervix has opened about ten centimeters and increases in size with each additional contraction. For first-time mothers, the opening period takes 12 to 14 hours. In women who have already had children, this phase usually only lasts six to eight hours.
After the opening phase, there is - somewhat insensitive - the expulsion period, in which the contractions also begin. It ends with the birth of the baby. During the expulsion period the contractions become shorter and shorter. The uterus also contracts, pushing the baby into the birth canal by the millimeter. Due to the pressure on the cervix that is created, it opens so far that it is no longer an obstacle for the child.
During this process, the baby's head is able to stretch to adapt to the birth canal. This will make it easier for the child to cross the vagina.
Once the baby's head has penetrated deep enough into the birth canal, pressure is exerted on the mother's perineum. This reflexively creates the urge to press in the laboring mother. The urge to press is primarily caused by pressure on a nerve plexus, which is located in the coccyx area. This plexus is called the lumbosacral plexus.
As part of the urge to press, the mother has the opportunity to support the birth of her child by pressing along. The expression of the urge to press is very different. The contractions that occur during this process show up every two to three minutes.
However, the mother shouldn't press too early. This leads to compression of the cervix that has not yet passed, which increases the risk of cervical edema. Due to the involuntary urge to press, the baby's head presses more and more on the cervix. As a result, the blood builds up, which in turn causes swelling. Before the mother is allowed to give in to her urge to press, a midwife checks whether the child has reached the pelvic floor by pressing the appropriate buttons.
In a normal labor, the mother can give birth to her child within ten labor pains. When the head emerges through the vagina, she perceives an intense external stretch. Breathing in the pressure contractions therefore also plays an important role in counteracting injuries to the perineum and vagina. This technique can be learned in the antenatal courses.
If the child's head is visibly protruding from the vagina, the woman in labor presses it out of her body with the next contraction. In most cases, this requires two or three contractions.
Illnesses & ailments
In the context of the urge to press and contractions, there is also a risk of some complications. This primarily includes the perineal tear, which tears the perineal area in front of the exit of the intestine and behind the vagina.If a perineal tear is suspected, a preventive perineal incision can be made, which is then sutured with a few stitches later. First, however, the midwife tries to prevent the perineal tear by applying light counter pressure to the child's head by hand.
In addition to a perineal tear, the vagina can also tear, which is noticeable by bleeding. These cracks can be sewn up again by the gynecologist after the birth. As a rule, the mother no longer feels any major effects of the tear afterwards.
Sometimes the heartbeat of the unborn child worsens during pressure labor. A drop in heart rate is often an indication 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. In order to advance the birth process faster, the doctor usually uses a suction cup or forceps. If the umbilical cord turns too tightly around the baby's head, there is a risk of severe disability or even stillbirth. Doctors therefore carefully consider whether the birth should not be brought about by a caesarean section.
Wrong rotation of the child is another risk during pressure labor. The baby has to turn several times during the pressing phase in order to be able to cross the birth canal. If there is no rotation during the pressing phase, the midwife tries to turn the baby over the mother's abdominal wall. If this does not succeed, pliers or a suction cup are used here as well.
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