This stage usually lasts 1 to 2 hours, and by now that your cervix is completely dilated the work of pushing begins. If you don't feel the urge to push, don't do it. You should wait until you actually feel the urge because pushing is hard and you want it to be as effective as possible. The urge to push comes with each contraction. In the pushing stage, contractions tend to be less frequent what will give you longer periods of rest between the contractions so you can make your effort stronger and more productive.

Positions for pushing
There are several positions effective in helping the baby move through the pelvis and the birth canal. The hospital's labor beds are designed to accommodate several positions for pushing. You can place your knees over a leg support or place your feet on footrests or even squat with the aid of a bar attached to the bed. Your health care provider will help you to decide the best position for you to give birth.

Breathing and pushing
There are two effective breathing patterns for pushing. One works better for some women the other for the others.

Pattern 1: Controlled exhalation
1. Take two cleansing breaths.
2. Inhale a full breath.
3. As you tighten your abdominal muscles and flatten your back, let air slowly escape, and make a grunting sound.
4. Continue to release your breath slowly while tightening your abdominal muscles.
5. After 10 seconds, release your breath, and repeat the pattern until the contraction ends.
6. Take a cleansing breath, and relax.

Pattern 2: Conventional pushing
1. Take two cleansing breaths as the urge to push builds.
2. Inhale deeply, hold your breath, and bear down for 10 seconds.
3. As you hold your breath, tighten your abdominal muscles and push the small of your back toward your partner's hand or the bed. This straightens out your lower back.
4. After 10 seconds, release your breath while keeping your abdominal muscles tight.
5. Continue this pattern for the length of the contraction.
6. Take a cleansing breath at the end of the contraction and try to relax.

As you are getting near to the end of the pushing stage your practitioner will guide you in easing the baby out. Don't worry if you feel a burning sensation, commonly known as the "ring of fire", it is normal and it only means that you are having your last push before the baby is born.


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