What to Expect in a Normal Delivery

What everyone else is doing

From the Doctor's Perspective...
I always ask my patient to pay close attention to my assessment of how well she is pushing while I'm examining her. I want her to focus on those pushing efforts that I've found to be effective and that are allowing her to progress, and for her to continue focusing on that particular pushing effort that she has made with each successive contraction. I'm providing her with feedback as to how well she is doing so that she can minimize any wasted effort and deliver the baby successfully.

There is the potential for the mother to tire out very quickly, so I don't want her to push in an ineffective way if at all possible. In between contractions, I advise patients to remember what they did right so they won't start the next contraction without knowing how to push effectively. I'm examining the baby's head while the mother is pushing so that I can tell if the baby is rotating or coming down the birth canal properly. Unfortunately, there is the potential for the mother to become distracted by her family with oohs and aahs of excitement. I want her to stay on track and not lose focus.

From the Mother's Perspective...
Hey, I delivered five times, and each time I was clueless about what an effective push was and what wasn't. They all felt the same. First of all, it's difficult to tell if you're pushing or not, since what constitutes "pushing" doesn't make a lot of sense. Second, when you're at that phase, it's all a blur. Your only thought is "GET THIS BABY OUT OF ME!" and do whatever it takes. Sorry, Dr. John. Maybe if you'd been my doctor I would have known what an effective push was.

What Everyone Else Is Doing While You're Pushing (aside from Taking Bets)
The doctor will usually have the spouse of the patient get involved in the labor and delivery process. The spouse will stand on the opposite side of where the nurse is, supporting the patient both emotionally and physically while she's pushing (her chin will be pressed against her chest). The patient is asked to open her legs as wide as possible, so the spouse can support her neck and legs on one side, while the nurse supports the other side (picture Twister on a Saturday night). In between contractions the spouse will encourage the patient with words, wipe her forehead with a cool towel, and feed her ice chips if necessary, providing basic support to help the mother deliver the baby.

The nurse is continually monitoring the baby's heart rate and checking the mother's blood pressure. She is also ensuring that IV fluids are running and not stopped for any reason and that drugs or medicines are being administered. The nurse has a huge responsibility during this time, as she is also charting everything that occurs and assisting the doctor as necessary. If requested by the patient, the nurse will bring in a mirror to position between the mother's legs so that she can watch her baby's head as it appears. Some mothers close their eyes through the whole pushing effort, while others may choose to see everything. According to Dr. John, to doctors it is a beautiful experience, but the mother may or may not share that sentiment.

excerpted from:

Reproduced from Absolute Beginner's Guide to Pregnancy, by John Adams and Marta Justak, by permission of Pearson Education. Copyright © 2005 by Que Publishing. Please visit Amazon to order your own copy.

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