WHEN IS THE BEST TIME AND HOW TO PERFORM BIDS DURING CHILDBIRTH

Maternal bidsDuring the expulsion phase during childbirth, they are essential for the baby to descend through the maternal pelvis and go outside. They are the force that the mother makes to push the baby through the birth canal.

It is a reflex act that usually coincides with the dilation of the cervix of 10 centimeters and the moment when the baby's head fits into the maternal pelvis. These Spontaneous bids are the most effective and respectful for mother and baby.

But ... how are they different from the bids led by the midwife? Are there different ways to push? Sara Cañamero, matron and director of Maternatal answers all our questions.

When to push

At the moment when the baby's head fits into the maternal pelvis, press a specific place, which is what causes the need to push, which generally coincides with the contraction. In this way both forces are united: the one exerted by the mother with the abdomen and the uterine contraction.

Although childbirth means patience and its duration must be respected, there are times when the mother does not feel those desires to push, as Sara Cañamero explains:

"A good epidural anesthesia should ensure that the woman does not feel pain but yes notice the contractions. But it is not always achieved, so on many occasions the mother does not feel that need to push, does not know where to direct the bid and cannot even exert the necessary force to help her baby to be born. "

That is when the midwife or gynecologist must tell you when to push, so that the bid matches the contractions: they are the targeted bids.

Childbirth bids should start when the woman feels the urge to push: this will be more effective

Healthcare professionals tell women when to start and finish bids, where to direct the force and sometimes, ask them to stop pushing. Sara Cañamero explains that:

"We can ask you to stop pushing at the end of the expulsion, when the baby's head is crowning through the maternal vulva, and the perineum is so tense that it can tear if the mother keeps pushing so hard. Then we try to eliminate the force of pujo, letting it be only the force of the contraction and gravity that helps the baby's head come out. "

In Babies and more When giving birth, better mother's bids or targeted bids?

How to push

But also the direction of the bid is essential . As the midwife explains, the woman must direct her strength towards the vagina, something that seems obvious but that is not always done like this:

"Women continue to come in the postpartum for consultation saying that the midwife or gynecologist told them that they should 'push as if they wanted to poop'. By exerting so much force towards the posterior perineum (towards the anus) we lose not only effectiveness, but we increase the risk of perineal injury. "

Contractions and the abdominal press are the 'motor of childbirth', which helps the baby to get out.

Ideally, you should make three bids on each contraction, followed by a period of rest between contractions so that the mother and the baby rest.

These bids will be more effective, and therefore will make the delivery shorter, if they coincide with the contraction and with the mother placed vertically, the most physiological position.

Two types of bids

Bid on exhalation or exhalation (open glottis). An inspiration is made and, after finishing it, the air is slowly released while the transverse muscle is activated (something like hugging the baby with the abdomen), and the force is directed towards the vagina.
Apnea Bid (closed glottis). An inspiration is made and, after finishing it, the air is kept inside the lungs, it is not released. And there, in apnea (without breathing), it is pushed. According to Sara Cañamero "It is similar to doing a classic abdominal, bringing the chin to the chest to keep glottis closed and activating the rectum."

In the last weeks of pregnancy, you can practice your bids, to be confident on the day of delivery, to train your abdominal muscles and know how to perform them correctly. The expert explains that:

"They usually work in maternal preparation classes with the midwife, although they can also be practiced privately in consultation. Sometimes we use intravaginal devices that inflate like a balloon and resemble the baby's head."

Pushing badly in childbirth has consequences

Sara Cañamero points out that:

"The more pressure in the pelvis, the more time pushing and less physiologically (with targeted bids that do not match the contractions), the more likely the mother has to suffer pelvic floor injuries."

In Babies and more What can we do to avoid episiotomies and tears in childbirth: the advice of a specialized physiotherapist

Because although the goal of targeted and spontaneous bids is the same, the scientific evidence suggests that "The performance of the former systematically alters the physiology of labor, by increasing the probability of health intervention with episiotomies and instruments."

This poses a risk to the woman's perineum, and can cause injuries that result in urinary incontinence, gas, pain in the perineum, coitalgia, prolapse, and other dysfunctions.

In short: as bids are a reflex act, the mother must be allowed to live the birth naturally. Allow it to move freely and adopt the posture requested by the body. "This translates into less suffering for the baby and less injury for the mother."concludes midwife Sara Cañamero.

Photos | iStock
In Babies and More | In a hospital in the United Kingdom they stopped telling women when they should bid on delivery and the results are amazing. To have a happy delivery: seven things you should avoid during labor