Chapter 12: Pushing – Stage 2 of labor
Deliver the baby’s shoulders
After the baby’s head is born and he turns to face the mother’s leg, wait for the
next contraction. Ask the mother to give a gentle push as soon as she feels the
contraction. Usually, the baby’s shoulders will slip right out.
To prevent tearing, try to bring out 1 shoulder at a time.
If the mother is in the
hands-and-knees position
If the mother is in the
half-sitting position
Bring out the first shoulder
by gently moving the
baby’s head towards the
mother’s bottom.
Bring out the second shoulder
by moving the baby towards
the mother’s belly.
WARNING! Do not bend the baby’s head far. Guide the head — do not pull it.
Baby gets stuck at the shoulders
Sometimes a baby gets stuck at the shoulders. One of the
shoulders is stuck behind the mother’s pubic bone.
Before this happens, there are usually warning signs.
His head may take lots of hard pushing to be born,
instead of coming out smoothly after it crowns. The chin
may not quite come out. Sometimes it looks as if the
baby’s head is being pulled back into the mother, like a
turtle pulling its head into its shell.
Sometimes when the head is born, it will be pulled tight against the mother’s
genitals. The baby may not turn to face the mother’s thigh. Even hard pushing will
not bring the shoulders out.
A baby who is stuck at the shoulders is in danger! The pressure of the mother’s
vagina on the baby’s body forces blood into the baby’s head. The head turns blue,
and then purple. After about 5 minutes, the blood vessels in the baby’s brain may
begin to break and bleed from the pressure. This will cause brain damage. In time,
the baby will die.
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A Book for Midwives (2010)