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Visualization/Relaxation Technique continued...

As your labor progresses and your cervix opens, you may find your contractions are stronger and longer lasting. They may also occur more frequently. You may notice that the bloody mucous plug from your cervix and your membranes eventually break. Focused breathing will make a tremendous difference in your ability to deal with contractions. If you feel that you would like medication or an epidural, be sure to communicate your wishes to your nurses and care providers. It is everyone's goal to help you get through this labor, and medication use or an epidural may actually help your labor. Listen to your body, and it will tell you what it needs in the way of breathing, pain relief, and rest.

The pressure of the contraction inside the uterus increases 100 percent during the active phase of labor. When you are sitting up, rocking, walking, squatting, or kneeling, your abdominal wall relaxes and allows the top of your uterus to fall forward. This directs the baby's head toward your cervix, increasing pressure, allowing it to stretch, and reducing the length of labor. Lying on your side is a good position when laboring as your heart is more efficient, your uterus gets more blood flow to it, and your baby gets more oxygen. Positions that reduce the length of labor but allow the contractions to be most efficient are best for the baby.

Transition is the last phase of labor before you begin to push out your baby. The uterus is working extremely hard, and it is very difficult to relax. You may feel nauseated, cold, shaky, restless, discouraged, and scared. You will notice an increase in bleeding from your vagina and an almost unbearable pressure in your rectum. You may find that you want to stop breathing during your contraction and grunt or bear down as with a bowel movement. Let your nurse know what you are feeling. Try to stay focused with your contractions, and keep breathing. Only think of one contraction at a time; each contraction is one less than you will ever feel again. If you feel the urge to bear down and push, try blowing quick breaths as if you are blowing out a candle.

When your cervix is completely dilated, your care provider will tell you to go ahead and push. Rest between the contractions, but when the contraction begins, take a couple of deep, cleansing breaths. Try to keep your face relaxed and your eyes open during pushing. All energy should be focused on your bottom. A wrinkled up face, eyes squeezed tightly shut, a mouth losing air through screams all take precious energy that need to be used to push out your baby. Premature babies are under much stress at this point, so it isn't a good idea to prolong the pushing phase. If you need to cry or scream, it will be better for both you and your baby to cry or scream between contractions. As the contraction grows in strength, take a breath and hold it. Now, while holding your breath, bear down straight into your bottom with all of your might. Hold that push long and strong. It may be helpful to count to ten in your head if possible. Quickly grab more air, hold it, and bear down again, long and strong. Try to repeat this one more time during your contraction. Now let this contraction go, letting your whole body sink into the bed. Take a deep cleansing breath. You may want to have an ice chip and rest, even sleep, between contractions. As your baby's head is crowning, bulging on your perineum, you may want to reach down and touch your baby's head for the first time. If a mirror is available, it may be motivational for you to see your baby's head and even watch it move as you push.

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