As fast as the head of the fetus is distinguished, the surgeon or nurse-midwife may place a sterile towel over the colon and press forward on the fetal chin while the other hand is pushed downward on the occiput. This helps the fetus achieve extension, so that the head is born with the littlest diameter presenting. This also controls the rate that the head is born. Pressure should not be applied to the fundus of the uterus to effect birth, because uterine rupture may happen. The girl is asked to resume pushing till the occiput of the fetal head is forcibly at the pubic arch. Then the head is born between contractions.
This helps to stop the head from being expelled too quickly. It can also help to avoid perineal tears and quick change in pressure in the infant’s head ( which could rupture cerebral veins ). The girl might be asked to puff purposefully so she doesn’t push in a contraction. She could be asked to bump again without a contraction present to supply the shoulders. Repeat instructions as mandatory because frequently the mother is so concerned with the approaching birth that she doesn’t hear. Offer steerage and support to the partner as well because he might be about as overcome by the birth process as the girl. The lady who hasn’t had anesthesia experiences the arrival of the head as a flash of discomfort or burning feeling, as if somebody had temporarily poured hot water on her perineum. It’s a fleeting sensation but isn’t especially uncomfortable. Right after birth of the head, the doctor or nurse-midwife suctions out the infant’s mouth with a bulb syringe and then passes their fingers along the occiput to the newborn’s neck to ascertain whether a loop of umbilical twine is encircling the neck. It isn’t rare for a single loop of twine to be positioned this way ( named a nuchal cord ).
If such a loop is felt, it is softly loosened and drawn down over the fetal head. If it is too firmly coiled to permit this, it has to be clamped and cut before the shoulders are delivered.
Otherwise, it might tear and meddle with the fetal oxygen supply. After expulsion of the fetal head, external revolution happens. The shoulders and remainder of the newborn must now be dropped at free the chest for the 1st breath. Mild pressure is exerted downward on the side of the infant’s head, and the anterior shoulder is born. Slight upward stress on the side of the head permits the anterior shoulder to nestle against the symphysis and the posterior shoulder to be born. The remainder of the body then slides free without any farther difficulty.