Premium Nahrungsergänzungsmittel | artgerecht

Expulsive Contractions: Stages, Tips & Care

Expulsive contractions are the powerful uterine contractions during the second stage of labour that push the baby through the birth canal toward delivery.

Regular tips about health Regular tips about health

Things worth knowing about "Expulsive contractions"

Expulsive contractions are the powerful uterine contractions during the second stage of labour that push the baby through the birth canal toward delivery.

What are expulsive contractions?

Expulsive contractions, also called pushing contractions or bearing-down contractions, are the intense uterine contractions that occur during the second stage of labour (the expulsive or pushing phase). This stage begins once the cervix is fully dilated (10 cm) and ends with the birth of the baby. These contractions are typically the strongest of the entire labour process and serve to propel the baby through the birth canal.

Characteristics and Pattern

During expulsive contractions, the birthing person experiences an overwhelming, involuntary urge to push, similar to the sensation of a bowel movement. The contractions are characterised by the following features:

Duration of each contraction: 60–90 seconds
Frequency: every 2–4 minutes
Intensity: greater than that of earlier (first-stage) contractions
Accompanied by an involuntary bearing-down urge

Difference from First-Stage Contractions

While first-stage contractions (latent and active phase contractions) are responsible for dilating the cervix, expulsive contractions serve the distinct purpose of actively moving the baby downward through the birth canal. They are generally longer, stronger, and more closely spaced than earlier contractions.

Active Pushing

Midwives and obstetric professionals guide the birthing person to work with the involuntary pushing urge through controlled breathing techniques and optimal positioning. Active pushing at the peak of each contraction can help shorten the duration of the second stage. Various birth positions, including squatting, hands-and-knees, or semi-reclined, may influence the effectiveness of expulsive contractions.

Breathing Techniques During Pushing

Deep inhalation at the onset of the contraction
Breath-holding and bearing down (Valsalva manoeuvre) during the contraction peak
Slow exhalation after the contraction subsides

Medical Monitoring

During the second stage of labour, both mother and baby are closely monitored. The baby's heart rate is tracked using cardiotocography (CTG) to ensure adequate oxygenation. If concerns arise, the obstetric team may intervene with an emergency caesarean section or an assisted delivery using vacuum (ventouse) or forceps.

Possible Complications

In some cases, complications may arise during the expulsive phase that require medical intervention:

Prolonged second stage: When pushing lasts longer than recommended thresholds (over 2 hours in first-time mothers, over 1 hour in multiparous women)
Fetal heart rate abnormalities: Detected on CTG, potentially indicating oxygen insufficiency
Shoulder dystocia: Difficulty delivering the baby's shoulders following delivery of the head

Pain Relief Options

Expulsive contractions are typically very painful. Several pain management options are available:

Epidural analgesia (EDA): Regional anaesthesia that significantly reduces labour pain
Nitrous oxide (laughing gas): Inhaled analgesic offering partial pain relief
Water birth: Warm water immersion may ease discomfort and promote relaxation
Massage and counter-pressure: Supportive techniques applied by birth partners or midwives

References

World Health Organization (WHO) (2018). WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: WHO Press.
Cunningham, F. G. et al. (2022). Williams Obstetrics, 26th edition. McGraw-Hill Education.
Beckmann, M. M., Stock, O. M. (2013). Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic Reviews, Issue 4.

Building Blocks for a Healthy Life

As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.