Some women do have a strong urge to push prior to a fully dilated cervix And there is no way to stop this, even with attempting position changes.
Often this is if the fetus is in OP position or a woman with a fully loaded rectum.
Without undertaking constant vaginal examinations, when would you commence 2nd stage observations, hence diagnosing second stage of labour And starting the arbitrary time limit?
what techniques do you find work to help ease the feeling?
Thank you.
This is very common with young primigravidas. The methods I have observed to be effective in my practice are-
1.Counselling about the mechanism of labour in the third trimester helps them to better understand the process and also be calm and co-operative during the labour.
2. Counselliing during the time of labour and one-to - one support helps them to cope up with the pain and anxiety which adds up to the urge to push before the full dilatation.
3. Labour analgesia helps in this regard a lot.
Regarding how to diagnose without vaginal examination, I too am curious to know.
A study done in South Africa says actually true labour starts when a woman is 6cm dilated.
There are 4 stages of labor
The 1st stage of birth is divided into two stages; passive phase (from 0 to 4 cm dilatation), and the active phase starts from 4cm to 10 cm dilatation, with regular and effective contractions.
Stage 2 of birth begins from the moment the fetal head is seen at the exit of the vagina to the separation of the umbilical cord.
Stage 3 of birth begins from the division of the umbilical cord to the birth of the complete placenta.
Stage 4 of labor begins with the birth of the placenta and continues the first 2 hours after birth.
Regarding how to diagnose without vaginal examination, at the moment when you see the fetal head in the exit of the vagina........
2nd stage of labor is full dilatation until the explusion of baby. So to answer your question, even if the patient has been pushing prior to cervical dilatation and despite of pushing still she doesnt have this full cervical dilatation, she is not on the 2nd stage yet but at first stage, active phase.
I USE THE BATH BECAUSE IT ACCELERATES DILATION IF THE CONTRACTIONS ARE REGULAR AND CLOSER. I CAN ALSO USE THE CARPONI POSITION IN TRANDELEMBURG
To diagnose second stage of labour without vaginal examination, is only possible by assuming the cervix is fully dilated, when you see the fetal presenting part at the exit of the vagina. Since, we know that the second stage actually starts at the point of full cervical dilatation. The danger however, will be a situation whereby the fetal presenting part is not descending to the vaginal exit, despite full dilatation as a result of a pathology, like inadequate passage or oversized passenger.
Concerning the technique of relief at this time, an epidural analgesia will be adequate
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