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What Happens When I’m 10 Centimeters Dilated?

Once your cervix reaches full dilation, you still may not be “ready” to push. A few things are happening even after you reach 10 centimeters, things that help baby navigate into an optimal position for birth, making pushing more effective and less exhausting. It can also reduce the risk of trauma to the pelvic floor, perineum, and yonal canal.

In the coached style of pushing often encountered in hospital settings, mothers are encouraged to begin bearing down as soon as the cervix is fully dilated. However, in many cases, baby has not made the last few cardinal movements of birth: internal rotation and extension of the head. Often, women who have reached 10 centimeters and are left undisturbed will experience a return to a contraction pattern more similar to early labor. This relaxation of the uterine muscle (often called “rest and be grateful” or “the quietude”) not only gives Mom a break, but it releases its grip on baby’s head, allowing them to perform an internal rotation from ROA/LOA (most commonly) to OA. Many women still do not have the urge to push at this point as it’s the next movement, extension of the fetal head, which puts increased pressure on the perineum and creates the urge to bear down.

During this pause, the cervix also pulls farther up, behind baby’s head and becomes fully incorporated into the lower uterine segment.

What pushing style did you use in labor? Were you coached to push or did you utilize mother-directed pushing?

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