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Powerful Pushing

New Method Promises Safer, More Efficient Delivery

By Susan Hyde

The third element of coordinated pushing requires that you learn to relax the muscles of your pelvic floor (the "Kegels"). Since Kegels typically provide support for the bladder and prevent urine leakage, these muscles are usually somewhat contracted throughout the day. Typically, we think of releasing the Kegels only when we are eliminating. While pushing, however, Kegel relaxation will allow the baby to pass through the birth canal with the least amount of resistance. In addition to shortening the pushing stage of delivery, women who have learned to relax their pelvic floor experience a lower incidence of perineal tears and episiotomies and may experience less pain during delivery.

To perform a basic Kegel, draw in the muscles of your vagina as though you are holding in urine. Hold the contraction for several seconds, and then concentrate on completely relaxing your pelvic floor. You will want to use the restroom before practicing this exercise!

1. Inhale deeply, allowing the air to fill your abdomen. During actual pushing, you should begin the inhalation at the beginning of a contraction.
2. Now exhale, contracting your navel to your spine. Imagine that your exhalation and belly press are gently pushing your baby into the birth canal. It may help to drop your chin and allow your spine to fall into a C-curve. During the real pushing process, you may find it helpful to grunt or otherwise vocalize during the exhalation. Hold the contraction for several seconds at the end of each press. During actual pushing, you may need to repeat the abdominal breathing and belly press several times during each of your body's natural contractions.
3. As you are contracting your abdominal muscles, completely relax your pelvic floor. This is the most difficult part of the coordinated push since we typically tighten our Kegel muscles during exertion. It may help to relax your legs and buttocks as well.

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• Exercise Your Way Through Pregnancy
• Talk about it!