At courses for pregnant women, experts regularly raise the question of how to give birth and push properly, because this is extremely important, but you know why?

Knowledge of the matter allows you to make the delivery process as quick and painless as possible at best, and at worst - to prevent the development of complications in the crumbs. It can be both banal injuries due to passage through the birth canal, and hypoxia due to the slightest delay. Needless to say, the treatment can then stretch for a lifetime, depriving the mother of the joys of motherhood, and her baby - a happy and carefree childhood.

A young mother can talk forever about her birth. For her, everything begins at the moment of the appearance of contractions, and ends with the release of the child's place. Meanwhile, doctors distinguish three main stages of labor activity, simultaneously explaining to the woman in labor how to breathe during each of them.

True, they are preceded by a preparatory stage. It usually lasts for a day. Due to the fact that at this stage the cervix is ​​only preparing for childbirth, it does not cause much discomfort. There is a softening of the tissues, opening the neck itself. There may be minor contractions that will intensify over time.

Does the woman hurt at this moment? No, if she does not have pathologies overshadowed by irregular, pronounced contractions. Only a doctor can identify them. Moreover, they are diagnosed most often in women in labor who experience severe fear due to the upcoming birth, accompanied by sleep disorders, chronic fatigue.

Please note that any difficulties during the preparatory period do not affect the further course of childbirth. Here, as in a lottery: you will definitely be lucky if you give birth correctly and with a good specialist.

Childbirth periods:

• The first is long, uncomfortable, even painful, it all depends on the woman's sensitivity threshold. It is characterized by regular contractions, due to which the cervix constantly opens.

Moreover, the fetus practically does not move along the birth canal at the time of its contractions. Doctors distinguish several phases, during which contractions can intensify or weaken, giving the woman in labor the opportunity to rest a bit.

The whole process is tied to the work of muscle fibers, which lead to thickening and softening of the walls of the uterus in certain places. Subsequently, the bladder bursts or pierces, and the cervix opens by 10 cm. Until this moment, the woman in labor usually moves quietly, sometimes she is injected with antispasmodics, analgesics, for example.

• The second is the period of expulsion of the fetus. It is characterized by the appearance of strong, prolonged contractions, which provoke the descent of the head into the pelvic area and the advancement of the crumbs to the exit. At this time, attempts develop - the same uterine contractions that increase pressure in the abdominal cavity and facilitate the process of giving birth to a baby.

It is for its successful implementation that a woman needs to learn how to breathe correctly so as not to harm. Moreover, nature has taken care of the appearance of a strong desire to push, which young women in labor can confuse with the desire to empty the intestines.

It is interesting that sometimes attempts occur even when the cervix opens only 8 cm. Then it is important to breathe properly and not push so as not to injure the cervix. In the birth period, you should listen to all the recommendations of the doctor, since passing through the birth canal, the child now and then turns or unbends and risks injuring himself.

During attempts, you need to help the crumbs move forward, otherwise they may weaken and completely disappear. What does it threaten? Operational intervention. Normally, the period lasts 15 - 30 minutes, but if complications are detected, it continues until the baby is born.

• The third is the postpartum period. It is characterized by separation of the child's place and a decrease in the uterus in volume. It starts, as a rule, 10 minutes after the end of the second period and lasts about 20 minutes.

In case of complications, the placenta is separated under anesthesia. If there is an injury to the birth canal, followed by uterine bleeding, the latter is stopped, drugs are administered, ice is placed on the lower abdomen.

How to know when it's time to push

In order to protect yourself from the problems that arise during labor, it is necessary not only to understand how to push, but also when to do it. If you start ahead of time, you can either get exhausted and lose all your strength before the onset of childbirth, or injure yourself and the baby. They usually push when pushing. They are felt when, due to uterine contractions, there is pressure on the rectum and tension in the muscles of the peritoneum and diaphragm.

Before pushing, you need to make sure that the child is in the correct position, and the cervix is ​​\u200b\u200bfully open. This can be done only through the study of the latter, which is what the midwife or doctor does. That is why it is so important to trust them. Inspection of the uterine cavity and listening to the fetal heartbeat, they are likely to do during labor and childbirth all the time.

Please note that in the process of labor, there will also be a need to stop pushing. This happens when the fetal head passes through the cervix. This must be done so as not to tear in the neck area.

Summing up all of the above, it is worth noting that a woman should push only at the command of the medical staff. If she feels pressure and a desire to empty her bowels before this command arrives, she needs to notify the doctor about this. He will inspect the neck and agree on further actions with it. Any delay, initiative, ignoring the advice of even "experienced" can lead to irreversible consequences.

How to push and breathe properly

Do you want to give birth to a strong and healthy baby? Tune in to fruitful work with the medical staff during childbirth and birth in a few attempts. At the same time, it is important to remain calm and not panic, since fear and stress entail not only loss of strength, but also hypoxia in the child.

Below is a guide to action, and also describes the main thing - what it means to push. So:

During the straining period, it is important to remember that sharp inhalations and exhalations entail changes in abdominal pressure and, as a result, tightening the baby's head back.

Breaks between attempts last no more than a minute, during which the woman in labor must rest and gain strength. There are situations when the midwife will ask you to endure the attempt, breathing quickly and superficially, like a dog.

At the beginning of the second stage of labor, with the full opening of the cervix, the fetal head, due to uterine contractions, begins to move down, squeezing the walls of the rectum. In response to irritation of the receptors of the rectum, the muscles of the anterior abdominal wall and diaphragm contract reflexively: this is how attempts begin. The head of the fetus presses on the pelvic floor and on the woman's rectum, causing her to want to empty her intestines - the urge to defecate. This is the push.

When can you push?

Before you start pushing, you need to call the doctor to determine where the baby's head is. It is necessary to push only if she has passed almost the entire birth canal and is already lying on the pelvic floor. Premature attempts lead to a rapid exhaustion of the woman's strength, weakness of attempts, impaired uteroplacental circulation and lack of oxygen for the baby.

For all women, the desire to push arises at different times. If it appeared when the head is already low enough, but the cervix has not yet fully opened, then by pushing the head with force, the woman in labor can provoke a rupture of the cervix. To restrain premature attempts, a woman in labor is recommended to use a special breathing pattern.

How to breathe during childbirth

1. Take a full deep breath.
2. Hold your breath, as if swallowing air, tighten your abdominal muscles (the muscles of the thighs, buttocks and face are completely relaxed). Gently increase the pressure on the bottom. Tighten your abdominal muscles more and more, helping the baby move through the birth canal.
3. Take a slow breath.
4. Further, when you feel that your breath is not enough, exhale smoothly - but in no case "jerk". During a sharp exhalation, intra-abdominal pressure decreases rapidly and the baby's head also quickly moves back, which can lead to a traumatic brain injury. After that, immediately, without relaxation and rest, take a breath - and push.

During the full effort, repeat all these steps three times.

After the effort, take a full breath and restore calm, even breathing with complete relaxation. So you can quickly restore strength for the next attempt.

Attention! At the moment of removing the head, the midwife will ask you not to push - breathe like a dog.

How to push properly during childbirth?

While pushing, press your chin tightly to your chest, grab your knees with your hands, spread them apart and pull them to the armpit. The force of the attempts should be directed to the point of maximum pain. Increased pain after an attempt suggests that you are doing everything right and the child is moving along the birth canal.

How long do the pushes last?

In primiparous, this period lasts an average of 2 hours, in multiparous - 1 hour. Its duration can be influenced by various factors. Thus, the use of one of the methods of anesthesia - epidural analgesia - leads to a lengthening of the second stage of labor to an average of 3 hours in nulliparous women and up to 2 hours in multiparous women. A large fetus, a narrowed pelvis, weak labor activity, overstretching of the anterior abdominal wall can also increase this stage of labor. Conversely, in women with well-developed abdominal muscles, the duration of the ejection period is reduced.

How to avoid tearing during childbirth?

Protection of the perineum begins from the moment of eruption of the head, i.e. from the time when the child's head does not go back between attempts. The midwife with three fingers of the right hand prevents the head from moving quickly during an attempt, which leads to a gradual stretching of the skin of the perineum and prevents tears. Normally, the fetal head passes through all the birth canals with its smallest diameter - in a bent state (the chin is pressed to the breast). To prevent ruptures, the midwife clasps the baby's head with two fingers of her left hand and monitors its correct progress.

The occipital region of the head erupts first, then the crown of the head, then the extension of the head occurs and the face is born. From the moment when the head of the fetus begins to unbend, until the full birth of the face, the woman in labor is forbidden to push. It should be remembered that the integrity of the perineum depends not only on the actions of doctors, but also on the behavior of the woman herself during childbirth. Breathing through the mouth with a “dog” can significantly weaken attempts. The born head in 96% of cases faces back; then the baby's face turns to the mother's right or left thigh. Simultaneously with the external rotation of the head, an internal rotation of the shoulders occurs, then the anterior shoulder (located at the pubic joint) and the posterior shoulder (located at the sacrum) are born. The further birth of the trunk and legs of the child occurs without difficulty.

Hello! Today we will analyze in detail the issue of correct attempts.

Thank you, Lyudmila! You provide very valuable information. And by the way, about attempts, very interesting - can you learn the right way? Although I gave birth, I have no idea what attempts are right and how to do it. I most likely pushed incorrectly, because my red whites of the eyes frightened my husband for another week after giving birth))))

So many women, due to improper attempts, are faced with such phenomena as:

• red eyes (this is not scary, it passes quickly);
• hemorrhoids (already worse, especially depending on the degree), more about hemorrhoids during pregnancy >>>;
• uterine ruptures (not good at all, since anesthesia will be required);
• tears in the perineum (unpleasant because it prevents you from feeling good after childbirth).

Do you want to avoid these phenomena? Then read on very carefully!

What are pushes?

Attempts are a reflex act that occurs spontaneously !!!

What we now see in maternity hospitals is the artificial straining of a woman. The doctor looks - the disclosure is complete, the head is lowered - and begins to command the woman when to push, and when not!

With such a development of events, then you ask the question - how to push correctly? After all, you didn’t feel true attempts or felt weakly, or maybe in a labor rush you didn’t even understand that they were darlings.

If the attempt is spontaneous - it is very difficult not to notice! At this point, your ALL body contracts and gently pushes the baby to the exit. This is a very gentle pressure that allows you to keep your tissues intact, and the baby's head from injury.

With natural attempts, a woman does not ask the doctor - is it possible to push? When to push? You just feel it!!! It's like a wave that has taken you and you can only surrender to its power and let it do the work!

Why don't women feel like pushing?

There are usually a number of reasons for this.

Poor sense of your body.

During pregnancy, little attention is paid to preparing for childbirth. And the point is not even to train breathing, or study postures. The bottom line is to create the maximum mood for natural childbirth. Remove anxiety and stress, and fill yourself with positivity, relaxation and softness.

I think it's primary. This is the foundation, without which all methods of anesthesia, breathing, etc. they just won't work. There will be mechanics, not feelings.

How to do this - this is the subject of the course "Five Steps to a Successful Childbirth". Take it and study it. Start practicing what I am talking about and you will see the result.

Artificial initiation of childbirth.

Everything has already been thought of for us. There is a time period when a child should be born, and at the moment there is a point of view that I really like, which says that it is the child who determines the onset of childbirth.

Not a doctor, not a schedule for closing maternity hospitals for washing, not the departure of a midwife with whom you agreed to give birth - a CHILD! And you need to let him do it! This is something worth fighting for and defending your rights and waiting for the independent start of childbirth.

No intervention during childbirth.

Perhaps this point seems to you not feasible and the most difficult? Perhaps that is how it is! However, it all depends on you and on your perseverance - if you want, you will give birth as you intended.

A friend of mine recently had a baby. The first birth was through a caesarean section, the second was the mood for an independent birth. The mood was there - but all her external actions were absolutely opposite.

She went to the maternity hospital in advance, fulfilled all the appointments and was not interested in why, she quickly got tired in childbirth, stimulation was required, after stimulation, the baby’s heartbeat worsened and the doctor suggested doing a caesarean so as not to suffer. She agreed.

Now there are big problems with breastfeeding, depression, guilt and difficult recovery.

Why am I telling you this? Moreover, if you declare that you want to give birth in such and such a way, sum up your specific actions under this! Take concrete steps to help you give birth well!

In it, we analyze in detail everything from the beginning of contractions to arrival at the hospital:

• Arrival at the hospital: when is the best time to do it?
• Reception department: what to do, what to refuse, which documents to sign and which not;
• Types of doctors and their view of childbirth;
• Ancestral branch - what's there?
• How to talk to doctors so that they listen to you, and not dismiss you as another woman in labor?

I love this course because everything is very specific and to the point. Although many people write that I am always on business, but Easy childbirth is the basis without which I would not even advise you to go to the maternity hospital.

See you!

Ludmila Sharova, pregnancy psychologist.

It is important to understand that attempts can take only a few tens of minutes in a standard birth process, however, it is attempts that are the most important period in labor. Note that, depending on the specific physiological characteristics of the female body, on, on its size, on the actual intensity of the current labor activity, and, of course, on what exactly the specific pregnancy is, the total duration of such attempts can be completely different. Modern statistics show that, as a rule, in primiparous women, the second or second period of labor lasts no more than two hours, but in multiparous women, this period takes no more than one hour.

The general value of attempts in labor

Recall that the period of attempts usually begins only when the woman's cervix opens enough to allow her baby to pass quietly in the future. Actually, this is usually the main role of attempts - to help the crumbs to be born into this world in a timely manner. Attempts are a rather strong contraction of muscles, and of completely different groups. The abdominal muscles, diaphragms, and many others are involved in attempts, and as a result of this, increased intra-abdominal pressure is created, which subsequently helps to expel the fetus from its home - from the womb. Strong attempts usually join the contractions of a woman at a stage when they themselves become noticeably more frequent, intensify and become more powerful, longer and, unfortunately, more painful.

Attempts during labor always occur reflexively, and they absolutely do not depend on the desire of the woman in labor, the attempts are due to the increasing pressure of the so-called presenting part of the fetus itself directly on the cervix, because the fetus by this time is strongly falling down. However, unlike the strongest fights, attempts can still be controlled by a woman. Note that it was in this that the very essence of labor activity was laid. Both the expectant mother and her child must make mutual efforts in order to speed up the very long-awaited moment of the birth of the crumbs.

The vast majority of women directly during attempts can experience a sensation very similar to the condition that occurs during defecation. Many people have a certain impression that the maximum emptying of the intestines occurs on this very day, which is probably why women have an simply irresistible and even irresistible desire to push hard. According to doctors, such a desire should not be restrained at all, especially if the obstetricians themselves insist on this, constantly monitoring the birth process. Thus, nature itself is trying to help a woman giving birth to survive the strongest attempts and most effectively, fully cope with her main task for this period of time.

Women in pushing

According to the medical staff in the first period of labor, when the contractions of the female body are aimed primarily at the full disclosure of the cervix, the woman in labor herself is only able to partially alleviate her well-being, trying to take a more comfortable position or applying. Recall that contractions in no way depend on the woman in labor, as well as the general course of labor in this period. However, already with the onset of full-fledged attempts from a completely passive participant in labor, the expectant mother will have to turn into a rather active participant.

It is extremely important to fully feel the attempts during labor, which is why anesthesia is not used by doctors to anesthetize contractions, well, at least in standard cases. However, many women in labor still note that with the onset of attempts, the pain of the strongest contractions is already felt, not as much as it was before. Almost the entire consciousness of a woman would switch to the most effective straining and expulsion of the child from the womb.

It is also important to understand that, passing through the birth canal of a woman, the body of a small child will strongly squeeze all the organs surrounding the baby. And with the simultaneous straining of the woman in labor, all this can lead to the fact that both the female bladder and, accordingly, the intestines may well involuntarily and regardless of the desire of the woman to empty directly during strong attempts. Although, as a rule, the woman herself does not pay much attention to such nuances during attempts, women often worry about such quite probable “embarrassments” only before childbirth, not remembering their worries during childbirth. Definitely, women should not worry too much about this at all. After all, firstly, such phenomena are more than physiological, absolutely normal and even familiar to any medical staff of a maternity hospital. And secondly, literally all unwanted or unplanned discharge from the body of the woman in labor will be immediately removed by the midwife, and as a result, their contact with the woman in labor with the medical staff or with the child is completely excluded.

For a woman in labor, the only right decision during the period of the onset of attempts will be to fully concentrate both on her own feelings and on the basic instructions of the physician taking your birth. Understand that a lot will depend on the woman in labor right now, and directly. It is important to understand that the better and more correctly a woman pushes, the easier it will be for the baby to be born into this world. However, at the same time, it should also be understood that the birth of a baby too fast is a very big stress for him, and that is why your doctor from time to time may well give the woman in labor a “hang up” by stopping her straining.

You should always remember that the baby himself, directly during the attempts, will work no less than yours. And, besides, right now, the little one will experience the greatest lack of oxygen, so you should obey your doctor who takes birth and observes the process unquestioningly! So it is necessary to restrain one's attempts, if the doctor so requires, if strong straining, in his opinion, may not be too safe for the child. You will also have to do your best directly on the attempt when the doctor gives the woman such a command.

What is the right way to push during childbirth?

Any woman in labor will certainly feel that she has begun to attempt (it will be useful for you to read an article about that). However, it may turn out to be very early to push at the same time - and therefore listen carefully to the instructions of the doctor taking delivery. If the doctor is convinced that it is necessary to restrain or even completely stop the attempt (after all, it is impossible to completely eliminate it, since it happens reflexively, regardless of the desire of the woman giving birth), and tells you about it, you should try and relax as much as possible, and as much as possible maybe, perhaps, when relaxing, it is desirable to take very short, but rather frequent and most importantly superficial breaths (as doctors call this process - switch to the so-called "dog breathing").

Also try to apply the correct breathing techniques during the period of attempts, constantly accumulating the maximum of your strength for straining. And when it is time to help your unborn baby, it is important to follow the further instructions of the doctor as clearly as possible. And the directions are usually:

• In anticipation of the attempts, take calm exhalations as deep as possible, and after them also calmly and as deeply as possible inhale into the stomach - and as deeply as possible, and not at all as much as possible, longer or more.
• Try to hold your breath, leaning forward slightly, and at the same time pressing your chin to your chest, and at this moment spread your knees to the sides, strongly pressing against your muscle cavities, you can clasp your knees with your hands.
• Then gradually begin to push, and at the peak of the physiological effort, when you yourself begin to feel the maximum urge.
• Then, with the onset of a new attempt, try to push down, as if “pushing” the baby out of the womb - and at the same time make maximum efforts. However, remember, in no case should you strain in the face or in the eyes - remember, only the diaphragm and the organs below should be involved in attempts.
• Next, try to push the baby forward, while applying maximum effort on each new attempt.
• Try to direct new attempts to the point of the most intense pain. Moreover, burning or pain in the area of ​​\u200b\u200bthe cervix or vagina itself should intensify each time, which will be proof of an absolutely correct and most effectively performed attempt.
• Then push until you feel the urgent need to take another breath. And in such cases, slowly exhale the air, inhaling deeply, hold a few breaths and try to repeat all over again.
• It is important to observe even, rhythmic and smooth breathing, without any jerks or drops. Sharp exhalations will “pull” the baby back into the womb.
• You should not scream during attempts - believe me, this will not help you in any way, but such screams will waste a lot of strength. Try to remain silent, or at least groan calmly.
• Remember, during one contraction, a woman in labor should arrange at least three attempts in a row, naturally, without interruptions and rest.
• In addition, in the intervals between strong contractions, the woman in labor should try to relax as much as possible and rest at least a little in order to restore her strength for subsequent straining.
• Don't force things. After all, a woman has hard work ahead, and you need to concentrate as much as possible and correctly distribute your own forces.
• And one more important nuance and good advice, when you take a breath before the next attempt, imagine that you want to absorb the ball - and even try to feel the big ball in your stomach. And then, with an effort at the level of the abdominals, try to push this virtual “ball” to the perineum. Although, of course, you should listen to your own feelings, know that nature, in this way, has arranged for us that women's own feelings during childbirth usually do not fail.

It is important to remember that on average, during a single contraction, about three attempts can occur, lasting approximately 10 or even 15 seconds each. Note that many women during childbirth try to make one maximally long attempt, although this, of course, is a global mistake. Believe me, it will be better to make two or even effective attempts during one contraction than to make one attempt, but unproductive, in which any supply of oxygen to the fetus, which is so necessary right now for your baby, can stop.

It is extremely important to push as correctly as possible, otherwise your obstetricians will have to resort to the most extreme measures, including squeezing the baby out of the female abdomen, using forceps, or a vacuum, which in reality is highly undesirable and dangerous for the baby. And therefore, the woman herself needs to calm down, and assess the current situation as objectively as possible and try to do absolutely everything in your power for the normal birth of the crumbs.

It is also worth noting that the so-called can not only speed up but also greatly facilitate the very process of giving birth to a baby. Such vertical childbirth also contributes to the correct straining, if only because a woman can completely succumb to her own sensations, without at all thinking about where to direct her exhalation (after all, the usual force of gravity acts). In addition, try to inquire about the most comfortable and beneficial postures during childbirth in advance, and even try these postures after trying to understand which one will be most comfortable for you. We definitely recommend watching an article with a video about existing ones today.

When pushing during childbirth does not occur

Unfortunately, not all of the women in labor feel full-fledged attempts during labor. In some cases, attempts are completely absent, which, however, is not at all a serious violation of the process. Rather, this may be due to some physiological characteristics of the woman in labor.

And, nevertheless, the complete absence of attempts may not have the best effect on the general course of childbirth and on the condition of the baby. In such situations, a woman simply has to completely and completely rely on the doctor taking delivery, listen to him as carefully as possible and just as diligently follow all his instructions. Although to be honest, it can be very, very difficult. However, what to do: such is mother nature - full-fledged physiologically correct attempts can occur, as it turns out, not all women in labor.

The final push

Remember, after the birth of your child, the placenta (or it is also called the placenta) will also have to be born. At this moment, the woman in labor may again feel the urge to strain, although this time it is not as strong and powerful as it was in the second period of the birth process. The last very small effort - and your entire birth process is completely completed!

We would really like, whatever the description of attempts scares you. Indeed, in reality, attempts are very helpful in full-fledged labor, and besides, attempts are not so terrible as they are described. The most important thing is to try to perceive your attempts as the most effective tool for the correct full-fledged delivery and try to use this tool in the best possible way.

Recall that in the process of attempts directly from the vagina, the small head of the baby will gradually begin to appear (or possibly another part of your baby's body, if in your case it was the buttock, and not the head). The baby itself will make special progressive movements, which is precisely why for some time its head will either show or hide, back into the womb. And finally, when such reverse "swallowing" of the baby stops, you will be transferred directly to the delivery room or transferred to a special delivery table. And remember, very soon you will not even remember how difficult it was for you at that moment.

Try not to worry about anything. After all, childbirth is a wonderful natural process, which has been perfectly studied for a long time and “worked out” to automatism, as they say in practice. Remember, you should not be afraid of childbirth - everything will definitely be fine with you!

While you're still carrying your baby, you should get advice on how to push and breathe properly during labor.

What are pushes?

Attempts are muscle contractions in the abdominal cavity, which begin after sufficient opening of the cervix and contribute to the promotion of the baby "to the exit", that is, his birth.

Pushing is the second stage of childbirth. They are preceded by the first stage - contractions.

The result of wrong attempts

Wrong attempts can lead to undesirable consequences for both the mother and the baby.

Due to improper attempts, the birth process is delayed, the woman is quickly depleted, uteroplacental blood flow may be disturbed, the baby may suffer from hypoxia (oxygen starvation), the child may suffer a skull injury, and the mother may have a uterine rupture

Why does a woman in labor not feel like pushing?

In the process of being born, the baby squeezes the internal organs of the mother. When the intestines are compressed, it seems to the mother's body that he is experiencing the urge to defecate. Therefore, involuntary attempts may occur.

Also, mommy cannot know if the cervix has dilated enough or if the baby has advanced enough so that she can start pushing again. These processes are supervised by a midwife.

When to start pushing?

You need to start pushing when the doctor tells you to. This will happen after the cervix has opened sufficiently, that is, it will be opened enough for the baby to pass through it without getting injured and without injuring the mother. By the time the push starts, the baby's head should be lowered into the woman's pelvic floor.

How to restrain premature attempts?

To hold back your efforts, you will have to focus and relax. Pushing is a controlled process, unlike contractions. You can relax your abdominal muscles and not push.

At the same time, you can help yourself with the help of breathing "like a dog": quick short breaths and exhalations.

How to push and breathe properly during childbirth?

When the doctor or midwife says to push, you should take a smooth deep breath, while the air needs to be drawn into the stomach.

After exhaling, which should last about 15 seconds, repeat the steps from the beginning. Within one attempt, you will need to do this three times.

It is necessary to strain the abdominal muscles. The gluteal muscles and muscles of the face at this time should be relaxed.

During attempts, you can not quickly and abruptly exhale the entire amount of air gained, as this can either lead to squeezing the baby's head or pulling it back instead of moving forward.