bearingdown

Bearing down is a term used in obstetrics to describe the deliberate contraction of abdominal muscles to increase intra-abdominal pressure in order to help deliver a baby during the second stage of labor. It typically occurs when the cervix is fully dilated (around 10 centimeters) and the presenting part has descended into the birth canal. The technique is usually guided by a clinician or birth attendant and is coordinated with uterine contractions.

There are several breathing and pushing approaches associated with bearing down. One common method is closed-glottis pushing, or the Valsalva maneuver, where the person bears down while holding the breath for short pushes. An alternative is open-glottis breathing, which involves relaxed, rhythmic breaths during pushing. Providers may instruct shorter, forceful pushes or longer, more relaxed pushes depending on the situation, the labor stage, and the newborn’s status. The overarching goal is to maximize effective maternal effort while maintaining oxygenation for both mother and baby.

Indications for bearing down arise in the active second stage of labor when the baby is ready to descend. Contraindications or cautions may include fetal distress, nonreassuring fetal heart rate patterns, or clinical concerns that a prolonged second stage could pose risks, in which case clinicians may alter management, including considering expedited delivery methods.

Outcomes and safety considerations emphasize coordination with healthcare providers, continuous fetal monitoring as needed, and individualized technique. When performed under appropriate supervision, bearing down supports vaginal delivery, though improper technique or excessive duration of pushing can increase maternal fatigue or other risks.