ractions and the placenta will be separated from the uterine wall
and expelled.]

CHANGE OF FEELING

Gradually the time between the labour pains grows shorter and the pains
increase in severity until they are coming every 2 to 3 minutes. It
will not be long now before the baby is born.

At this stage the mother will notice a change. Instead of the tightness
in the lower abdomen and pain across the back, she will feel a bearing
down sensation almost as if she were having a bowel movement. This
means the baby is moving down.

When this happens, she should lie down and get ready for the birth of
the child. The tightening and bearing down feelings will come more
frequently and be harder.

She will have an uncontrollable urge to push down, which she may do.
But she should not work too hard at it because the baby will be brought
down without her straining too hard. There will probably be more blood
showing at this point.

_The person attending the delivery should thoroughly scrub hands with
soap and water. Never touch the vagina or put fingers inside for any
reason. The mother also should keep her hands away from the vagina._

As soon as a bulge begins to appear in the vaginal area and part of the
baby is visible, the mother should stop pushing down. She should try to
breathe like a panting dog with her mouth open in order not to push the
baby out too rapidly with consequent tearing of her tissue.

She should keep her knees up and legs separated so that the person
helping her can get at the baby more easily.

MOMENT OF BIRTH

_The person helping the mother should always let the baby be born by
itself. No attempt should be made to pull the baby out in any way._

Usually the baby's head appears first, the top of the head presenting
and the face downward. Infrequently the baby will be born in a
different position, sometimes buttocks first, occasionally foot or arm
first. In these infrequent situations, patience without interference in
the birth process is most important. The natural process of delivery,
although sometimes slower, will give the child and the mother the best
chance of a safe and successful birth.

The baby does not need to be born in a hurry, but usually about a
minute after the head appears the mother will have another bearing down
feeling and push the shoulders and the rest of the baby out.

As the baby is being expelled, the person helping the mother should
support the baby on her hands