What instruction should be given to the patient during crowning in labor?

During the stage of crowning in labor, the appropriate instruction for the patient is to push down vigorously. This is when the baby's head is visible at the vaginal opening, and strong, effective pushing is essential to assist in the delivery of the baby. By pushing, the mother aids in moving the baby further down the birth canal, ultimately leading to the birth.

Vigorous pushing at this moment is crucial because the contractions will help propel the baby out, and coordinated pushing can help manage the pace of delivery, minimizing the risk of tearing or other complications. The importance of this action also lies in the need for the mother's effort to align with the force of the contractions, creating an optimal situation for delivering the baby safely and efficiently.

While deep breaths can be beneficial at various times in labor, during crowning, focused pushing takes precedence. Relaxing the pelvic muscles is not advisable when crowning because tension is needed to effectively push the baby out. Holding the breath may hinder the mother’s ability to maintain the energy needed for effective pushing. Therefore, the instruction to push down vigorously aligns with the physiological needs of the birthing process at this critical moment.