What should the midwife instruct Mrs. Patrimonio to do when the baby's head crowns?

When the baby's head crowns, it is essential for the midwife to instruct the mother to bear down, as this action helps facilitate the delivery process. Bearing down, also known as the second stage of labor, occurs during contractions and allows for effective engagement and descent of the fetal head into the birth canal. It promotes the expulsion of the baby while ensuring that the mother is using her abdominal muscles to assist with the process.

This instruction is critical because when a baby crowns, it indicates that the head is visible at the vaginal opening, and optimal pushing techniques can lead to a safer and quicker delivery. It is also during this stage that the mother might receive tips on managing her breathing and timing her pushes to prevent any tearing or trauma during delivery.

While taking deep breaths is important for maintaining relaxation and preventing fatigue during labor, it's not the most effective instruction at the moment of crowning. Similarly, while pushing during contractions can be beneficial, simply stating to push does not encapsulate the more focused approach of bearing down that is specifically recommended when crowning occurs. Stopping pushing is not advisable at this stage since the delivery process is at a crucial point where active engagement is necessary. Thus, instructing Mrs. Patrimonio to bear down aligns perfectly with the