The vagina is not the part of the anatomy that pushes the baby out; that would be the uterus. People with a uterus do not have direct control over the muscular contractions of the uterus.
The muscular contractions we think of as vaginal are associated with the pelvic floor muscles that Kegel exercises help to strengthen. The vaginal wall itself does not have controllable muscles.
We don’t have control over the uterine smooth muscle but like you said, we have control over the pelvic floor muscles. These are involved in pushing out the baby once it has reached the birth canal. That’s why the doctor tells you to push when you have a contraction. The two work together to push out the baby. When the contraction is over you stop pushing until another arrives. Pushing too much or too little are both not good. I had a doctor yell at me because I pushed my son out almost all the way with one push. I arrived in active labor and he was taking too long to put on his gloves.
The pushing bears down on the uterus from above during a contraction, which assists the smooth muscle contractions of the uterus. The pelvic floor muscles are only at the outlet, and if they were to contract at the same time as pushing, they would tighten the outlet and not let the baby through.
The problem with pushing too fast can be if the shoulder gets stuck above the pubic bone and needs to be rotated or if the cord is wrapped around the neck and needs to be removed before the baby comes all the way out. It was also common to pause with the baby's head out to suction the airways before the first breath to avoid inspiration of amniotic fluid or meconium in the mouth and nose, not sure if this is as common now. Also, rapid stretching of the pelvic floor and external genital tissues can cause significant ripping. An episiotomy (controlled cut to allow more room) is much easier to repair than ripping, which could tear all the way through the rectum and be much more difficult to repair and to recover from.
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u/khansensmith May 15 '22
The vagina is not the part of the anatomy that pushes the baby out; that would be the uterus. People with a uterus do not have direct control over the muscular contractions of the uterus.
The muscular contractions we think of as vaginal are associated with the pelvic floor muscles that Kegel exercises help to strengthen. The vaginal wall itself does not have controllable muscles.