Techniques to be professional in vaginal delivery:
1. When you press on the pelvic floor by your fingers, this stimulate uterine contraction.So, press by 2-4 fingers (whatever the volunteer fingers you have) on the posterior vaginal wall just at the level of occiput/ischial spine, you will see more descending of the head.
2. If you did the previous step perfectly & saw your outcome proceed for the most efficient step;
Put your fingers between the head & vaginal wall at the level of ischial spine then swab the fingers you put inside from one side to the other side beneath the occiput i.e. make the head of baby on the dorsum of your fingers & swab the fingers from the lt. side to the rt. side almost at the level of ischial spine while you are pressing on the pelvic floor by the same fingers at the same time. This will help internal rotation.So, by this step you assisted the head descend & the internal rotation.
3. If you become professional in doing the previous steps, do this last one. Do all I mentioned before by fingers from one hand & the other hand pressing on the fundus doing fundal pressure by one hand in the direction of vagina or just correct the axis of uterus over vagina during contractions (sometimes uterus it tilted to one side acc. to position of the baby inside).
3 common techniques are mentioned in obstetric literature
1st. is Anti-Frugsonreflex .
2nd. is modified manual rotation.
3rd. is proper gentle fundal pressure
Tnx for teaching skills.