What is bearing down efforts during labour

It is the additional voluntary expulsive efforts that appear during the second stage of labour (expulsive stage). It is initiated by nerve reflex set up due to stretching of the vagina by the presenting part. In majority, this expulsive effort start spontaneously with full dilatation of the
cervix. It helps in passing the baby through birth canal.
                    Along with the uterine contraction, the woman is instructed to exert downward pressure as done during straining at stool. Sustained pushing beyond the uterine contraction is discouraged. In the first stage of labour, bearing down efforts may suggest uterine dysfunction. There may be slowing of the fetal heart rate during pushing and it should come back to normal once the contraction is over.