What should be the first step if a woman is in labor and feels the urge to push?

The first step when a woman is in labor and feels the urge to push is to assess for the position of the baby and prepare for delivery. This is crucial because understanding the baby's position can provide important information on how to proceed safely with the delivery. If the baby is positioned correctly -- typically head down -- delivery can often occur without complications.

Evaluating the situation allows the responder to determine whether they can manage the delivery themselves or if additional medical assistance is necessary. Additionally, ensuring that the environment is safe and that all necessary equipment is ready for the birth is vital for the health and safety of both the mother and the baby.

While calling for immediate medical assistance, encouraging the mother to push, or administering pain relief are important considerations in the labor process, they come after a proper assessment of the baby’s position. If a provider does not evaluate the baby's position first, they may not be adequately prepared for any complications that could arise during delivery.