The second stage

ready set push: the second stage

Okay, maybe labour isn’t exactly a party – but it is a special, exciting event! The three stages of labour are a natural process designed to guide your baby into the world.

Every mum’s experience of labour and birth is different, and unfortunately, it’s impossible to predict what yours will be like – when it will start, how long it will last, what it will feel like. But generally, births follow a pattern of three stages, each defined by specific events and milestones.

The second stage

When your cervix is fully dilated to 10cm, and you feel the urge to push, you’ve entered the second stage of labour. This stage of labour can last anywhere from a few minutes to a few hours, although for a first baby, it is usually an hour to an hour and a half. This is the phase where you will get a bit of a workout, actively using your abdominal and pelvic muscles in conjunction with your contractions to push your baby out. Sometimes there is a lull between the first and second stage of labour – a few minutes to catch your breath before your body feels an overwhelming urge to start pushing. During the second stage of labour, you’ll push your baby down past your pelvic bones, through the birth canal, and out of your body. At the end of this stage, you’ll meet your baby!

Assume the position

The position you give birth in is a personal choice, although some forms of pain relief or your baby’s position may dictate that you are partially reclining with your legs in stirrups, for example, or in other positions in which your midwife or LMC will instruct you. In general, it is better if you can give birth in a position you find comfortable and conducive to pushing. Squatting, kneeling on all fours, leaning over the back of a chair, leaning on your partner, lying on your side, semi-sitting, laying over a birthing ball, a lunge pose, or even standing may be what you prefer at the time – your body will tell you, and your midwife will help you find the best position for the situation.

Contractions last around five to six seconds, giving you the opportunity for two or three short pushes. Try to breathe through the pushes, as holding your breath while bearing down can cause you to feel faint. It’s normal to make grunting or groaning noises while you push.

You’ll feel the pressure of your baby’s head low in your pelvis. Listen to your body’s urges, and listen to your midwife, who by this time will be “down at the business end” and able to see your baby’s progress firsthand. If she tells you to stop pushing, listen.

Some mums-to-be may want to have a mirror which they can use to look at their baby’s head as it crowns. With each push, your baby may slip back a little, but it will gradually move down until its head is ready to be born.

At this point, you may feel a stinging, burning sensation as your perineum (the skin between your vaginal opening and your anus) and your vaginal opening stretch. This is commonly called the “ring of fire”, and this happens when your baby’s head and body are born.

Your midwife or LMC may ask you to stop pushing, and to take short breaths, which can help you resist the urge to bear down. Your midwife or LMC will take steps to minimise the risk of tearing, and will try to help your baby be born gently and slowly.

The moment of birth

Your baby’s moment of birth may occur over the course of a few minutes, as he will emerge gradually and in stages. He will probably be born head-first during one push, then his shoulders and the rest of the body will follow in the next push. Some women do push their babies out in a single push. Once your baby has been born, your LMC or midwife will place him directly on you, or will tell you to go ahead and pick him up yourself, for skin-to-skin contact. Some mums-to-be like to “catch” their babies as they are being born, or have their partner or another family member “catch” the baby, under the close supervision of the midwife. Your midwife will then give you a clean, dry towel to wrap around your baby and keep him warm.

At this point, once your baby is born, the majority of the pain of labour will stop – just like that. You may feel suddenly clear-headed and relieved, and be able to talk and laugh and enjoy those first moments with your newborn. There may even be tears from you and the dad-to-be, but they’re the happy kind of tears!

What is an episiotomy?

AN EPISIOTOMY IS A DELIBERATE CUT TO THE PERINEUM, TO ENLARGE THE OPENING WHERE YOUR BABY WILL COME THROUGH AS HE IS BEING BORN. IT IS NOT USUALLY NECESSARY, BUT CAN SOMETIMES HELP. IT’S IMPORTANT TO ASK YOUR MIDWIFE OR LMC FOR HER PHILOSOPHY WITH REGARDS TO EPISIOTOMIES OR TEARING.

DADS-TO-BE

For dads-to-be or birth support people, labour can be challenging in a different way. While the mum-to-be is doing quite a lot of hard work, you may feel helpless, worries, upset, and even useless. But you are extremely important to the mum-to-be, even if you don’t realise it. Your presence helps to centre and calm her, helps keep her focused, and lets her know that someone in the room cares for her deeply, which is immensely comforting. She may not ever say any of these things, but she needs you there, and your job is to be supportive and to give her the help she needs from you. Here are some ways you can help:

+ Be fully present. Stop work, put down the TV remote, and be there with her. She is your number-one priority and if she needs you, you need to drop everything in an instant.

+ Be aware of her birth plan and what she wants and doesn’t want. During labour, she might not be able to advocate for herself, so discuss ahead of time when you can speak for her. Be her advocate.

+ Familiarise yourself with the stages of labour ahead of time, so that you can understand what she’s going through and help her get to the next step.

+ Particularly during active labour and during the second stage of labour when she is pushing, you might need to be on hand to give massages, hold her hand, hold her legs, breathe with her, encourage her, and go through the experience with her.

+ Be prepared for surprises. She may not want you anywhere near her. Don’t take it personally.

+ Yes, labour can last for a long time. While you may be bored, your role is to stay focused and present. No sneaking off to watch the rugby.

+ If you’re in it with her for the longhaul, you’ll need to eat, drink, and rest, too. Birth is intensely emotional, and you might hit a wall. Make sure you have some support lined up – call a friend who’s been there for a pep talk if you need it.

 

What to expect during the other two stages:

First Stage

Third Stage