2nd Stage of Labor

Many women find the second stage easier to cope because they find things under their control more or less. In essence this stage lasts from full dilation until the birth. Once the cervix is completely dilated, baby's head makes its descent through the birth canal. This basically marks the beginning of the second stage.

Labor Facts

• The second stage generally lasts about an hour to two. In some cases labor is over in a few contractions. Subsequent births may result after one or two pushes in a single contraction! (lucky indeed)
• Contractions last 60-90 seconds and occur at 2-4 minute intervals
• Bearing down is an instinctive reaction which is not within your control
• Push only during a contraction
• Prolonged second stage which goes beyond 2 hours is not only exhausting for the mother but leads to undue stress to the baby
• With a pain relief, especially the epidural the mother will have to depend on the medical staff for prompts on when to push as she won't even be aware of her cervix being fully dilated nor feel the urge to push
• Without a pain relief, the mother is conscious of every feeling she is undergoing including the feeling of wanting to bear down and push
• If the mother and or baby are not handling this stage well, coupled with the fact that it is a prolonged labor medical intervention will become necessary viz forceps, vacuum extraction and even a cesarean.

What is happening with You

• Each contraction and each push helps the baby move down the vagina. In the start when the contraction ends there will be some resistance from the pelvic floor and vaginal muscles which will help prevent the birth. With the first baby the head will slip back between contractions several times.
• The mother is less aware of pain and any discomfort at this time than at any given time since her labor began
• After a few more contractions of the uterus, the resistance is overcome and baby's head starts to move further down with each contraction. Eventually the head stays in position.
• When the top of baby's head becomes fully visible at the vagina site, the head is said to have 'crowned'. Some women experience a burning sensation at this point.
• Contractions during this stage are different from those experienced during the first stage. Here part of the contraction is to push. They remain painful but many women find them easier to handle
• To begin with although each contraction can last up to 90 seconds, the intervals in between are longer, giving the mother more resting time.
• The most efficient position is the upright one because of the need to push and the force of gravity. During pushing it is important to relax the pelvic and anal muscles so if a little expulsion of stool or pee occurs don't go obsessing about it.
• The urge to empty the bowel grows as baby's head presses against the back of mother's pelvis and on her bowel. It is normal to evacuate the bladder and the rectum during the pushing stage and the mother should not let this urge impede her pushing. Your bowels may not open but it will feel like it did so there is no way of knowing for sure. Don't hold back - if you feel the urge, just do it!
• Perineum skin continues to stretch as the head continues its exit. Sometimes the skin of the perineum is stretched thin to the point of causing a temporary burning sensation. Medical staff at hand may advise against pushing as there is a risk of tearing the perineum. Deep breaths or panting and gentle pushing will help prevent tearing and a possible episiotomy. If tearing is inevitable, an episiotomy will be performed.
• While the baby is being delivered, mother's uterine muscles continue to contract. With the next contraction or two, baby's head will make the exit smoothly.

What is happening with Baby

• Baby will be continuously monitored throughout this stage. At the start itself baby will turn its head so that her crown faces the front enabling the widest part of the body to fit through the pelvis. Before you know it baby's head is crowned.
• As baby descends, the edges of her soft skull bones slide under and over each other to aid in its journey. This is called moulding. Because of this moulding baby's head appears misshapen after its birth for a few days at least. Sometimes there will be tiny broken blood vessels because of the narrow birth canal
• After her head is born which is always face down, almost immediately she will twist her head sideways; the caregiver will feel around for the umbilical cord in case it is around baby's neck which will be lifted up over the head. Baby's subsequent contractions.
• As soon as her shoulders are delivered the rest of her body will glide out followed by a gush of amniotic fluid. Baby will feel slippery to the hold as she will be covered with blood, amniotic fluid and vernix. The mother will probably be able to hear her baby's first cry now.
• After baby is born, she is still attached to the placenta by the umbilical cord. Once baby is breathing well the cord is clamped and cut either by the doctor or your partner. The baby is then given to the mother to hold and cuddle

Interesting Facts

• Having twins or multiples doesn't necessarily mean labor and delivery will be longer and more arduous in comparison to the birth of one baby. On the contrary since twins come earlier they are usually smaller and weigh less than average; delivery may be quicker and easier.
• Baby's first bowel movement is termed meconium. It is dark greenish black in color and tar-like in consistency. Baby's first stool comprises of bile pigment, mucus, amniotic fluid, lanugo and cells from the wall of the bowel. If baby becomes distressed, meconium can be passed during labor.
• Baby may begin to draw her first breath through her mouth even before her whole body emerges from the birth canal. She may either gasp or give a cry as the first rush of air enters her lungs; some babies breathe without producing any sound. Once the cord is cut, baby will start to breathe at the rate of between 40-50 breaths a minute with the occasional gasps in between. The oxygenation of baby's blood is responsible for changing the purplish blue tone when she was first born to the pinker one she now gains.