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The Second Stage: Delivery

What Your Baby Does^*

Her body goes through several twists and turns as she descends through the birth canal, all of which are aimed towards achieving a smooth, safe birth.

Your baby has a pliable body but fairly firm, oval head. Both these parts have to adapt themselves to a curved lower birth canal made up of the lower part of the uterus inside the pelvis, dilated cervix, and stretched vagina. There are various adjustments that your baby makes as labour progresses.

• She will bring her chin down on to her chest as she descends through the pelvis.
• She will rotate her head.
• She will extend backwards so that the back of her head touches her back as she emerges from the birth canal and vagina.
• She will make a little sideways wriggle so that her head turns to one side or the other; the shoulder of that side can be delivered through the vagina.
• She will make another little wriggle to swing her head all the way round so that the other shoulder is delivered. (If you imagine this in quick succession, it’s like shrug of one shoulder after the other: during delivery this is so fast that you hardly perceive it).
• Her trunk, buttocks, and legs follow her head out through the birth canal.

Giving Birth^*

Your baby’s journey down the birth canal lasts about an hour average. You will probably feel swept along by an unbelievably strong, fundamental urge to bear down and push your baby out of the uterus, although if you have had an epidural anaesthetic the urge to bear down is somewhat reduced.

Pushing^*

As each contraction builds until it reaches its peak, you will experience powerful urges to bear down and push out your baby as she descends. Bearing down is not something that you decide to do; it is an instinctive reaction that you will be powerless to resist.

The Head Crowns^*

There comes a point when your baby’s head does not slip back between contractions, but remains visible at the vaginal outlet. This is when the head is said to crown, and you will feel a burning or stinging sensation as her head stretches your vagina. It is important that you stop pushing at this point so that you give the tissues of your perineum a chance to thin and stretch. This may be difficult as you may still be experiencing the urge to bear down, but you must try to resist, because if you continue to push you will put undue stress on the perineal area, which is likely to result in a tear or necessitate an episiotomy. Panting is a good way to try and control your desire to bear down.

The Head Emerges^*

As her head is born, she will immediately turn her head sideways. Your contractions will probably pause for a few moments at this point, and your caregivers will feel around your baby’s neck to make sure that the cord is not present. If it is, they will either lift it up over her head or make a loop through which she can be born. Her shoulders will be delivered in the next contraction.

The Baby is Born^*

As soon as her shoulders are free, the rest of her body is born immediately. As she slithers out of your vagina she will usually be followed by a great gush of amniotic fluid. Your caregivers will hold her very carefully as she will be slippery. She may be breathing and crying already.

The First Cuddle^*

Your caregivers will usually wrap or cover her in a blanket to keep her warm and then give her to you to hold in the first few minutes after the birth. She may start to suckle spontaneously.

*Dr Miriam Stoppard MD FRCP, Conception, Pregnancy & Birth, Dorling Kindersley, Australia 2002