Your midwife is crucial at this stage. She will guide you through the labour, encouraging you and helping you and your partner in the last minutes before the birth.
At this stage, contractions are helping to push your baby out. You may want to try different positions at this point and find the one that feels best for you.
What you can do
When you reach the second stage, you will probably feel a powerful urge to push. This is called bearing down. You may want to push about three times in each contraction. You may feel when the time is right to push, or your midwife will guide you.
If you have had an epidural for pain relief , you may not feel the urge to bear down as strongly, so your midwife will tell you when you should push. Some women like to hold their breath when they are pushing but it’s important not to hold it for too long.
As your baby’s head stretches the birth canal and the perineum (the area of skin between the vagina and the anus), you may feel a powerful burning sensation, which normally lasts only a few minutes.
You will feel your perineum stretch at this point. If there’s a risk of tearing, you may be asked to stop pushing (see Episiotomy below). Instead, you may be asked to pant or push more gently to ‘breathe the baby out’. If a small tear in your perineum occurs it may need to be repaired after your baby is born.
When her head can be seen completely at the vulva it is ‘crowning’. This is a truly amazing moment. The midwife may encourage your partner to have a first look at your new baby.
With the next couple of contractions, your baby’s head comes out. The midwife may feel for the umbilical cord to make sure it’s not around her neck. Your baby’s shoulders will turn so that she’s sideways on, facing your leg. The rest of her body then comes out quickly and easily.
Your baby is born!
Sometimes the perineum doesn’t stretch easily over the baby’s head. Your midwife may suggest that she cuts the perineum to help with the birth of the baby’s head. This cut is known as an ‘episiotomy’. Before the procedure is performed, a local anaesthetic may be injected into the muscle to reduce the discomfort or pain during the procedure.
Episiotomy is only done when necessary and is not a routine procedure so it will be discussed with you. You will need stitches after the birth.