The Second Stage: Delivery

Delivery is the main event: it’s what you’ve been getting ready for over the last nine months. Your expectations are realistic­a manageable labor, not necessarily painless but happy and relaxed, with your chosen birth partner and staff you know around you in familiar surroundings. One of the key factors in your feeling happy and relaxed is that everyone around you is a familiar friend.

CONTRACTIONS AND PUSHING

The second stage is the expulsion stage-you push your baby out. It lasts from the time your cervix is fully dilated until your baby is born and, for a first baby, generally takes less than two hours. The average second stage lasts about one hour, and it may be as little as 15-20 minutes for subsequent babies. At this time contractions are 60-90 seconds long and come at two- to four­ minute intervals.

You’ll almost certainly feel the urge to push, known as bearing down. The urge is caused by your baby’s head pressing down on your pelvic floor and rectum, and is quite involuntary. Keep your pushing as smooth and continuous as you can; make the muscular effort smooth and slow so that your vaginal and perineal tissues and muscles have enough time to stretch and will be able to accommodate your baby’s head.

The most efficient position to be in when you’re pushing is upright, whether you sit on a birthing stool, stand with your arms around your partner’s neck, or squat. This means that the downward muscular force of your body and the downward force of gravity are working together to push your baby out.

If you’re lying on your back, even if you’re supported by pillows, you’re pushing your baby out uphill against the force of gravity.

This is much harder work, and so delivery is slower.

As you push, it helps if your pelvic floor and anal area are fully relaxed, so make a conscious effort to let go of this part of your body. Don’t be embarrassed if you urinate or lose a little stool­lots of women do and your attendants have seen it all before. When you’ve finished a push, take two slow, deep breaths, but don’t relax too quickly at the end of a contraction. Your baby will continue to maintain her forward progress if you relax slowly. If doctors think that your second stage is going on too long, they might suggest using forceps to assist the delivery of your baby.

Comments