Second Stage of Labor
Be Empowered Birth Series
The second stage of labor comes with a renewed sense of energy. As a laboring woman has worked with her body to get to this part, the joy and excitement of getting to meet their little one so soon, becomes even more real, as you begin to push. Specifically, the second stage of labor begins once the body has completely dilated, and begins the process of pushing the baby through the birth canal.
During the second stage of labor, the cervix has been pulled back as it completely dilated, into the fundus. The sensation of the contraction typically shifts too feeling your abdomen pushing with increased pressure, similar to the sensation of having to have a bowel movement. With this stage, contractions will typically be anywhere from three-to-five minutes and last upwards to 60 to 90 seconds.
But since the second stage is all about pushing, we are going to cover the different ways of pushing, and give you some tips that can help you along the way.
Mother-led pushing is when the laboring women indicates when she desires to push. Often this desire comes from the change in contractions and bearing down can help the mother with the contraction, rather than just breathing through the contraction. In fact, with mother-led pushing, a woman could allow her body to naturally birth her baby down as the body naturally pushes without the added force of physically pushing.
Mother-led pushing can be most effective when a laboring woman is able to feel and be aware of the sensations. It can help reduce tearing, duration of pushing and is not limited to one type of position. Regardless of your birth setting, this can be an option for you. Talk with your provider about your desires in pushing.
Directed pushing consists of your provider, birth partner, nurse or doula supporting you in directing when to bear down and push, like you are having a bowel movement, to work your baby through the birth canal. This type of pushing can be most effective if the laboring mother is unable to sense when she is having a contraction. During direct pushing, as the monitors begin to indicate the building of a contraction, your pushing coach will remind you to take a big deep breath and holding it while they count for 10 seconds. To make directed pushing most effective, ensure that you are pushing in your bottom (like you would be pushing for a bowel movement) and not pushing in the face or legs, which takes away from pushing your baby down and out.
Directed pushing does not always occur if a mother has received an epidural. In fact, in some settings, it is part of the process. And though, as we mentioned above, you have other options. However, directed pushing can actually be helpful if the laboring mother is having a hard time knowing when or how to push.
Tips for Pushing
Laboring baby down can be most effective in reducing the duration of pushing. Ensure that when you are ready to push that the pressure in your bottom is constant, and position change does not reduce the sensation.
Pushing involves two steps forward, one step back. Each time you push baby moves a little more.
Getting under the pubic bone is the biggest “obstacle” of pushing. Once baby slips under, typically the next push brings crowning!
Do not just push through the “ring of fire.” In fact, this may increase the risk of tearing. Allow baby to stretch the skin, reducing the likelihood of tearing.
Ask for a mirror! This may seem undesirable, but often clients that can see how well they are pushing become more effective with the motivation of seeing their baby’s head.
3 words: Tug of War! Sometimes having something you are working at with tug of war while pushing helps pull energy and curling for effective pushing.
Get mad. It sounds counterintuitive, but getting mad builds force, and force can help move your baby down and under that pubic bone!
Don’t be afraid to change positions: squatting, hands and knees, side lying, or whatever feels more comfortable for you. Pushing takes time, and as the baby is trying to navigate the birth canal, moving can help promote space and meeting your sweet baby!
Want to be prepared and empowered for your birth? Sign up for childbirth classes, where we discuss all of the elements of what to expect in labor, learn about the benefits and risks, and how to prepare with thoroughly going over positions for all stages!