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2nd stage of labour
The second stage of labour, as it is known, starts when your cervix is fully dilated and the baby is ready to come out. While the first stage can last a very long time, the second stage is usually short – less than two hours, and sometimes only half an hour. You may feel a strong need to push or you may notice a change in the contractions, perhaps they will slow down or stop – giving you a chance to take a rest before pushing your baby out. You may find your mood changes and you feel you have had enough – this is a good sign that you are moving through what is often called the transition stage between 1st and 2nd stage.
During the second stage, the baby is pressing on your pelvic floor, creating an urge to push, or ‘bear down’. You will usually find it easier to work with gravity by kneeling or going on all fours – lying down makes it harder to push the baby out. See “Positions for labour and birth” for some helpful suggestions. If you feel so tired that you must lie, then lie on your left side, not on your back.
If you have had an epidural, or the baby is being monitored, you will probably be leaning back or lying down, however. Pushing can be hard if you’ve had an epidural, because you are won’t be able to feel the contractions – you may need to rely on the midwife to tell you when to push, because she will be able to see your contractions on a monitor.
Listen to your body as each contraction comes and do what feels right. It helps to take frequent, shallow breaths during the contraction. Resist the temptation to hold your breath – it makes pushing harder. The midwife and your partner or birth assistant may be able to encourage you by telling you when the baby’s head appears. Your midwife will help you to birth as gently as possible. Once the baby’s head is out, the rest of the body will follow quickly.
Sometimes, if second stage labour has been going on a long time with little progress, an obstetrician may be called in to deliver the baby by forceps or ventouse. This is more likely to happen if you have had an epidural, because you won’t be able to feel the baby moving down the birth canal.
Forceps
Forceps look a bit like serving tongs. The doctor may first perform an episiotomy (a small cut) in the perineum to create a bigger opening for the baby to come out. She will then insert the forceps and put them around the baby’s head. While you are pushing during a contraction, the doctor will pull gently to deliver the baby.
Ventouse
A ventouse is a suction cup that the doctor will place on the baby’s head. As with a forceps delivery, though, the doctor may perform an episiotomy first. She will then place the cup on the baby’s head and, using a pump, suck the air out. While you are pushing during a contraction, the doctor will pull on the cup to deliver the baby.
Sometimes the midwife will offer your partner or birth attendant the opportunity to cut the cord. The midwife will probably pass the baby to you so you can have a cuddle and perhaps a first breastfeed. Then the midwife will weigh and wash the baby and take her Apgar scores before wrapping her up warm in a blanket and handing her back to you.
