During the second stage of labor, the baby passes through the fully dilated cervix and down the birth canal into the wide world. The contractions of the uterus do a lot of this work, but you can help the baby along by pushing – bearing down during contractions and using your abdominal muscles to help move the baby along the birth canal.
This stage of labor lasts anywhere from a few minutes to several hours. On average, it takes about 1 hour for first-time mothers, but only 20 minutes if you’ve had a previous vaginal birth. It also tends to be longer if you have an epidural.
Different women prefer different positions for pushing: reclined or lying down in a birthing bed, on all fours or squatting to let gravity help do the work. Change positions if you need to, more than once if necessary.
Try to listen to your body’s signals about when to push, but follow your care provider’s advice as well. If you push before you’re fully dilated, the cervix can swell or tear, so wait until you’re told it’s okay to push. Also slow down if your care provider suggests, especially as the baby’s head emerges – this gives your tissues time to stretch, which will help prevent or minimize tearing.
Finally the baby’s head emerges – many women feel an intense burning or stinging sensation as the perineum, or tissue between the vagina and rectum, stretches. The next contractions deliver the shoulders, and finally the whole body slides out. The doctor clamps and cuts the umbilical cord (or perhaps your birth partner wants to do the honors), and you have a baby!