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The second stage of labour begins with full dilation and ends with your baby's birth.  

It can take anywhere from a few minutes to two or three hours. 

Contractions in second-stage labour are powerful, coming every two to three minutes and lasting 60 to 90 seconds. You may feel a strong urge to push or go through a short time with no contractions and no urge to push.

You will have a splitting and burning sensation on your perineum or vagina as these parts of your body stretch to accommodate your baby's head.  You may also feel surprised, overwhelmed or frightened by pushing.

What to Expect During Second Stage Labour

• Vaginal examination to ensure full dilation. Pushing too soon can make the cervix swollen and difficult to open further. 
• Once cervix is fully open, baby is pushed out.
• If water (amniotic sac) is still intact it may be broken to help you along. The amniotic sac is the membrane inside the uterus that holds the fetus and amniotic fluid.

Did you know? An episiotomy is an incision (cut) made in the area between the vagina and rectum to enlarge the space for the baby to pass through the vaginal opening.Baby's head pushes against mother’s perineum.

• Fetal heart rate is checked every five minutes or after every contraction. 
• Baby's head is usually facing mother’s spine.
• As baby’s head first emerges, it will slip back into mother’s vagina between contractions. 
• Vagina stretches to allow baby to pass through.
• Perineum may not tear at all or tear only slightly.
• An episiotomy (cut in the perineum) may be performed to allow more room for baby's head.
• As baby's head crowns mother may be asked to stop pushing.
• When baby’s head emerges it is usually face down but will turn to one side. Mucus in the baby's nose and mouth may be suctioned. With the next contraction baby’s shoulders and body will emerge.

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Tips for you and your support person

• Breathe deeply.

• Relax your bottom and go with the urge to push.

• If you feel better grunting with contractions and giving small pushes, go with this urge.

• Use the same muscles to push that you would use for a bowel movement.

• Drop your chin towards your chest and relax your tongue.

• Change positions as needed for comfort and to assist your baby in passing through the birth canal (try semi sitting, squatting, kneeling or lying on your side). Support people can help hold your legs, or support you as you squat.

• Continue with relaxation techniques between contractions.

• Listen to your body and use the breathing techniques you practiced.

• If you are asked to stop pushing, try panting.

Labour Partners

• Reassure her that she's doing a great job.
• Wipe her forehead with cool cloths.
• Offer small sips of fluid between contractions.
• Look into her eyes and help her focus during her contractions.

Resources & Links:

• Labour and Delivery
• Contractions During Pregnancy: What to Expect