The second stage of the labor
Mom may grunt with effort or she may breathe her baby down
Contractions may space out some and mom may have more time in between again to rest. When the baby moves through the cervix it may trigger the fetal ejection reflex. She may feel an overwhelming urge to grunt and push. Alternately, she may continue to breathe slowly and deeply as her baby descends. Many mothers find this stage exhilarating. They may feel invigorated, knowing that they are done with the opening stage of labor. While the opening phase demands surrender, the pushing phase may be more interactive and controlled. Instead of feeling like she is riding the waves of the contractions, she may feel more like a participant in guiding them.
Positions for Pushing
One technique for this stage is to tie a knot in the end of a rebozo and place the cloth above the door. Many find it helpful to have a rebozo to hang on or to pull during this stage. The rebozo can also be tied to the bed or placed around her partner's shoulders for her to hold and pull. She may like to grip her partner's hands and pull this way as well. There are many options, but knowing that it helps to release tension in the pelvic floor when a laboring mom is pulling on something, is helpful for setting up her birth location. Her birth team can look around the room and find ways for her to kneel, grip onto something and move freely. Some moms like to sit on a low stool, while others prefer to be supported from behind, like we saw in the video on the Active Labor page.
Things to Think About
This stage may last 1-2 hours in a first time mom who has had no medication, while a medicated mom might push for an average of 3-5 hours. A mom who gets medication in the opening phase may get a break, but may also have more difficulty with the pushing stage. Because the medication may numb her body in an unnatural way, the baby may slip into more awkward positions. She may also have more difficulty using gravity, although in some cases the squat bar may be used with the bed elevated so that she can be in a more upright and semi-squatting position. This may help explain why mothers with epidurals are more likely to need forceps or vacuum assistance.
Sometimes when a mother is pushing, she is told to hold her breath for 10 seconds. This is called Valsalva Pushing. It is also known as purple pushing. Evidence shows that this is a risk factor for decreased fetal oxygen.
Mother directed pushing is considered best clinical practice according to An International Journal of Obstetrics and Gynecology. They say, "...supporting spontaneous pushing and encouraging women to choose their own method of pushing should be accepted as best clinical practice."
Deep slow breaths taken often will help to protect your baby. Find your own breathing and pushing patterns that oxygenate your baby and feel productive to your body.
Once the baby is born the mother only needs to wait for the placenta to detach!
This may take 15/20 minutes on average