Giving birth - second stage of labour
What is the second stage of labour?
The second stage of labour begins when your cervix is open (dilated) to 10 centimetres. Your midwife may check how dilated your cervix is by doing an internal examination.
You may not feel an urge to push straightaway. This is called the passive second stage. It becomes the active second stage when you have the urge to push and ends when your baby is born.
Your contractions will be longer and more powerful than they were during first stage of labour, but they may also be slightly most spaced out. This gives your body time to rest. Each contraction pushes your baby’s head further down your pelvis, slowly edging the baby closer to being born.
You may feel an urge to push to help your baby be born. This is because the baby’s head is pressing down on your pelvic area. You will feel your baby's head moving through your pelvis, and a stretching or burning feeling as the skin around your vagina and perineum make room for your baby to be born.
How long can the second stage last?
If your labour lasts for more than 2 hours, or if you or your baby become unwell, your midwife may recommend that they give you more help. This could be by manually helping your baby to come out. This is done using forceps or suction.
What pain relief can I have and when can I have it?
Your options for pain relief will depend on where you choose to give birth and how close your baby is to being born. For example, if your baby is close to being born, there may not be time for you to have an epidural, and other medications, like morphine, may not be recommended.
It is always best to talk to your midwife or doctor, since advice may vary according to your own circumstances.
It is also important to know that some hospitals and birthing centres do not have a bath for you to use for pain relief. You can keep using other medical and non-medical methods of pain relief, such as movement or relaxation.
Different women have different preferences for pain relief during labour and birth, so it can be helpful to think ahead and discuss your plans with your doctor or midwife before the birth to make sure that your preferences will be suitable for your circumstances.
What is the role of the birth partner during the second stage of labour?
During the second stage of labour your birth partner can continue to support and look after you. This could be by giving you sips of water to drink when you are resting between contractions, or by helping you to change position if you would like to.
Your birth partner can give you emotional support and encouragement as you labour. Before labour, it can be helpful to discuss with your birth partner how you would like them to support you.
Your midwife will also continue to support and encourage you as they look after the health of you and your baby.
Why is it important to push during labour?
Pushing when you feel a contraction helps your labour to progress. The most effective way to push is to push 2 or 3 times each time you have a contraction. Give yourself time to breathe and rest between each one.
You only need to start pushing when you feel that you are ready and when your midwife has told you that you are fully dilated, meaning that you are in the second stage of labour. Your body is the best guide, and you will naturally feel this urge to push.
If you have had an epidural, you may not feel an urge to push or the sensation may not be as strong, so your midwife might help to guide you on when to push and for how long.
What happens as my baby is being born?
At the end of the second stage of labour, your baby is born. You midwife or doctor will support your baby as it is coming out of your vagina. With your consent, they may also apply a warm compress to the skin around your vagina (perineum) to help protect it from tears and to make you more comfortable.
If your midwife or doctor thinks it may be needed, they may ask for your permission to perform an episiotomy. This is a cut made in the skin around the vagina (perineum) to prevent the skin from tearing in an uncontrolled way. This may also be recommended if you are having an assisted delivery (with forceps or vacuum).
When your baby is born, your midwife will check that the baby does not need any immediate medical care. Then they will give you your baby to hold and cuddle. This is known as ’skin-to-skin’ contact, or kanagroo care, because your baby’s bare skin is in contact with yours. This helps to create a bond between you and your baby. Your midwife will cover you both with a warm blanket and you will have the opportunity to breastfeed your baby if you would like. Your midwife will stay close by in the first hour or so to support you and to make sure you and your newborn baby are well.
What happens if something goes wrong?
Every labour is unique, and sometimes things don’t go according to plan. You may have to adjust your birth plan if the situation calls for it.
There can be labour complications in which extra medical support is needed. With your consent, your midwife or doctor will work with you to make the best decisions for you and your baby.
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Last reviewed: February 2022