Second Stage Breathing

When the cervix is fully dilated, you enter the second stage of labour. For many women this is a relief as they can take a more active role in their labour process. This second stage is the real work of labour and the most exciting. Some women begin pushing involuntarily, responding to an overwhelming urge, others will begin pushing after they are told they are ready.

Breathing for second stage follows a similar pattern to first stage. You need to adjust your breathing so you are working in harmony with the contractions as this will be the most effective way to push your baby out. Increased vocalization is common during second stage; however, ensure that you are keeping your voice low and slow. Yelling or screaming is not effective and will waste your energy. Keep your chin toward your chest and resist the urge to arch away from the contraction.

Let the contraction build, take one or two greeting breaths, bear down strongly and slowly let your breath out. You may make a grunting sound—this is good. It is a natural sound with pushing. It often takes several contractions to get into the rhythm and work with the sensations. Let your bottom relax and open. Sometimes pushing on the toilet can be a really good place to let go.

Sometimes it is necessary to hold your breath for a few seconds as you are bearing down during second stage contractions. Your midwife will give you feedback about what is effective pushing. If too many people are telling you what to do, request that only one person direct you.

Crowning and Birth

As the baby descends, the head will become visible and then slide back between contractions. This back and forth movement helps to stretch the perineal tissues. Finally, you will reach a point when the widest part of the baby’s head is coming through the vaginal opening. This is referred to as crowning and you will feel a burning sensation in your perineal tissues. At this time it is important that you not push. Your midwife will tell you to stop pushing. Instead, lessen the pressure by using short, panting or blowing breaths. Think of breathing your baby out slowly and gently.
Once the head is crowned your baby will turn its head and shoulders and will be born with the next contraction. This is usually an easier push. The placenta will follow soon after—requiring a gentle push to complete your birth.

Courtesy Village Health Clinic, Surrey BC