Stages of Labor: Birthing Stage
This stage of labor can last from a few minutes to a few hours. If you have had a baby before, this stage is more likely to be shorter than your previous. First time mothers and women who have chosen to have an epidural, often have longer birthing stages.
Phases of the Birthing Stage
The birthing stage can be broken down into three different phases: the resting phase, the descent phase, and the crowning and birth phase.
The resting phase can often take women by surprise. She has been having dramatic contractions during transition and at a point may feel she can no longer go on. Then, suddenly, things seem to go on pause. She may think something has gone wrong but this is a phase that God has created to give women a bit of a break to let their uterus and their energy catch up before the hard work of pushing begins. This phase can last between ten to thirty minutes.
The resting phase is a good time to get some much needed rest. You may feel excited, more relaxed, more alert, and optimistic. Some women do not experience the calming of the contractions but they may have the boost of energy and mood. You may start to feel anxious or like your body is failing you if this momentary resting goes on for very long but do not worry. This is normal and should be a time where you are allowed to rest and recuperate. Take a few sips of water and maybe even a small snack of nuts or a honey stick to give you a boost of energy for the next two phases.
During the descent phase, your contractions will pick up again to help rotate the baby and descending through the vagina. This is the longest of the three phases and can last up to a couple of hours.
As the baby’s head starts to press further into the birth canal, your perineum will begin to budge and stretch. You may ask for a mirror to catch a glimpse of top of your baby’s head.
As your uterus contracts and you push, your baby will descend and the baby’s head will start to be seen and even felt. When your uterus relaxes, you may feel or see the baby’s head retract back inside of you. This may feel like you are not making progress but you are. Do not get discouraged. This is normal and good. It is giving your baby’s head time to mould into a cone shape so he glides down the birth canal more easily and it is helping your perineum to stretch. This gradual stretching will help you to prevent tearing.
Crowning and Birth Phase
As the perineum stretches more and more, you will be able to see your baby’s head more clearly. Once the head begins to emerge and not retract, your baby is said to be crowning. This is a very exciting time. Your baby will be in your arms in a matter of minutes.
You may be taken off guard a bit when you see your baby’s head, especially once the head is out. Your baby may look blue or purple. Do not let this alarm you. This is quite normal. Your baby is receiving oxygen through the placenta and umbilical cord, he is not breathing air yet. Once he has taken his first breath, he will start to pink up.
Once the baby’s head is out, the care provider will suction the baby’s mouth and nose and check to see if the umbilical cord is around the neck. In the past, the umbilical cord around the neck was something that frightened mothers. However, this is very common and it is very rarely the cause of any complication. The physician or midwife will simply slip the cord over the baby’s head and you will continue to birth your baby.
After the baby’s head is out, his body will rotate and the shoulders will be delivered one at a time and then his body. The baby will be dried off and wrapped in a clean towel. If there are no complications, the baby will be handed to you. You will now have the opportunity to gaze at your beautiful gift, kiss him, sing to him, say hello, and tell him how happy you are to see his face.
You may want to try a couple of different positions to see which one you feel most comfortable pushing. Some women prefer an upright position as it uses gravity to help pull the baby down. Others prefer to push on all fours due to this position giving the baby more room to rotate and get into position. While many women chose to lie in the bed in a slightly upright position. At the moment of birth, your body will be giving you clues as to what position to get into that is best for you and your baby.
Birthing positions may be something you should go over with your care provider before hand. Some older, more traditional providers prefer and my only have experience delivering a baby in the traditional woman flat on back position.
When I worked in an ER setting, one of the ER physicians was called up to help in a delivery one night. The woman was only comfortable in an upright, squatting position. Because the ER physician was not experienced in birth and had only seen it with the woman lying on her back, he felt very ill-equipped in the moment and unsure how to handle the situation. The mother delivered her baby without the assistance of anyone, as she desired, and the baby was healthy.
While this is an unusually case, it is a good idea to check with your caregiver and birth team as to how you will be asked to deliver your baby. It may also give you the opportunity to advocate for yourself and other mothers that may want to deliver in more natural positions.
Pushing in the Birth Stage
During the birthing stage, you may actually feel relief with the urge to push. A very common sensation women report is the feeling of needing to poop. You may actually poop a bit. Do not feel embarrassed about this. Again, this is very normal and is a really good sign. It typically isn’t much and the birth team will quickly remove it without you even noticing. This lets the birth team know that the baby is coming very soon.
At the beginning of the birthing stage, you may want to avoid pushing and continue to let your uterus do the work for you. Your birth team may even recommend this. Pushing can be exhausting so if it looks like the birthing stage may be one of the longer ones, it is a good idea to rest up for when you can no longer control the urge to push. Some coping methods to help avoid pushing is to breathe out the contraction, vocalize through the contraction, or do tiny pushes rather than strong pushes.
It is very common still in hospitals for the birth team to coach you in pushing. Some women do not like this. If you would prefer to push spontaneously, be sure to talk with your care provider about it and include it in your birth plan. Also, speak with your nurse and birth team before you get to the birthing stage to remind them of your preference to not be coached in pushing.
Many women wonder what it will actually feel like to push. It is almost always compared to pooping. Many women wonder in the moment if the baby is actually coming out of their rectum rather than their vagina. If you have opted for an epidural, you may not actually feel these sensations. Your birth team will probably coach you on how to push. If may take several practice runs but you will eventually get the hang of it.
After the Birthing Stage
Within one minute and again at five minutes after birth, the nurse or care provider will check the baby and determine an Apgar score. They check five signs to see if your baby to determine if the baby needs a little more attention and assistance. The five signs are: heart rate, breathing, muscle tone, reflex irritability, and color. A score of seven and above is very good. Almost all concerns are typically corrected within five minutes.
After the birth of the baby, your baby will still be connected to the inside of your uterus though the umbilical cord. In the past, the umbilical cord was immediately clamped and cut. However, due to additional research, it has been shown to be safe and beneficial to wait at least ninety-seconds before cutting the cord. Some families prefer to wait until the cord stops pulsing. If you would like more information on delayed cord clamping, I have written an article explaining the benefits. What ever you choose, make sure you put your desires in your birth plan and discuss it with your provider before hand. At this point, if you have any other requests such as father wants to cut the cord or you desire to keep cord blood for blood banking, you need to also include those in your birth plan, go over them with your care provider, and remind your birth team of your requests.
Your baby does not have the ability to regulate his body temperature as we do so skin-to-skin contact is a great way to use your body heat to help keep him warm. This is becoming more and more accepted and common in hospitals however, it is probably something you may consider adding to your birth plan. Some hospitals even allow it in surgery in the case of c-section if the baby is born without complications. This is less common but is becoming more and more accepted.
One of my clients delivered her child by c-section and, even though she was not able to do skin-to-skin in the OR, her husband unbuttoned his shirt and I helped him place their new son against his chest and wrapped him up in blankets. Their son soon stopped crying, opened his eyes, and started looking around at this new world. It was a very sweet moment.
This is the stage that most women both dream about and are terrified of. It is a moment of pain, fear, amazement, unspeakable joy, and unfathomable love. This moment you will remember for the rest of your life; a moment you will never be able to adequately describe in words.
This article is part of a series on the stages of labor. If you are interested in other articles related to this subject, you may find them on my Stages of Labor Resource Page.
If you are in the Denton, TX area and are interested in hiring a doula for your birth experience, contact me today to schedule a free consultation. If you enjoyed this article, you may be interested in checking out my Comfort Measures in Labor page.