![]() Parity, delayed pushing, use of epidural analgesia, maternal BMI, birthweight, OP position, and fetal station at completed dilation all have been shown to affect the length of the second stage of labor. At this time, maternal expulsion efforts may begin. Although fetal descent begins before the cervix becomes fully dilated, the majority of fetal descent occurs once full cervical dilation is achieved. ![]() The second stage of labor begins once the cervix becomes fully dilated and ends with the delivery of the neonate. Wing, in Obstetrics: Normal and Problem Pregnancies (Seventh Edition), 2017 Disorders of the Second Stage It is a time of great anticipation the mother becomes much quieter and the atmosphere in the delivery room should be calm and unhurried. Prior to this, it will slip back between contractions. When the full diameter of the baby's head has emerged under the pubic arch, it is said to have crowned. The pain from the perineum is nature's way of signalling the mother to hold back from pushing, allowing the perineum to stretch without tearing. The mother may experience the sensation of the baby's head descending through the birth canal as a tight burning sensation, as the perineum begins to stretch. ![]() Many mothers close their eyes and withdraw, to concentrate on the effort of giving birth Īs the pushing urge develops, she may become introspective.She will become more energised and focused She may panic about needing to open her bowels at this stage and may need reassurance She is likely to feel calmer, and the sense of purpose that she may have experienced earlier may return She may feel a spurt of energy or ‘second wind’ Mother's behaviourĪ number of features are typical of the mother's behaviour during the second stage: This is a signal to push gently as the baby's head crowns, to allow the skin of the perineum to stretch gently, easing it over the baby's face. A burning sensation will develop as the skin of the perineum stretches to its full capacity it may feel to the woman as though she is going to tear completely. As the head presses down, pressure is first felt on the rectum and then, as the baby continues to descend, the head presses on the perineum and the vaginal tissues open up. This action is irresistible and with each pushing action, the baby moves down through the birth canal. As the second stage begins, the woman feels an overwhelming urge to push or bear down. What happens to the perineum at birth?Īt the end of the first stage of labour, the cervix has thinned out and opened up, so that the uterus and birth canal become one opening ready for the baby to start its descent. In addition to the contractions, the mother will feel a strong urge to bear down, and this urge to push can be regarded as an indication that the second stage is under way. When they occur, they are shorter and more widely spaced. Contractions become slower, and may stop altogether, to allow the mother a rest. The character of contractions in the second stage of labour is different from those in the first stage. It is often described as ‘cramping’ or ‘burning’. The pain at this stage of labour has a different quality, as the cervix is now fully dilated ( Figs 13.1, 13.2). Lyndsey Isaacs RGN BSc(Hons) MBAcC, in Acupuncture in Pregnancy and Childbirth (Second Edition), 2008 Characteristics of the second stage of labour Pain in the second stage
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