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Second Stage of Labor
Curriculum Topic: Group Activity, Educator Demonstration, Practice
Activity Type: Labor & Birth, Healthy Birth Practice 1, Healthy Birth Practice 2, Healthy Birth Practice 5
Supplies: Birth balls
Chairs
Photos of hospital bed in different positions for pushing
Sample or photos of squating bar
Instructions:
Have the participants work at stations, each with a different pushing position to try. Demonstrate positions and tehniques. Describe and have the participants use vocalizations.
Talking Points:
There are three phases of the second stage of labor.
- Lull or resting phase — When the baby’s head leaves the uterus, that muscle is no longer stretched as much as it was when the baby was totally inside. There may be a welcome lull in the contractions as the uterus now works to take up the slack which before was tight around the baby. The muscle fibers shorten, but the birthing person may not be aware of contractions. Sheila Kitzinger refers to this as a “rest and be thankful” time which may last up to 20-30 minutes. Once the uterus is again hugging the baby tightly, the urge-to-push generally begins. If not, a squatting position, as long as the baby has descended to 0 station, may help to bring it on.
- Active or descent phase — The contractions resume and intensify, with the urge-to-push occurring at the peak of each wave during the contraction. If allowed to push spontaneously, a birthing person will generally bear down intermittently with lighter breaths between her urges. They may wish to change positions to facilitate the baby’s descent during this phase.
- Crowning or perineal phase — The last few contractions from crowning to birth are intense, both physically and emotionally. Emotionally the birthing person is ready to give birth, but physically they experience an intense burning and stretching sensation which signals them to stop pushing hard and to allow the birth to happen gently. If being directed by the care provider, they may be instructed to blow to counteract the urge-to-push. Their reluctance to push too vigorously at this time often allows the perineum to stretch so that an episiotomy is unnecessary. The laboring person's body knows what to do to birth this baby!
Reference: Adapted from the Lamaze Toolkit
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