You’re almost ready for the big event — your baby’s birth. Once your cervix becomes fully dilated, you can begin pushing. At this point you may have a burst of energy. The delivery itself may take a few contractions or a few hours. If your baby needs help getting out of the birth canal, your healthcare provider can assist.
Getting ready to push
The shortest but most intense part of labor is transition. This is when the cervix becomes fully dilated. Contractions may become even stronger. They may last 60 to 90 seconds, with almost no rest in between. This is a demanding time. You might experience hot flashes, chills, nausea, vomiting, or gas. IV (intravenous) pain medicines are also rarely given so close to your baby’s birth. However, epidurals are continued during birth. Help yourself by working with your support person or labor coach. You may feel an urge to push or bear down. But do not push until your healthcare provider or midwife tells you to.
Pushing toward birth
After your baby’s head enters the birth canal, contractions may come less often. Pushing down with the contraction helps move your baby further into the birth canal. If you’ve had a cesarean in the past, your labor will be managed to help prevent tearing the scar.
Your baby’s birth
Once your baby’s head passes under the pubic symphysis, your perineum starts to stretch and bulge. Soon, the top of your baby’s head crowns (appears at the vaginal opening). You may have a burning feeling as this happens. Your healthcare provider or midwife may tell you to pant. This is so you won’t push too hard and tear your perineum as the baby’s head and shoulders come through. (A small amount of tearing is not rare and is not a problem.) Your baby is born soon after the shoulders leave the birth canal. The umbilical cord is then cut.
Your baby may need extra help getting out of the birth canal. If so:
An episiotomy (a small incision in the perineum) may be made. This enlarges the vaginal opening and helps prevent tearing. A local anesthetic may be used to numb the area. After your baby is born, the incision is stitched closed with sutures. These are usually dissolvable.
Forceps (spoon-shaped instruments that cup the baby’s head) may be used to help your baby’s head through the birth canal.
Vacuum extraction, which uses a small suction cup attached to the baby’s head, may be used to assist the birth.
After your baby’s birth
After the baby is born, the placenta is delivered. Mild contractions separate it from the uterus and move it into the vagina. Then you push it out. Your healthcare provider or midwife may press on the uterus to expel blood clots. If you had an epidural anesthetic, the catheter is removed.
Support person’s note
Help the mother into a pushing position. Support her body as she pushes. A semi-sitting or semi-squatting position allows gravity to assist the birth.
Remind her to rest between contractions.
Encourage her by telling her when the baby’s head appears.
Keep in mind that you may be masked and gowned for the birth, depending on hospital policy.