Once your cervix is 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 will assist you.
Getting ready to push
The shortest, but most intense, part of labour is the transition. This is when the cervix becomes fully dilated. Contractions may become even stronger. They may last 60-90 seconds, with almost no rest in between. This is a demanding time as pain medications are rarely given so close to your baby’s birth. Help yourself by working with your doctor or labour coach. You may feel an urge to push or bear down, but do not push until your doctor 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 Caesarean in the past, your labour 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 feel a burning sensation as this happens. Your doctor 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.
After your baby’s birth
After the baby is born, the placenta is delivered. Mild contractions shear it from the uterus and move it into the vagina. You the push it out. Your doctor may press on the uterus to expel blood clots. If you have registered for cord blood banking, the cells will be collected at this stage. If you had an epidural anaesthetic, the catheter is removed
Your baby may need extra help getting out of the birth canal, ie:
- An episiotomy (a small incision in the perineum) may be made. This enlarges the vaginal opening and helps prevent tearing. A local anaesthetic may be used to numb the area. After your baby is born, the incision is stitched closed with sutures.
- 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, maybe used to assist the birth.