The Second Stage of Labor

According to popular belief, a woman reaches her second stage of labor at a definable moment, and she is told that is now time to push.

In reality, few women experience such a clear-cut transition to the second stage of labor. Technically speaking, the second stage begins when the cervix is fully dilated at 10 centimeters. The transition into the second stage, however, begins somewhere between 8 and 10 centimeters of dilation.

Transition into the Second Stage
For many women, transition is marked by a sudden intensity of contractions that begin to follow each other quite rapidly. The contractions may become erratic and don’t seem to follow the neater wave pattern they had before. Other signs of transition might include:

• Discouragement, feeling as though you just can’t manage labor anymore
• Disorientation or dizziness
• Shaking and shivering—some women find their legs shake
• Prickly skin
• Hot and cold flashes
• Nausea or even vomiting
• Hiccups
• Sleepiness in between contractions
• Feeling like you are going to have a bowel movement, or that there is pressure on your anus

This is the time when you will need support most of all. Some women are tempted to ask for medication at this point, even when they have managed without it up to this point—yet, the pain is almost past.

If you are feeling fear or anger, or feeling overwhelmed, ask your birth attendant about these aids:

• Chamomilla is a homeopathic remedy that can help with unproductive labor pains, irritability, and an inability to relax. Aconitum napellus can also soothe a fearful woman who is hot and restless.
• Gelsemium is another homeopathic remedy good for fear, especially for women whose symptoms include trembling and chattering teeth.
• Rescue Remedy is a blend of five Bach flower essences. Add a few drops to a glass of water and sip as needed. This is good for labor attendants too!
• Try some essential oils in a diffuser or on a warm compress for your forehead. Lavender is always a good choice.

Sliding the Baby Out
The trend in labor and delivery in recent years is to begin pushing the moment a woman is fully dilated, whether or not she feels a particular urge to do so. Women are directed to bear down with all their might, holding their breath for as much as ten to thirty seconds and straining until each contraction is over. Some women actually break blood vessels around their eyes and cheeks from straining.

In fact, there is no evidence that pushing right from the very start is particularly effective in speeding labor along. It may actually have the opposite effect, or might put the baby into transverse arrest, where he gets stuck.

There is also evidence that holding the breath and sustained bearing-down may seriously reduce the amount of oxygen the baby receives, or affect maternal blood pressure.

Birthing doesn’t have to be so rough and tough. In one study, women were allowed to bear down spontaneously during the second stage and were given no directions on how or when to do so. The women tended to hold their breath for no more than six seconds at a time and bore down briefly only two or three times during each contraction. The average length of second-stage labor was only 45 minutes for these women, and none of them went longer than 95 minutes.

Many women will not feel an instant urge to push once they are fully dilated. Some may experience a kind of holding pattern at the beginning of the second stage, taking a bit of a break before they are ready to push the baby down the birth canal. Some women, especially second-time moms, may not ever feel a strong pushing urge during their whole labor. All of these scenarios are normal.

Occasionally, a woman will feel a strong urge to push before her cervix is fully dilated. Bearing down before full dilation can bruise or tear the cervix. It can help to pant softly to avoid bearing down. You can also get on your hands and knees or lie down on your left side for a moment to slow things down a bit.