Second Stage of Labor

On reaching complete cervical dilatation, the woman has entered the second stage of labor. The second stage lasts until the delivery of the baby. During the second stage, try to measure the fetal heart rate every 5 minutes.

During the second stage of labor, the woman will feel the uncontrollable urge to bear down. This Valsalva has the effect of increasing the expulsive forces and speeding the delivery process.

For most women, the most effective way to push is in the semi-recumbent position. With the onset of a contraction, she takes several, rapid, deep breaths. Then she holds her breath and tightens her stomach muscles, as though she were trying to move her bowels. She pushes for 10 seconds, relaxes, takes another breath, and pushes for another 10 seconds. Most women can get three or four pushes into a single contraction. She will usually push more effectively if her knees are pulled back towards her shoulders.

• Some women find they are not comfortable in the semi-reclining position and they may push while tilted toward one side or the other.

• Some women prefer to deliver on their side, with one knee drawn up and the other leg straightened (the Sims position).

• Some women prefer to deliver in the sitting or squatting position.

Duration of the second stage is typically an hour or two for a woman having her first baby. For a woman having a subsequent baby, the second stage is usually shorter, less than an hour.