In Part 1 of this lesson, we explained the early (latent) stage, the active and transition stages of labour, and what examinations and monitoring may be involved.

In Part 2 of this lesson, we will explain what happens in the second and third stages of labour.

Once you’ve reached the second stage, the moment of delivery is just on the horizon, and you will soon meet your long-awaited bundle of joy.

The second stage

When your cervix has fully dilated, at 10cm, and your baby has moved deep into the pelvis, you have reached the second stage of labour. If this is your first labour, this stage usually lasts for 45 minutes to two hours and 15 - 45 minutes in subsequent births. If you have an epidural, this stage lasts longer. The second stage is intense as your contractions become stronger but may become less frequent, around every 2 - 5 minutes.

At this point, you may have a strong urge to push. Many women feel that labour pains are much more bearable in the second stage as they now actively push their baby out. Other women find this stage particularly difficult, as they are completely exhausted from prolonged pushing.

Your midwife will recommend some comfortable positions for you to give birth in. You may want to sit, stand, squat, kneel on all fours, or lie on your side.

Pushing out your baby

Your baby will start to rotate its head and shoulders to enable an easier descent through your pelvis to be born. You will feel an uncontrollable urge to push, which will feel a little like needing a poo. Your midwife will encourage you to push when you feel the urge and follow your instincts. If this is your first baby, the pushing stage should last no longer than three hours and no more than two hours in subsequent births. With every contraction, you will need to focus on pushing into the pelvic area and bottom.

As you can imagine, this stage of labour is hard work, but your midwife and birth partner are there to support and encourage you.

The third stage

The third stage is from when your baby is born until the delivery of the placenta. The delivery can be managed actively with the help of drugs or physiologically (naturally) where no treatment is involved. Your doctor and midwife will discuss these options with you before labour.

Cutting the cord

After your baby is born, the cord will be left to pulsate for a few minutes before being cut. This is so your baby receives more blood from the placenta, boosting your baby’s oxygen supply. The cord is clamped 1cm and 4cm from your baby’s tummy and is cut with scissors between the clamps. Your partner will be offered to cut the umbilical cord if they choose.

Active delivery of the placenta

Once your baby has been delivered, you will be offered an intramuscular injection (IM) of a drug, usually Syntometrine, in your thigh to help you deliver the placenta quickly (within 5 to 15 minutes after the birth of your baby). This can help avoid excessive bleeding during the third stage, known as postpartum haemorrhage and avoid blood transfusion.

Natural delivery of the placenta

If you prefer to deliver the placenta without drugs, known as a physiological third stage, this can take up to an hour. You will be encouraged to bear down and find positions that help, such as squatting. After the delivery of the placenta, your midwife will check to see that nothing is left in the womb, which can cause a postpartum haemorrhage.

What can I expect in each stage of labour (Part Two)?

On Unii’s Giving Birth Journey, we explore the second and third stages of labour.