What to expect when you're expecting (156 page)

An overwhelming urge to push (though not every woman feels it, especially if she’s had an epidural)

Tremendous rectal pressure (ditto)

A burst of renewed energy (a second wind) or fatigue

Very visible contractions, with your uterus rising noticeably with each

An increase in bloody show

A tingling, stretching, burning, or stinging sensation at the vagina as your baby’s head emerges (it’s called the “ring of fire” for good reason)

A slippery wet feeling as your baby emerges

Emotionally, you may feel relieved that you can now start pushing (though some women feel embarrassed, inhibited, or scared); you may also feel exhilarated and excited or, if the pushing stretches on for much more than an hour, frustrated or overwhelmed. In a prolonged second stage, you may find your preoccupation is less with seeing the baby than with getting the ordeal over with (and that’s perfectly understandable—and normal).

What You Can Do.
It’s time to get this baby out. So get into a pushing position (which one will depend on the bed, chair, or tub you’re in, your practitioner’s preferences, and, hopefully, what’s most comfortable and effective for you). A semi-sitting or semi-squatting position is often the best because it enlists the aid of gravity in the birthing process and may afford you more pushing power. Tucking your chin to your chest when you’re in this position will help you focus your pushes to where they need to be. Sometimes, if the pushing isn’t moving your baby down the birth canal, it may be helpful to change positions. If you’ve been semi-inclined, for example, you might want to get up on all fours or try squatting.

Once you’re ready to begin pushing, give it all you’ve got. The more efficiently you push and the more energy you pack into the effort, the more quickly your baby will make the trip through the birth canal. Frantic, disorganized pushing wastes energy and accomplishes little. Keep these pushing pointers in mind:

A Baby Is Born

1. The cervix has thinned (effaced) somewhat but has not begun to dilate much.

2. The cervix has fully dilated and the baby’s head has begun to press into the birth canal (vagina).

3. To allow the narrowest diameter of the baby’s head to fit through the mother’s pelvis, the baby usually turns sometime during labor. Here, the slightly molded head has crowned.

4. The head, the baby’s broadest part, is out. The rest of the delivery should proceed quickly and smoothly.

Relax your body and your thighs and then push as if you’re having a bowel movement (the biggest one of your life). Focus your energy on your vagina and rectum, not your upper body (which could result in chest pain after delivery) and not your face (straining with your face could leave you with black-and-blue marks on your cheeks and bloodshot eyes, not to mention do nothing to help get your baby out).