Second Stage of Birth: Delivery

The second stage of labour involves the passage of the baby to the outside world. This stage begins when the cervix reaches complete dilatation and effacement and ends with the birth of the baby. Contractions have now slowed and are similar to those in the early stage of labour , lasting 60 to 75 seconds and being about 3-5 minutes apart. Delivery, according to the WHO typically lasts between 45 minutes and 1 hour, unless there are complications .

In the birthing or delivery room, the woman assumes the birthing position. A number of studies [ 2 ] suggest that an upright (vertical) position or a lateral tilt during the second stage of labour show greater advantages than a dorsal (on the back) position. The upright position gives less discomfort and difficulty in bearing down, less labour pain, less perineal /vaginal trauma and wound infections. However, more tears of the labia and an increased risk of postpartum haemorrhage may result. The classic lithotomy position (with the legs in stirrups) is often experienced as less comfortable and more painful and restricted in movement.
The WHO conclude that: "for both the first and the second stage, this means that women can adopt any position they like, while preferably avoiding long periods lying supine. They should be encouraged to experiment with what feels most comfortable and should be supported in their choice."

During delivery the mother is asked to bear down and push with each contraction to help move the foetus' head down through her pelvis and to widen the vaginal opening. When about 4-5 cm (1½ to 2 inches) of the head appears, the doctor or midwife may place a hand over the foetus' head during a contraction to control and, if necessary, slightly slow the foetus' progress. The head and chin are eased out of the vaginal opening to prevent the mother's tissues from tearing. Such maneouvers aid the mother in the delivery of her child. Once the baby's head has emerged, the body rotates to allow the shoulders to come out one at a time. The rest of the body then usually slides out quickly. In rare circumstances forceps or an episiotomy may be need. The baby needs immediate attention following birth (cf. care of the baby immediately after birth ).

Birth then enters the third stage, the delivery of the afterbirth .

The information in this page is presented in summarised form and has been taken from the following source(s):
1. Bayfront's Health Adventure, A Woman's Way to Health: http://www.bayfront.org/
2. Care in Normal Birth: A Practical Guide. Report of a Technical Working Group, World Health Organisation, Department of Reproductive Health and Research, 1999. http://www.who.org