The baby’s birth

This stage begins when the cervix is fully dilated and lasts until the birth of the baby. Your body will tell you to push. Listen to your midwife who will guide you.

Position

Find the position that you prefer and which will make labour easier for you. You might want to remain in bed with your back propped up with pillows, or stand, sit, kneel or squat (squatting will take practice if you are not used to it).

If you are very tired, you might be more comfortable lying on your side rather than your back. This is also a better position for your baby. If you’ve suffered from backache in labour, kneeling on all fours might be helpful. It’s up to you.

Try out some of these positions at antenatal classes or at home to find out which are the most comfortable for you. Ask the midwife to help you.

Pushing

You can now start to push each time you have a contraction. Your body will probably tell you how. If not, take two deep breaths as the contractions start and push down.

Take another breath when you need to. Give several pushes until the contraction ends. As you push, try to let yourself open up below. After each contraction, rest and gather strength for the next one.

This stage is hard work but your midwife will help you all the time, telling you what to do and encouraging you. Your birth partner can also give you lots of support. Ask your midwife to tell you what is happening. This stage may take an hour or more, so it helps to know how you’re doing.

The birth

As the baby’s head moves into the vaginal opening, you can put your hand down to feel it, or look at it in a mirror. When about half the head can be seen, the midwife will tell you to stop pushing, to push very gently, or to puff a couple of quick short breaths, blowing out through your mouth. This is so that your baby’s head can be born slowly, giving the skin and muscles of the perineum (the area between your vagina and back passage) time to stretch without tearing.

Sometimes the skin of the perineum won’t stretch enough and may tear. Or there may be an urgency to hurry the birth because the baby is getting short of oxygen. The midwife or doctor will then ask your permission to give you a local anaesthetic and cut the skin to make the opening bigger. This is called an episiotomy. Afterwards the cut or tear is stitched up again and heals.

Once your baby’s head is born, most of the hard work is over. With one more gentle push the body is born quite quickly and easily. You can ask to have the baby lifted straight on to you before the cord is cut so that you can feel and be close to each other immediately. Then the cord is clamped and cut, the baby is dried to prevent him or her from becoming cold, and you’ll be able to hold and cuddle your baby properly.

Your baby may be quite messy, with some of your blood and perhaps some of the white, greasy vernix which acts as a protection in the womb still on the skin. If you prefer, you can ask the midwife to wipe your baby and wrap him or her in a blanket before your cuddle.

Sometimes mucus has to be cleared out of a baby’s nose and mouth or oxygen given to get breathing under way. If this happens your baby will be passed to you as soon as possible.