STAGE TWO:
The second stage of labor ensues once you are COMPLETELY dilated and ends with the BIRTH of the baby. It can last anywhere from a few minutes to hours depending on maternal pushing effort, and whether or not it is your first baby(it typically goes faster with subsequent deliveries).
Having an epidural can sometimes affect the pushing effort with regards to moms not being able to actually feel the urge to push or tell exactly “where” to push. If this is the case, the epidural can either be turned off, or decreased.
SOOOOOOO, We’ve gotten to being completely dilated, now what??!?!
Well, I trained with a bunch of midwives and prefer to take a “hands off” approach. I like to let your body and baby do most of the work and tell ME when it’s time.
Ever heard of the phrase LABORING DOWN?!?!? Well, that’s just what I previously described. Once you are completely dilated, we let baby descend into the pelvis and will begin pushing once you have “THE URGE” to do so. Pushing too soon can lead to YOU, the MOM, getting tired, as well as cervical swelling.
The OTHER reason I like to let moms LABOR DOWN is that it allows for babies to gradually stretch the perineum(the skin between your vaginal opening and your rectum). This, I find, helps decrease the occurrence of lacerations.
MY BIGGEST piece of advice during pushing is the following: “PUSH LIKE YOU’RE HAVING THE BIGGEST BOWEL MOVEMENT OF YOUR LIFE”!!!! Those are the muscles you need to be using; ALSO, try to focus on something in the room, whether it be your spouse/partner, a spot in front of you, WHATEVER. This will prevent you from closing your eyes and keeping “THE ENERGY” of the push in your face. Trust me, you DON’T want to blow your top(smile).
STAGE THREE:
Commences with delivery of baby and ends with the delivery of the placenta.
Remember in the movie, The Wizard of Oz, when THE WIZARD tells Dorothy and her crew to “pay no attention to the man over there” as they had JUST discovered who HE was hiding behind the curtain pushing all sorts of buttons, controls, etc.?!?!?
Well, I’m going to tell you to do the same thing…..your focus at this point should be on “meeting and greeting” your brand new baby boy/girl. At this stage; MY focus is on delivering your placenta. This typically takes anywhere from a few minutes to 30 minutes.
Delivery of the placenta will involve your ob/gyn manually massaging your uterine fundus (the top of your uterus) to encourage separation, while at the same time providing gentle, downward, cord traction(on the placenta).
After the placenta has been delivered, it will be inspected to ensure that it is intact/complete(as retained placenta can be a source of postpartum bleeding), and has a 3 vessel cord. At this point, your vagina/cervix/perineum will also be inspected to ensure that there are no lacerations requiring repair.
Remember, KNOWING is half the battle! HAPPY LABORING!
Hoping this blog post adds value to your day!
Until next time,
Look Better. Feel Better. Be Better.
Dr. Angela
