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What happens during stage 2 of labor

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HealthWiki > A Book for Midwives > Chapter 12: Pushing: stage 2 of labor > What happens during stage 2 of labor

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Genitals bulge
Genitals relax

During stage 2, when the baby is high in the vagina, you can see the mother’s genitals bulge during contractions. Her anus may open a little. Between contractions, her genitals relax.

Each contraction (and each push from the mother) moves the baby further down. Between contractions, the mother’s womb relaxes and pulls the baby back up a little (but not as far as he was before the contraction).

After a while, you can see a little of the baby’s head coming down the vagina during contractions. The baby moves like an ocean tide: in and out, in and out, but each time closer to birth.

Each contraction brings the baby closer to birth.
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During a contraction, the baby's head shows. Between contractions, the baby's head goes back inside the vagina. A little more of the baby's head shows with each contraction. The head slips back but not as far as before.

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When the head crowns, the vaginal opening is a bit larger than the palm of a hand.

When the baby’s head stretches the vaginal opening to about the size of the palm of your hand, the head will stay at the opening — even between contractions. This is called crowning.

Once the head is born, the rest of the body usually slips out easily with 1 or 2 pushes.

How the baby moves through the vagina

Babies change position as they move through the vagina. These pictures show only part of the mother’s body, so you can more easily see how the baby moves inside.

This is what happens inside: This is what you see outside:
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First the baby tucks his head down, chin to chest. This makes it easier for the head to fit through the mother's pelvis.
Nothing shows outside the vagina.
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The baby's head is squeezed and changes shape as it comes through the mother's pelvis. The baby turns his face toward the mother's back.
The head is barely visible from outside.
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The baby begins to lift his chin when he gets near the vaginal opening. This is called extension.
Part of the head can be seen from outside.
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The baby lifts his chin more when his head crowns.
The vaginal opening is round, showing the top of of the baby's head.
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The baby continues to lift his chin as the head comes out. This way the head is born smoothly.
The top of the head and forehead are seen from outside.
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The baby continues lifting his chin until his head is born. At first, the baby's face is still toward the mother's back, while his shoulders are turned at an angle.
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The whole head is outside the vagina.
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Soon the baby's head turns toward the mother's leg. Now the baby's face is lined up with his shoulders.
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Then the baby's whole body turns inside the mother. The baby's shoulders are now straight up and down. The baby faces the mother's leg.
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The rest of the baby slips out easily.
Note: Babies move this way if they are positioned head-first, with their backs toward their mothers’ bellies. But many babies do not face this way. A baby who faces the mother’s front, or who is breech, moves in a different way. Watch each birth closely to see how babies in different positions move differently.

This page was updated:11 Sep 2019