The second stage of labor begins when you are 10 cm dilated. Your contractions may become shorter in length and there may be longer breaks between them. If this is your first baby, Stage 2 can last two hours or more. In future pregnancies, this stage is usually much shorter.

During this stage you need to work with your body to push your baby through the vagina (birth canal). As your baby gradually moves down, your vagina will slowly stretch. This slow stretching helps prevent a tear that could happen if your baby was born too quickly.

At full dilation (10 cm), you may feel an overwhelming desire to push or an intense pressure on your perineum (the area between your vagina and rectum) or on your rectum. Some women have this desire before their cervix is fully dilated. If this happens to you, your nurse will suggest ways for you to avoid pushing until your cervix is fully opened.

Your nurse will help you and your partner as you work with your body to move your baby through the birth canal. You'll use your diaphragm and abdominal muscles to help with pushing. All your other muscles should remain as relaxed as possible. Keep your jaw relaxed. Try not to arch your back or neck.

You might find it helpful to do the following:

• At the beginning of a contraction, take a deep cleansing breath.
• When you feel the urge to push downward, gradually release your breath as you push. Some women find it helpful to make grunting sounds.
• Breathe in and repeat pushing during the entire contraction.
• Take a deep breath and relax when the contraction is gone.
• Please note: You may find there are times during the pushing phase when you are holding your breath. Try not to do this for longer than five to six seconds. It is important to breathe to provide oxygen for you and your baby.

Just before birth, the opening of the vagina will stretch around your baby's head. This is called "crowning." Your caregivers may tell you to stop pushing at this time, and just to breathe, so that they can guide your baby out slowly and gently.