The Sec­ond Stage of Birth is dif­fer­ent from the First Stage. The actual expul­sion of the baby requires a change in energy axis. Dur­ing dila­tion (first stage), oxy­tocin is most eas­ily released from the pitu­itary gland dur­ing relax­ation (see pre­vi­ous post), but dur­ing tran­si­tion, a change occurs so that the ergotropic response takes over and adren­a­line is key in help­ing oxy­tocin to spike.

What does this mean as far as prepa­ra­tion is con­cerned? While it is impor­tant to learn to relax or main­tain posi­tions such as one does in yoga, the abil­ity to sprint, or turn on an aggres­sive action at the end, is crit­i­cal. You need  good aer­o­bic con­di­tion­ing. Begin exer­cise with easy breath­ing and move­ment, then prac­tice aer­o­bic endurance and power moves at the end of your work­out! Fin­ish up with cool down and stretch­ing.

The con­trac­tions them­selves change. They remain intense for a longer stretch, but the time between them increases. Push­ing involves not only the uterus con­tract­ing, but the pres­sure exerted by the trans­verse abdom­i­nal (TrA) mus­cle. Sim­i­lar to squeez­ing a tube of tooth­paste, TrA pres­sure helps press the baby toward the exit — yes, that is the vagi­nal open­ing. If the labor­ing mother is not able to apply ade­quate pres­sure, labor assis­tants some­times apply pres­sure man­u­ally to the top of the uterus or — if need be — for­ceps or a vac­uum extrac­tion may be necessary.

How can a mom best pre­pare so that the TrA can pro­vide the needed pres­sure? Strength train­ing the TrA! Like any other motion requir­ing power strength, this mus­cle can be strength­ened to do its job! Here’s how:

pic­ture 1:  sit upright, inhale

pic­ture 2:  exhale, com­press abdomen and curl down

Return to upright and repeat 8 times. Rest. Repeat 8 more times.

What if some­thing goes awry? Cesarean, or sur­gi­cal birth is an alter­na­tive. Major com­pli­ca­tions before labor include a pla­centa pre­via, infec­tion or unde­liv­er­able breech posi­tion. Dur­ing labor, the most com­mon prob­lem is dys­to­cia — stalled progress through dila­tion (first stage) or push­ing (sec­ond stage). In the push­ing stage, head to large for pelvis is the most com­mon difficulty.

What hap­pens next? If the birth is nat­ural, you will feel a tremen­dous eupho­ria. Bring the baby right up onto your chest for skin-to-skin con­tact. If you have had med­ica­tions, your response may be slightly blunted, but you will def­i­nitely be over­whelmed by the emo­tions of birth.

Third Stage is expul­sion of the pla­centa, which can no long remain con­nected to the shrink­ing uterus. When it detaches, the nurses or mid­wives will ask you to push and !plop! out it comes. It can be inter­est­ing to see what has nour­ished your baby for so long!

CONGRATULATIONS!  YOU’RE A MOM!