The second stage of active labor is when the woman finally gets to react to those strong contractions. Contractions are like signals to push, and as the second stage of active labor begins the woman will feel the need to push stronger than ever before. If the cervix is not dilated and effaced 100%, the attending physician or nurse may advise the a woman to hold off on pushing for a bit. This can be the hardest task any laboring woman will ever have to do. Pressure on the pelvic floor is like a primal signal to push until the pressure subsides. Breathing through each contraction is the only choice a woman has until the cervix ripens fully for childbirth.

Pushing: When is the right time?

Some doctors and hospitals advise women to push through every contraction during the second stage of active labor. Contraction of the uterus is the body’s natural expelling process; each contraction moves the baby further down the birth canal. This movement will happen whether or not a woman pushes. Some babies move fast and others take their time. If a woman wants to wait for a strong urge to push, she will need to talk about this decision with her physician before the second stage of labor begins.

When the urge to push hits, a woman's natural birthing instincts will take over. As each contraction begins, she needs to take a deep, cleansing breath and bear down as if she were trying to pass a large bowel movement. The same muscles that control bowel movements also control childbirth. As the pressure and pain ease off, she needs to take another cleansing breath and wait for the next contraction. Pushing between contractions is just a waste of energy as the uterus is only going to work with the woman when contractions are in full effect.

The second stage of active labor ends with the delivery of the baby. After the head crowns, one more push is often all that is needed to deliver the head. Most doctors will ask women to breathe through the next contraction so the physician can clear the throat of amniotic fluid and mucus. A couple of final pushes are all that remain until the birthing process is over.