Second stage of labour
The second stage begins when the cervix is fully dilated (10 cm) and is completed when the baby is completely born. After the cervix is fully dilated, the mother typically has the urge to push. Her efforts in 'bearing down' with the contractions of the uterus move the baby out through the cervix and down the vagina. This is known as fetal descent. The rate of fetal descent is an important indicator of the progress of labour, which will be described in more detail later. The average duration of second stage is 1 hour and usually not longer than 2 hours. Table 1.2 summarises the symptoms and signs during the first and second stages of normal labour.
Table 1.2 Characteristics of the first and second stages of normal labour.
| Symptoms and signs | Stage | Phase |
|---|---|---|
|
Cervix not dilated Uterine contractions not regular or strong |
False labour/Not in labour | |
|
Regular uterine contraction but not very strong Cervix dilated less than 4 cm |
First | Latent |
|
Regular and strong uterine contractions Cervix dilated 4–9 cm Rate of dilatation typically 1 cm per hour or faster Fetal descent begins |
First | Active |
|
Cervix fully dilated (10 cm) Fetal descent continues Mother has no urge to push |
Second | Early (non-expulsive) |
|
Cervix fully dilated (10 cm) Presenting part of fetus reaches pelvic floor Mother has the urge to push |
Second | Late (expulsive) |
The delivery of the baby marks the end of the second stage.