Chapter 12: Pushing – Stage 2 of labor
Help the mother give birth
Help prevent tears in the vaginal opening
The birth of the baby’s head may tear the mother’s vaginal opening.
Some midwives do not touch the vagina or baby at all during the birth. This is a
good practice because interference can lead to infection, injury, or bleeding. But
you may be able to prevent tears by supporting the vagina during the birth.
Often tears happen whether you try to prevent them or not.
Cutting a circumcision scar
In some communities, circumcision of girls (also called female genital
cutting) is common. Female genital cutting (FGC) causes scars that may not
stretch enough to let the baby out.
If the mother has been circumcised, you may need to cut open the scar of
the circumcision before the baby’s head starts to crown. Page 367 explains
more about female genital cutting, and how to cut a circumcision scar.
You should not cut the opening of the vagina to let the baby out, except in
an emergency or for a woman who has had FGC. See page 354 to learn how to
cut the opening of the vagina in an emergency.
Support the vaginal opening
These instructions can be used when the baby is in the most common position —
facing the mother’s back.
1. Wash your hands well and put on sterile gloves.
2. Press one hand firmly on the
perineum (the skin between
the opening of the vagina and
the anus). This hand will keep the
baby’s chin close to his chest —
making it easier for his head to
come out. Use a piece of cloth or
gauze to cover the anus.
3. Use your other hand to gently
move the top of the baby’s head
down towards the mother’s
bottom and out of the vagina.
A Book for Midwives (2010)