82 Pregnancy and Childbir th
Stage 2: Pushing the baby out
Signs that it is time to push (this means the cervix is fully open):
• The mother feels a strong need to push. It may feel like
needing to pass stool.
• During contractions, you can see the mother’s bottom
bulging and you may see the baby’s head at the opening
of the vagina. At first, the baby’s head moves back inside
What to do:
• Stay with the mother all the time and reassure her that she
and the baby are doing well.
• Each contraction will come with a very strong urge to
push. When the mother feels like pushing, have her take a
deep breath and push as if she were passing stool, but with
all her strength. Many women find it helpful to moan or
groan in a deep voice with the pushes.
• Make sure that everything is going well and is ready for
the birth. If the woman has been pushing for more than
2 hours, see ‘Too-long labor,’ page 86.
Birth of the head
When the baby’s head stays at the opening of the vagina,
even between contractions, it is time for the head to be born:
1. Tell the mother not to push hard, but to
give little grunts or little pushes.
2. Allow the head to come out slowly,
between contractions. This will help to
prevent the mother’s skin from tearing.
3. After the head is born, wipe the baby’s
mouth and nose with a clean cloth.
Now push hard.
Now do not push hard.
The head usually comes ...then the baby turns so
out face down... the shoulders can be born.
Birth of the shoulders
To help the shoulders come out:
1. Gently hold the baby’s head and guide it toward the
mother’s back (away from her abdomen). This lets the front
shoulder be born first. Never pull or twist the head.
2. The rest of the baby will then come out easily. Be ready!
Hold the baby so it does not fall.
Where Women Have No Doctor 2012