1.3.2  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 signsStagePhase

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

FirstLatent

Regular and strong uterine contractions

Cervix dilated 4–9 cm

Rate of dilatation typically 1 cm per hour or faster

Fetal descent begins

FirstActive

Cervix fully dilated (10 cm)

Fetal descent continues

Mother has no urge to push

SecondEarly (non-expulsive)

Cervix fully dilated (10 cm)

Presenting part of fetus reaches pelvic floor

Mother has the urge to push

SecondLate (expulsive)

The delivery of the baby marks the end of the second stage.

1.3.1  First stage of labour

1.3.3  Third stage of labour