Stage 2: Time to push! When you hit 10 centimeters, you’ve officially entered the second stage of labor— and you’ll finally hear the word, “push!” For a first-time mom, pushing usually lasts one to three hours, says Riley. Without pain medication, you’ll feel a strong urge to push when a contraction hits. If you had an epidural, your doctor or midwife will tell you when one is coming. (She’ll keep a close eye on the fetal heart monitor, which tracks your baby’s heartbeat and your contractions.)
In both cases, she’ll help coach you through contractions.
With each push the baby makes his way down the birth canal until his head crowns, or becomes visible. At this point, an episiotomy, a cut made in the perineum to enlarge the vaginal opening, is possible but unlikely. “They are only done when the baby is in trouble or too big,” says Harth. After your baby’s head is out, your doctor or midwife will check to see if the umbilical cord is around his neck (she’ll simply unwrap it if it is). Your next push should bring out your baby’s shoulders, quickly followed by his body. The umbilical cord is then clamped and, if he’s up to the task, Dad can make the final cut.
Stage 3: The afterbirth While you and your partner are marveling at your new baby, your doctor or midwife will deliver the placenta, which may happen immediately or take as long as 30 minutes. Once it’s out, any tears or episiotomy will be stitched up and you’ll be monitored for excess bleeding or infection. This is also when you may first breastfeed your baby—and it will start to sink in that you’re no longer a mom-to-be but a new mother.
Used to induce labor or to help labor progress, Pitocin is the synthetic form of oxytocin, the hormone that causes contractions. Given intrave- nously, it will cause your contractions to become stronger and closer together. If the risk of continuing a pregnancy is high for you or your baby or your labor is slow, Pitocin is a useful tool. But, inductions scheduled for convenience can lead to health risks for you and your baby. “Induction increases the risk for C-sections, prolonged labor, infection and the need for pain medication,” says certified nurse-midwife Chris Kenlan.