them into the birth canal.
   Transition can vary in length from 10 minutes to 2 hours. This timing is dependent on several factors namely: presentation of the baby; the mother’s position and movements; the mother’s stamina and her ability to relax. Here a well presenting baby is an advantage, as are adopting bodily positions which ensure the birth canal is vertical to utilise gravity to assist the baby down into the pelvis, and an active and energetic mother who can use her contractions to open up rather than tense up.
   During this phase the woman will need to be ably supported by her companions – both emotionally and sometimes physically – to help her move about from one position to another. This is a challenging time for both mother and the support people. Typically, the woman will feel ready to give up, want to go home (if at hospital birth), want to go to the hospital (if at home-birth), want to sleep through exhaustion, request / demand relief from the pain, and may consider accepting offers of intervention to end the labour sooner. The most valuable thing a woman can be reminded of during this time is that the birth of her baby is coming closer with each contraction and to welcome the intensity which signals that.
   The end of transition is sometimes, but not always, followed by a lull. This can be a welcome and valuable rest period which should be savoured, rather than interrupted with unnecessary talk or distraction. Close your eyes and use all your resources to relax completely – breathe deeply, keep up fluids, and simply wait for what is to come.

Stage Two
   Second Stage Labour is the movement of the baby down the birth canal and out into the world. This can also be a very intense and exhausting phase for some, but most women feel happier during this time as they are focussed on the immanent outcome – the arrival of their baby. The timing of these contractions is usually less frequent and somewhat less intense than during transition. Second stage can last anything from 5 minutes to 2 hours and can vary from birth to birth. For example, during the birth of my second child, these contractions were long lasting (1 - 2 minutes), fairly regular at about 3 - 5 minutes apart, continuing for over 40 minutes. For my third and all subsequent children, my second stage contractions were typically irregular, sometimes up to 10 minutes apart, about 1 - 2 minutes duration, and only lasted about 20 - 30 minutes overall. Being completely spaced out on endorphins, I used these longer quiet times to relax in preparation for the last few powerful contractions of the birth.
  

      (a)                (b)              (c)


          

            (d)                       (e)

       

     Figure 20 - The Second Stage

   
   In a hospital, when a woman begins to exhibit transition behaviour, she may be vaginally examined. If the cervix is found to be fully dilated, and the baby’s head is easily felt, she will usually be encouraged to begin “pushing”. In a natural birthing situation, pushing is less of an instruction and more something to be done if and when the mother feels like it. This instructed pushing is actually not necessary but is used (by some hospital midwives) from transition onwards, to hasten the birth. It also seems to take the edge off the contractions. Certainly the contractions are of a different nature now. Second stage contractions still come in waves and with peaks, but they are no longer pulling up the cervix. They are pushing down the baby. If you are birthing naturally you will not be encouraged to push unless there is some indication for urgency, but rather, you will be instructed to simply respond to your body.
   Gradually the baby’s head will become visible to onlookers in the birth canal. Touching it at this stage can be a powerful stimulant for helping a woman to make those last few efforts to birth her baby.