Few childbirth books today discuss the resting phase of labor so when it happens, laboring women may not be prepared for what it is or what to do. Understanding the physiology when women transition from the first stage to the second stage of labor is helpful so that both mothers and partners do not begin pushing too soon and waste precious energy.
Contractions Can Slow Down in the Resting Phase
After the intensity of transition where contractions are often as close as every two minutes, the resting phase can cause the mother to feel as if her labor has stopped. Her contractions may space out and the interval between contractions could be five minutes apart or more. In some cases, the lull she experiences during the resting phase may last for ten to 20 minutes or longer.
It is important for laboring mothers and the support team to recognize that this is a normal part of labor and for her not to feel rushed or encouraged to push during the resting phase.
After Full Dilation, Your Body Needs to "Catch Up"
One significant reason for why the mother's body takes a "rest" during this early phase of second stage labor is that her cervix has fully dilated and the baby's head now descends further into the cervical opening and into the top of the birth canal.
The shift of the baby moving downward into the top of the vagina causes a small space at the top of the uterus. Her uterus will need to "catch up" by moving downward to begin contracting around the baby again. This can cause a longer break in between contractions.
Not All Mothers Feel the Urge to Push after Being Fully Dilated
It is clear that not all mothers will feel an urge to push once they are fully dilated to 10 centimeters. Much of the urge to push comes from how low the baby's head is in relation to the mother's pelvis, also known as pelvic station. If the baby's head is at a higher station, (above zero station) it is more likely that the mother will not have an urge to push right away when she is fully dilated.
If the mother does not have an urge to push or there is a lull in contractions, it will be important for her not to push just because it is safe for her to do so because the cervix is fully dilated. Delaying pushing is one issue that can be discussed in the mother's birth plan with her provider. Not only does pushing without an urge go against the mother's own physiological responses during labor, research also shows that delaying pushing can actually shorten the overall length of second stage.
What Should You Do in the Resting Phase?
If mothers experience a lull in contractions or they do not have an urge to push after they reach 10 centimeters, the first thing to do is not to push! In some cases this may mean requesting more time from the medical staff, who might be more used to encouraging mother to push right away.
During the resting phase, the mother can try to empty her bladder to make room for her baby as it descends. She can use this time to sip some fluids, rest and think about what positions she feels would be most comfortable in when pushing does begin. Since it is called the "resting phase" it is important that moms follow their body signals and do just that – rest! She can begin pushing when she begins to feel the urge.
If mom has an epidural that masks an urge to push, she should wait for as long as 90 minutes or for the baby's head to descend to a +2 station before beginning to push. Delaying pushing, with or without an epidural, is one of the best ways to decrease the length of time the mother actually spends pushing.
References:
Kelly, M., "Delayed versus immediate pushing in second stage of labor," American Journal of Maternal Child Nursing, March-April 2010.
Simkin, P., The Birth Partner, Harvard Common Press, 2008.
Lane, B., Kirsch, I., Knack Pregnancy Guide, Globe Pequot Press, 2009.
Brenda Lane - Brenda Lane is a published author, Lamaze certified childbirth educator, DONA certified birth doula and approved birth doula trainer.
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