Labour is a long and intense process that involves several stages. One of the events in childbirth is the head of the baby crowning. Crowning in childbirth means the baby’s head is visible through the vaginal opening during delivery.
This blog helps learn what crowning is and what to expect during that stage.
What is crowning?
As mentioned above, crowning refers to the baby’s head being visible through the vaginal opening during birthing. It happens in the second stage of labour when the birth canal is fully dilated, and the mother will have to push the rest of the baby’s body out at this point. Crowning is sometimes referred to as a ‘ring of fire’ due to the intensity of the process. This birthing stage may cause tears and intense pain, though each woman has different experiences.
When does baby crowning happen?
Childbirth has four stages: Early and active labour, fetal passage through the birth canal, placenta delivery, and recovery. As already mentioned, crowning happens during the second stage of labour.
Early labour dilates the cervix to about 6 cm and may happen in a few hours to a few days. During active labour, the dilation increases and reaches approximately 10 cm over four to eight hours. This dilation period may be less for women who have had babies before. It is at this point crowning happens. After the crowning, it may take a couple of minutes to a few hours for the baby to fully come out. This period depends on several other factors, such as whether the mother has birthed before etc.
What does crowning feel like?
Different women experience crowning differently. For some, it is a thrilling moment when they are finally able to welcome their baby to this world. But others may be overwhelmed. Crowning feels like stinging and gives a burning sensation to many women. Therefore, it is known as the ‘ring of fire’. Sometimes stretching the skin may lead to numbness, and the mother may not feel anything.
If a woman opts for an epidural during labour, the person may feel pressure down in the cervical canal than feel pain. So, feelings and pain differ in each woman, and it is normal to have mixed emotions.
What to do during crowning?
During crowning, the baby’s head stays in the birth canal and won’t get pushed inside between the contractions. At this stage, the mother must relax and let the uterus do its work. In most cases, in two contractions, the baby may come out. The urge to push will be more at this point, but the mother must relax and push slowly as the doctor instructs. It helps avoid tearing the skin between the vagina and the rectum (perineum tears).
What is tearing?
Tearing refers to damaging the skin and tissues surrounding the vagina while birthing. It is common even though the mother is guided throughout the labour. If the baby’s head is large, the extra pressure to push may cause tears. One may also get tears if the skin and associated tissues are not stretched properly.
There are four degrees of tearing:
First-degree tears: This involves tearing skin and perineum and may heal on its own with or without stitches.
- Second-degree tears involve tearing the perineum and tissues inside the vagina. The tear may heal in a few weeks with optimum care and stitches.
- Third-degree tears involve tearing the perineum and some muscles associated with the anus. It may require surgery and an extended recovery time.
- Fourth-degree tears: This damages the perineum, anal sphincter, and mucous membrane surrounding the rectum and, similar to third-degree tears, require surgery and longer recovery time.
The first and second-degree tearing causes a burning sensation while urinating. The third and fourth-degree tears show more severe symptoms such as painful intercourse and faecal incontinence.
What is an episiotomy?
Episiotomy is an incision doctors make in the skin between the vagina and anus. Healthcare providers previously did this to ease the delivery and prevent severe tearing. But these days, episiotomy is not performed in every case. It is only preferred when the baby has an abnormal heartbeat, shoulders are stuck, or the doctor uses forceps or a vacuum to pull the baby out.
The incision will take up to two weeks to heal, and if any woman experiences prolonged pain, the healthcare provider should be contacted.
What are some tips to prepare for crowning?
The journey of delivery is different for each woman. The experiences of friends and family members may not always help a person. Joining a childbirth class and practising breathing, relaxation, or distraction techniques may help during birthing. It is also vital to listen and follow the instructions of the healthcare provider or midwife. One can also get the correct information or tips to help oneself during the process.
Some other tips include:
- Consult a healthcare provider about various pain management plans. Multiple options include massages, breathing techniques, epidural, local anaesthesia, and nitrous oxide.
- Relaxing helps the tissues to stretch and may prevent severe tearing. Also, resisting the urge to push too quickly also helps.
- Understand the different birthing positions that may ease delivery. Doctors consider moving on all fours, side-lying, or semi-sitting an ideal position. Lying on the back makes it challenging to push easily.
- Always remember, the ring of fire indicates that soon the baby will be born. Knowing this may help a woman push through the pain and discomfort.
Childbirth can be an exciting and an overwhelming experience for mothers. With proper guidance and relaxation techniques, women can undergo this process with lesser discomfort. Get valuable tips and techniques from experienced certified healthcare providers for a wholesome birthing experience.
Frequently Asked Questions (FAQs)
Does an epidural prolong the period of crowning and delivery?
It was believed that the lack of pain during delivery reduces the urge to push and thus prolongs delivery. But recent research disapproves of any relation between epidural and prolonged delivery.
How rare is perineum tear?
Studies suggest that 70 per cent of women experience perineal tears while birthing.