As soon as the cervix is completely dilated and the baby’s head has already descended far into the pelvis, the expulsion phase begins. Find a position which you find the most comfortable for giving birth (e.g. on all fours, lying on your back, standing, or sitting on a birthing chair).
Now try to follow the instructions of your midwife, breathing and pressing “on demand”. This is not so easy, as you will have the strong urge to bear down – supported by pushing contractions. However, the midwife knows from experience when it is better for you not to push.
During the final stage of birth, the midwife will support your perineum as far as possible in order to prevent tearing.
An episiotomy nevertheless often needs to be carried out to prevent deeper tears and to make the birth easier. The incision is made during the peak of a contraction and is mostly not really perceived by the woman giving birth.
By the way, your unborn child is also actively working with you. The baby positions its arms and legs close to the body and gradually pushes his/her head forward. With the last contractions, the baby’s head emerges first, followed by the shoulders. The rest of the small body then slips out easily.