Birth crowning, which is when your baby's head starts to emerge bit by bit during each contraction, occurs during the second stage of labor. (A contraction is when the uterine muscle tightens and relaxes to help your baby pass from the uterus into the birth canal.) As you push, your baby's head may appear, but after the contraction is over, it will withdraw from view once again.
"Once you can see the head and it doesn't slip back in, that's crowning," says Ami Burns, childbirth educator and doula. "A fun way to think of it is that birth crowning occurs when you can see the part of the head where a princess would wear her crown." Once crowning occurs, your baby's arrival is imminent.
Your body starts preparing itself to deliver weeks before labor actually happens. Your baby's head moves into your pelvis, which is a process known as engagement.
This is followed by active labor, when the cervix dilates more rapidly and contractions are longer, closer together and more intense. This stage is often referred to as the "pushing" phase, and coincides with the full dilation of your cervix. This is also the stage of labor when birth crowning occurs.
During this second stage of labor, you will push to help your baby finish the descent through your pelvis and into your birth canal. Although every instinct will be urging you to keep pushing, it's best to follow your doctor or midwife's direction on exactly when and how to push. If this is your first birth, the second stage of labor can last a couple of hours; if you've already had one or more children, it tends to be shorter.
As birth crowning takes place and your baby's head begins to emerge through your vaginal opening, you may experience a sensation of burning and stretching that Burns calls "the ring of fire." This is because your baby's head is stretching your vaginal tissue, and usually lasts only a few minutes. You might be advised to change positions or told to ease up on the pushing, which can be difficult but can also reduce the risk of vaginal tearing. Once the "ring of fire" feeling passes, the major part of labor is over. (If you've had an epidural, you might not experience this feeling at all.)
During the pushing process, Burns suggests trying an upright, squatting position to make tearing less likely. She also recommends following your natural urges to push. Even though this is probably the most painful part of labor, it helps to relax as much as possible. "Light breathing - taking short, shallow breaths in and out as if blowing out a candle on a birthday cake - can help minimize tearing," she says. This helps you resist the urge to bear down with all your might, which, if your baby's head is on your perineum, can cause a tear.
You can prepare for birth crowning part before the actual event. Burns recommends perineal massage, which can reduce the risk of tearing as well as minimize the stinging sensation during crowning. It may even make an episiotomy -- a surgical cut in the perineum performed to facilitate childbirth -- less necessary.
The perineum is the area of skin between the vagina and the rectum, and perineal massage involves inserting a lubricated finger to stretch the vaginal opening for about 10 minutes per day, from the 35th week of pregnancy onwards. Burns also recommends placing hot washcloths on the perineum and around the vagina during the countdown to baby's arrival.
There are other techniques that can be beneficial during birth crowning, according to Burns. "It can be helpful for the mother to have a mirror brought in to watch as her baby crowns and/or to reach down and feel her baby's head." This may be encouraging and comforting, since your baby's tiny tuft of hair will not disappear from view.
Partners can also assist during this stage of labor by providing support and encouragement. "Pushing is a lot of work," says Burns. "Placing a cool washcloth on the back of the mother's neck can help, as can keeping a cold drink nearby to sip after each push."
Finally, during birth crowning, your doctor or midwife will be able to establish whether the umbilical cord is wrapped around your infant's neck and if there are any other obstructions. Sometimes your doctor may need to use forceps or another means of assistance to manually deliver your baby if she or he is stuck in the birth canal.
After birth crowning, the rest of your baby's head will emerge, followed by your baby's body. Now, you're almost done: All that's left is for you to deliver the placenta, which is the third and final stage of labor.
Copyright © 2010 Meredith Corporation.