Is there a second stage in labor? Who says so? Who thought it up and why? How did they decide what it would be and when it would start? How it would be measured? When it would end? Is there really even such a thing as second stage? If there isn’t, might it not be important for midwives to know that? Is the Earth really flat? Well, it is in some places. Mothers that lie, sit, walk, stand, crawl, glide, stride, squat, climb stairs or hills, dance, sway, cry, throw up, chant or create positions and sounds never heard or seen before are moving their baby from the inside of them to the outside of them. That’s labor. It doesn’t have stages. One thing melts and overlaps another. It starts slowly and gets bigger. It changes a mother’s breathing from light to deep. Her sounds change as her body and baby mould and mimic each other on the journey from inside to outside. By the time the baby is low so is the mother, her breathing and her sounds and her body. –Sister MorningStar in “Midwifing Second Stage” in Midwifery Today, 98, Summer 2011
After having written recently about the rest and be thankful stage and the spontaneous birth reflex and then finally about the
birth pause, the above quote caught my eye in an issue of Midwifery Today from last year (I’m trying to catch up with my stack of magazines/journals). I explain to my birth class clients that birth looks different from the outside than it feels on the inside. Perhaps from the outside we can identify stages and phases of labor. From the inside, we are just doing it and the stages and phases meld into one continuous experiencing.
I love the final comment in this quote especially–we don’t really need tips, tricks, and vaginal checks to tell us where baby is positioned. When mother gets “low” baby likely is too! This reminds me of another article I read in MT recently. (I didn’t save the actual quote, just going from memory.) It was about a traditional midwife who was asked, “aren’t you going to check her?” when a mother felt like pushing. The midwife put the tip of a finger in and the other people laughed at her—“that isn’t checking her!” She said that all you needed to do was feel for the baby’s head—it the finger only goes in a tip, that means baby is close, if it goes in up to the knuckle, baby is pretty close, if you can’t reach the head, baby will be a while. Why would you need to try to reach the cervix or know what it is doing?
I love Sister MorningStar’s writing. It is so beautiful and expressive. Some time ago, I reviewed her book The Power of Women and I highly recommend it.
Talk Birth 
I really like this post!
I like what you said about the midwife checking. Makes sense to me!!
Being a midwife who doesn’t in general check for confirming second stage, there are occasions when women do push but no progress is made when it is justified to check to see what is going on, especially with first-time mum’s as the urge to push can come very early. Pushing on a cervix that is not ready/fully dilated can be quite detrimental. In general I don’t advocate pushing at all as actually the out breath and the contraction will get that baby out without extra pushing effort – the getting “low”. I guess it is pushing but not in the sense of taking a deep breath in and push for all your mighty but a breathe down and gently follow the contractions down and low.
Getting back to there being a second stage or not, there is often a change that happens when you know that, both woman and midwife that it is not long now before baby comes. But sometimes we do get it wrong too, both woman and midwife. It’s a tricky business, like anything else in life, to know if we are ready or not.
Yes, birth always involves a certain Mystery! Thanks for commenting–I’m interested in your thoughts 🙂