As soon as the cervix of the expecting mother has fully dilated to 4 inches, the second stage of labour – delivery of the foetus, begins. The second stage ends when the mother delivers the baby. About 40% of the pregnant women, especially in their first pregnancies, are likely to go through various problems during delivery. With medical advancement and proper management, normal vaginal delivery is possible these days. However, the situation can become difficult to handle when the second stage of labour lasts for longer time and the oxygen supply to the foetus becomes insufficient. Vacuum suction or forceps, or a caesarean section may be carried out in such a case to minimise the risk of foetal distress.
There is no reason to believe that if the first stage of labour has progressed smoothly, the second stage would progress without any problems. Contractions that are ineffective or weak may slow down the process of delivery. Epidural anaesthesia and other pain relievers given to the woman during the labour may also affect the strength of the contractions. If, because of a long first stage of labour, the mother is exhausted and cannot push with required strength, it may lead to problems in delivery. Also, when the mother has a weak body, her contractions tend to be ineffective and this can cause a difficult delivery.
Apart from weak uterine contractions, there are other reasons as well that are responsible for problems during delivery. If the foetus is in an abnormal position, it may not pass through the cervix and vagina easily, and as a result, a delayed second stage of pregnancy occurs. Also, if the foetus is big or the mother has a narrow or irregularly shaped pelvis, the foetus cannot pass through the pelvis easily. It is necessary that the vaginal tissues stretch enough so that the foetus’s head can come out. If there is a problem in this stage, the delivery can become difficult and may cause foetal distress.
If the uterine contractions are not strong enough to push the baby out, an intravenous drip of oxytocin may be given to the mother so that her contractions are stimulated. The delivery process is assisted with forceps or vacuum suction when the foetus cannot pass smoothly through the cervix and vagina. An incision, called as an episiotomy, is normally made in the tissues between the anus and the vagina. Such a method is used when the vaginal opening is too narrow for the foetus’s head to pass through. This also eases the baby’s passage and helps prevent the tissues around vagina from tearing.