“Crowning” is a term used during childbirth that marks a moment in the second stage of labor. It occurs when the baby’s head has descended through the birth canal and becomes visible at the vaginal opening. Crowning is officially noted when the largest diameter of the baby’s head remains exposed and does not recede between contractions. This event signals that the birth of the baby is imminent, as the head is poised for delivery.
The Physical Mechanics of Crowning
Crowning is the culmination of several movements as the baby passes through the mother’s pelvis, a process known as the cardinal movements of labor. The baby’s head, which is typically tucked with the chin to the chest (flexion), extends as it reaches the pelvic outlet to accommodate the upward curve of the birth canal. This extension causes the back of the baby’s head to press against the pubic bone, allowing the face and chin to sweep out from under it.
This moment represents maximum distension, where the vaginal tissues and the perineum—the area of skin and muscle between the vagina and the rectum—are stretched to their limit. The baby’s head presents in what is usually an occiput anterior position, meaning the back of the head is facing the mother’s front. The widest part of the fetal head is now engaging the narrowest point of the vaginal opening.
Crowning is a direct indicator of the baby’s progress, showing they are at a station of +4 or +5, very low in the birth canal. To reach this point, the cervix must be fully dilated to 10 centimeters, allowing the fetal head to pass through the uterus and into the vagina. The pressure exerted by the head at this stage is continuous, as it is too low to slip back up the birth canal when the contraction subsides.
Sensations and Navigating the Moment
The intense stretching of the perineal tissue as the baby’s head passes through the vaginal opening is often described as a burning or stinging sensation. This feeling, sometimes referred to as the “ring of fire,” is caused by the rapid tension on the skin and nerves of the perineum, often lasting only a minute or two.
Following the peak of the burning sensation, many people experience numbness. This natural anesthetic effect occurs because the extreme stretching of the vaginal tissue temporarily blocks the nerves in the area.
To manage the intensity, healthcare providers often coach the birthing person to use controlled pushing techniques. Instead of forceful bearing down, they may instruct the mother to pant or blow through contractions to slow the delivery of the head. Slowing the process allows the tissues to stretch more gradually, which reduces the risk of severe tears. Care teams may also use warm compresses on the perineum to soften the tissue and make it more pliable.
The Final Stages of Delivery
Once the head has crowned, the next steps occur rapidly. The baby’s head, which has just extended to pass out of the pelvis, performs a movement called restitution, or external rotation. The head rotates naturally to align itself with the baby’s shoulders, which are still positioned inside the pelvis.
The care provider applies gentle downward traction on the baby’s head to deliver the anterior shoulder, the one closest to the mother’s pubic bone. After the anterior shoulder is free, the provider lifts the baby slightly to assist in the delivery of the posterior shoulder. Once the shoulders are delivered, the rest of the baby’s body typically follows quickly in the same or the next contraction.