Labor is a complex process divided into stages, each marked by milestones signaling progression toward birth. Crowning is one such milestone, representing a clear sign that the second stage of labor is nearing its end and delivery is imminent. Understanding this event provides insight into the final moments of childbirth.
The Definition of Crowning
Crowning describes the moment in the second stage of labor when the baby’s presenting part—usually the top of the head—becomes visibly fixed at the vaginal opening. This occurs after the widest part of the head has passed through the narrowest part of the birth canal. The head is then firmly rimmed by the vaginal wall.
The visual cue gives the event its name, as the top of the head forms a “crown” within the opening. At this point, the baby’s head no longer recedes between contractions, indicating that descent is complete. This sustained visibility signals that the baby is moments away from being born.
The second stage of labor begins once the cervix is fully dilated to ten centimeters. Crowning marks the final push phase of this stage, signifying that the head has successfully navigated the bony pelvis and is poised for delivery.
The Sensation and Mechanics of Crowning
As the baby’s head reaches the vaginal opening, the birthing person experiences intense pressure. This pressure results from the baby’s head exerting force on the pelvic floor and the rectum. The perineum, the tissues between the vagina and the anus, begins to stretch to its maximum capacity.
This extreme stretching of the perineal tissues often causes a powerful burning or stinging feeling. This sensation is a physiological result of the skin and underlying tissues distending fully around the baby’s head. For many, this intense feeling lasts only a short time before the tissue becomes naturally numb due to nerve signal blockage from the stretching.
The care team focuses on guiding the process to prevent tearing of the perineum. They may coach the birthing person to transition from forceful pushing to controlled bearing down or panting. This controlled delivery allows the tissues to stretch gradually, which can reduce the risk of a severe laceration.
What Happens Immediately After Crowning
Once the entire head is born, the baby performs a maneuver called restitution, or external rotation. The head, which internally rotated to pass through the pelvis, now turns sideways to align with the baby’s shoulders. This rotation positions the shoulders for their passage through the pelvic outlet.
The shoulders are the next widest part of the body delivered after the head. The healthcare provider applies gentle downward traction to assist the delivery of the anterior shoulder, followed quickly by the posterior shoulder.
Once the shoulders are clear, the rest of the body, including the torso and legs, is delivered quickly and smoothly. The delivery of the shoulders concludes the second stage of labor and marks the moment of birth.