Crowning is a distinct moment during the second stage of labor when the baby’s head becomes visible at the vaginal opening. At this point, the baby’s head no longer recedes between contractions, indicating significant progress. It signifies that the baby is very close to being born.
The Mechanics of Crowning
As labor progresses into its second stage, the baby descends through the birth canal, with its head applying continuous pressure against the birthing person’s perineum. This sustained pressure causes the tissues around the vaginal opening to stretch significantly. Visually, crowning is the top of the baby’s head, or part of the scalp, becoming continuously visible. Unlike earlier phases where the head might appear and then recede with each contraction, during crowning, the head remains externally visible, confirming it has passed the narrowest part of the birth canal.
Sensations and What It Signifies
During crowning, many birthing individuals experience intense sensations due to the stretching of vaginal tissues. Common descriptions include a burning or stinging feeling across the perineum, often referred to as the “ring of fire.” This sensation arises from nerve endings in the perineal area being stretched and compressed as the skin reaches its maximum capacity. While intense, this burning sensation is brief, sometimes followed by a numbing effect as nerves become blocked from the extreme stretch. Crowning signifies that birth is imminent, meaning the most challenging part of pushing is nearing its completion.
Navigating the Crowning Stage
Managing the crowning stage involves specific techniques to facilitate a safe birth and minimize perineal trauma. Healthcare providers often guide the birthing person to use controlled pushing or “breathing the baby out” rather than forceful bearing down. This controlled approach allows the perineal tissues more time to stretch slowly, which can reduce the risk of tearing. Providers may also apply a warm compress to the perineum or offer manual perineal support to help the tissues become more pliable. The goal is to allow the uterus to do much of the work, with the birthing person relaxing and following instructions to ease the baby out gently.
The Immediate Next Steps
Once the baby’s head has fully crowned and emerged, the process moves quickly toward the complete birth. The head will perform a movement called “restitution,” rotating to align with the baby’s shoulders. With the next one or two contractions, the shoulders emerge, followed rapidly by the rest of the baby’s body. The caregiver will then check for any obstructions, such as the umbilical cord around the baby’s neck, and assist with the delivery of the remaining body.