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Second stage: delivery During the second stage, the infant passes from the uterus, through the cervix and birth canal by both the uterine contractions and by the additional maternal efforts of "bearing down," which many women describe as similar in sensation to straining to expel a large bowel movement. The baby is most commonly born head-first. In some cases the baby is "breech" meaning either the feet or buttocks are descending first. Babies in the breech position can be helped to be born vaginally by a midwife, although caesarean births are becoming more common for breech presentation. The length of the second stage varies and may be affected by whether a woman has given birth before, the position she is in and mobility. The length of the second stage should be guided by the condition of the fetus and health of the mother. In the "transition phase" from 8 cm–10 cm (3" or 4") of dilation, the contractions often come every two minutes and are typically lasting 70–90 seconds. Transition is often regarded as the most challenging and intense for the mother. It is also the shortest phase. During this stage, the expectant mother typically goes through several emotional phases. At first, the mother may be excited and nervous. Then, as the contractions become stronger, demanding more energy from the mother, mothers generally become more serious and focused. However, as the cervix finishes its dilation, some mothers experience confusion or bouts of self-doubt or giving up. It is important during this time for the birth partners to stay positive and supportive of the mother; to actively encourage if this is what she wishes and to provide nutrition and hydration in order to keep her energy reserves up. Problems may be encountered at this stage due to reasons such as maternal exhaustion, the front of the baby's head facing forwards instead of backwards (posterior baby), or extremely rarely, because the baby's head does not fit properly into the mother's pelvis (Cephalo-Pelvic Disproportion (CPD)). True CPD is typically seen in women with rickets and bone deforming illnesses or injuries, as well as arbitrary time limits placed on second stage by caregivers or medical facilities.
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