During delivery, your baby’s head will begin to show through your vaginal opening with each contraction. When your baby’s head remains visible without slipping back in, it is known as crowning.
What you should know about baby crowning
When your baby’s head crowns, you will experience a burning or stinging sensation, often referred to as “the ring of fire,” as your baby stretches the vaginal opening. As soon as you feel this sensation, stop pushing! It is very important to stop pushing at this point because continuing to push and bear down increases the risk of tearing or the need for an episiotomy. If you forget, your doctor or midwife will remind you.
The burning or stinging sensation only lasts for a short time and is followed by a feeling of numbness. The numbness comes from the baby’s head stretching the vaginal tissue so thin that the vaginal nerves are blocked. The effect is like a natural anesthetic. There is no set time frame for how long this step of delivery will last.
Tips to fight that urge to push:
- Lean back and try to go limp.
- Make a conscious effort to relax the muscles of the perineal floor (the layers of muscles and tissue between the vagina and rectum).
- Focus on deep breathing techniques.
- Allow your contractions to do the work for you during this time.
If you choose to have an epidural, you may experience more of a dulled-down burning sensation. Or it may feel more like pressure than burning. It depends on the amount of pain relief you’re receiving. The pressure is likely because your baby is very low in the birth canal.
Tearing
Speaking of tearing when the baby is crowning, sometimes baby’s head is large and causes a tear. Or when the skin doesn’t stretch enough it can cause tearing in the skin and/or muscle.
There are different degrees of tearing:
- First-degree tears involve the skin and tissue of the perineum. These may heal with or without stitches.
- Second-degree tears involve the perineum and some of the tissue inside the vagina. This tear requires stitches and a few weeks of recovery.
- Third-degree tears involve the perineum and the muscle surrounding the anus. This tear often requires surgery and may take a bit longer than a few weeks to heal.
- Fourth-degree tears involve the perineum, anal sphincter, and the mucous membrane that lines the rectum. Like third-degree tears, this tear requires surgery and a longer recovery time.
With first- and second-degree tears, you may experience mild symptoms, like stinging or pain while urinating. With third- and fourth-degree tears, the symptoms may be more severe issues, like fecal incontinence and pain during intercourse.
Whatever the case, tears are common and tend to heal on their own within a few weeks after delivery.
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Compiled using information from the following sources:
1. Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 17. Pregnancy, Childbirth and the Newborn: The Complete Guide. Simkin, Penny, P.T., et al, Ch. 9.
