And now for one of the most amazing moments of your life: the birth of your baby. As the fetus descends through the birth canal, the top of her head starts to show with each push. You may be able to see it if you ask for a mirror, or feel it by reaching down. One nice thing about a mirror is how it shows you when your pushing is most effective, so you can see exactly what works. Pretty soon, the head will be visible even between pushes: this is called crowning.
With an epidural, crowning may feel like pressure or discomfort. Without an epidural, this part is often very intense and unpleasant. Most mothers-to-be want to speed things up and get the baby out. Warm compresses can be soothing, helping the muscles to relax as the baby descends.
When the baby is crowning, the midwife or doctor will be able to see how the vagina is opening up to accommodate the baby's head. A slow, controlled birth helps prevent your tissues from tearing. If the birth needs to be hurried along (due to concerns about the baby, for instance) or if it looks like there truly isn't enough room, a surgical incision or episiotomy may help to enlarge the vaginal opening. Typically you would be numbed up with an injection of local anesthetic, unless you had an epidural that was keeping that area anesthetized. Sometimes just the baby's head stretching the vaginal opening makes it numb enough so that the incision isn't felt.
After the baby's whole head delivers, the doctor or midwife may suction out the nose and mouth; then the rest of your warm wet baby will slither out. Try to remember to open your eyes so you can see your little one as he or she emerges into the world.