You may not have heard Johnny Cash’s 1963 hit song “Ring of Fire,” but if you’ve had a baby or are planning to in the near future, the term may be all too familiar.
Crowning is often referred to as the “ring of fire” in the birthing process. It’s when your baby’s head becomes visible in the birth canal after you’ve fully dilated. It’s the home stretch — in more ways than one.
Why does crowning get so much attention? When your cervix is fully stretched, that usually means that it’s time to push your baby out into the world. For some women, this is very exciting, relieving news. For others, however, crowning is painful or — at the very least — uncomfortable.
However, knowing what to expect during a vaginal delivery is powerful. Let’s take a look at some of the details about crowning that you want to know — but are too afraid to ask.
Labor is divided into four stages:
- early and active labor
- fetal descent through the birth canal (birth)
- delivery of the placenta
- recovery
Crowning occurs in the second stage that results in the birth of your baby.
Leading up to this point, your body will have gone through a number of regular contractions as your cervix thins out and dilates from 0 to 6 centimeters (cm) in early labor. The time this takes can vary from hours to days.
In active labor, the cervix dilates from 6 to 10 cm over the course of 4 to 8 hours — approximately a centimeter an hour. In total, the first stage of labor may take some 12 to 19 hours. This process may be shorter for women who have previously had a baby.
Crowning happens when you’re fully dilated. You may feel like you’ve already done so much work, but you may have a while yet to go. Hang in there, mama!
This second stage of labor — birth — can take anywhere from just a couple minutes up to a few hours, sometimes more. In general, it lasts 20 minutes to 2 hours. First-time moms or those who’ve had an epidural may be on the longer side of these time estimates.
Your doctor or midwife will closely monitor your progress through these stages to give you updates on your individual timeline.
When you’re crowning, you may even be able to reach down and touch your baby’s head or get a look at it by using a mirror. Some women may find the sight motivating. Others may be overwhelmed by the experience or, frankly, a little grossed out. Whatever you feel, don’t feel ashamed! Mixed emotions are perfectly normal.
The good news: Once you reach crowning, your baby may be born within just one or two contractions.
To many women, crowning feels like an intense burning or stinging sensation. This is where that “ring of fire” term comes from. Others share that crowning didn’t feel at all like they had expected. And others say they didn’t feel it at all.
As you can imagine, there’s a spectrum of experiences, and there’s no one right or wrong way to feel.
How long the feeling lasts will vary as well. As your skin stretches, the nerves become blocked and you may feel nothing at all. That’s right — the stretch may be so intense that you may feel more of a numbing sensation than pain.
Speaking of pain, 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.
Keep in mind that what you’ll actually experience during crowning may be different from what your mom, sisters, or friends have experienced. As with all other parts of labor and delivery, what will happen and how it will feel is individual.
That said, when you feel you might be crowning and your doctor or midwife confirms it, resist pushing too quickly. In fact, you should try to relax and let your body go as limp as possible.
That probably sounds crazy, because you may have a strong urge to push — let’s get this show on the road! But try your best to take things slow and let your uterus do most of the work.
Why? Because relaxing may prevent severe tearing.
When you’re crowning, it means that your baby’s head stays stationary in the birth canal. It doesn’t drop back inside after contractions.
Your doctor will help coach you through the pushing process at this stage and help guide the baby to prevent damage to the skin between your vagina and rectum. This area is also called the perineum, and you may have been warned about perineum tears.
Ouch! Even with the best guidance, with so much stretching, there’s also an opportunity for tearing while giving birth. (We’re talking about tears that rhyme with cares, not what you produce when you cry. It pains us to say you may have both — but you’re bound to have tears of joy when your newborn babe is placed in your arms.)
Sometimes baby’s head is large (no, this isn’t cause for concern!) and creates tears. Other times, the skin doesn’t stretch well enough and leads to tearing in the skin and/or muscle.
Whatever the case, tears are common and tend to heal on their own within a few weeks after delivery.
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.
Some 70 percent of women experience damage to the perineum during birth, whether through tearing naturally or receiving an episiotomy.
Episi-what? In some cases, your doctor or midwife may choose to make an incision — a cut — in the area between the vagina and anus (episiotomy). This procedure used to be more common because doctors thought it would prevent the most severe tearing.
But they don’t help as much as originally thought, so episiotomies are no longer routinely performed. Instead, they’re saved for cases when baby’s shoulders are stuck, baby’s heart rate is abnormal during labor, or when your healthcare provider needs to use forceps or a vacuum to deliver your baby.
Pain from tears and episiotomies may last two weeks or longer, but taking care of tears after delivery can help. Some women do go on to experience long-lasting pain and discomfort during sex. Talk to your doctor if this happens to you, as there are solutions that can help.
There are things you can do to prepare for the experience of crowning and pushing.
Above all else, consider signing up for a childbirth class at your hospital to learn more about what to expect during labor and delivery. Can’t find a class locally? There are some you can take online, like those offered through Lamaze.
Other tips
- Speak with your doctor about a pain management plan that will work for you. There are many options, including massage, breathing techniques, epidural, local anesthesia, and nitrous oxide.
- Resist the urge to push too fast when you’re told you’re crowning. Relaxing will allow your tissues to stretch and may help prevent severe tearing.
- Learn about different birthing positions that may help ease delivery. Moving onto all fours, side-lying, or semi-sitting are all considered ideal positions. The standard — laying on your back — may actually make pushing difficult. Squatting may increase your chances of tearing.
- Try to remember that once you feel the ring of fire, you’re close to meeting your baby. Knowing this may help you quite literally push through the pain and discomfort.
There’s a lot to think about during pregnancy. What colors to paint the nursery, what to put on your registry, and — of course — what the actual birth experience will be like.
Whether you’re feeling excited or anxious, understanding what’s happening to your body during labor may help you feel more empowered.
And if you just want your baby out already, rest assured that your little one will enter the world in one way or another sooner rather than later. You’ve got this, mama!
