Hint: there's nothing royal about this kind of crowning, but you certainly could call it a regal event!
"Crowning" refers to the time during birth when your baby's head begins to appear at the opening of your vagina and does not retract (go back in) after pushing with a contraction. Cue the song: "I'm comin' out!"
Crowning is worth talking about -- enough for its own post -- for many reasons: it's a big milestone in labor and birth; the sensations you feel are often distinctly different than what you were feeling up to that point; and there is often a change in how you move/work with your body and birth when crowning happens.
Crowning - What's Actually Happening?
When your baby moves down for birth, they are making lots of little movements and adjustments in order to fit just right into your pelvis and present for birth. You baby's head, which thankfully is not hard like an adult or older child's skull, is also molding (shaping) as it enters the birth canal. When baby drops low enough so that their head is visible through your vaginal opening, each contraction will bring their head a little further out, but after each contraction (and push) is over, the head will retract back (not all the way, though; baby moves forward in small increments with each contraction - think two steps forward, one step back). Crowning is official once enough of baby's head is in your vagina so that it does not retract after each contraction. From this point on, it's all forward progress! In most cases, babies are fully born within a few contractions after crowning. During crowning, the vaginal opening stretches to fit around baby's head. Don't worry though -- the vagina, which is amazing in so many ways, is designed to stretch and designed to return to its normal size.
Crowning - What Does it Feel Like?
For a lot of people, crowning is a distinct sensation, different than anything else that is felt up to that point. The vaginal opening is stretching to accommodate baby's head to pass through, so yeah, you'll probably feel that. It's a little different for everyone, but many people use the words "burning" and "stinging" to describe the feeling of crowning. Many people will instinctively reach down with their hands to apply pressure to or support their vaginal opening. The good news is that crowning is generally a short-lived phenomenon, so if you experience intense sensations, they're over relatively quick. If you have an epidural, you may or may not feel crowning, or you may feel a dulled down version of crowning -- or you could feel it fully if the epidural is not providing complete coverage. If you do not have an epidural, you will feel crowning like you have been able to feel everything up to that point.
Crowning - What Should You Do?
When your baby is crowning, you may feel like continuing to push at full force (due to the enormous amount of pressure pushing down into your pelvis), but it may actually be in your best interest to slow down/ease up on pushing a bit. Easing baby out slowly upon crowning allows your vaginal tissues to stretch open more slowly, which may help you avoid tearing, or tear less. Your care provider may apply a warm compress with oil to your perineum to help make the tissue more pliable to prevent/reduce tearing, and/or your provider may instruct you to push lightly or even "blow through" the urge to push. Your baby will emerge whether or not you push, as contractions naturally push out baby. However, for many people, it feels almost impossible not to push with contractions at this point in birth as the pressure is so intense. That's ok too. Your instincts will likely kick in and take the wheel. Just know that in most cases, you don't have to full-force bear down at this point in birth.
As for your position during crowning, many people instinctively move to an all-fours positions or wide-legged kneeling position when baby's birth is imminent. Side lying or semi-sitting are also good options. Ideally, you avoid lying on your back as it can make birth more difficult, or squatting as it can increase the likelihood of tearing and can be a difficult position to sustain unless squatting is part of your everyday movements.
The picture sequence above shows the progression of crowning to birth in one couple's waterbirth.
If you give birth vaginally, you'll understand why we use the term "crowning achievement" -- crowning truly is a big deal! If you've already given birth, we want to hear what you have to say about your own experience with crowning. Tell us: what did it feel like and what do you remember doing during those moments?