Baby Crowning: Recognition, Management Techniques, Medical Intervention, and Post Crowning Care
Baby crowning is an important moment when a baby’s head becomes visible during childbirth. Understand its significance, recognise signs, and learn about effective strategies that can empower expectant parents during labour.
Written by Dr Sonia Bhatt
Last updated on 3rd Jul, 2025
Baby crowning is a crucial phase of childbirth, characterized by the visibility of the baby's head at the vaginal opening, which does not recede between contractions. It is also termed as a "ring of fire" because many women feel a burning sensation due to the stretching of vaginal tissue during this process. This typically occurs in the second stage of labor and concludes with the declaration of the baby's arrival.
This time can be thrilling as well as painful for the parents. However, knowing the details can support them in getting along with the process.
This is a comprehensive guide that offers all the information both expectant mothers and fathers need to have regarding baby crowning. With this guide, parents can get through their birthing experience in an efficient way.
Recognising Baby Crowning
The baby crowning stage is after the cervix is fully dilated to 10 centimetres and is followed by the active labour stage when the baby is born. Though this experience varies from woman to woman, there are some key signs that expectant parents during the last stage of their pregnancy must keep an eye for -
Visible Head of the Baby: The most definite symptom is when the baby's head appears and remains at the vaginal opening during contractions.
Burning or Stinging Sensation: Most women experience a harsh, stinging feeling as the perineum expands to accommodate the baby's head. This is due to the expansion of the skin and tissue.
Increased Pressure: If you feel you are crowning, you might feel strong pressure in the perineal area, which sometimes is called a feeling of needing to push.
Role of Support Person during Crowning
A support person can make a woman feel stable and comforted during the crowning stage. Here are some ways in which they can support her -
Provide Emotional Support
Give calm and reassuring words to ease fear.
Maintain a calm and cheerful attitude to help build a warm and safe environment.
Provide Practical Assistance
Offer to hold hands, give massages, or apply a cooling compress.
Encourage the mother to focus on the pattern of controlled breathing to alleviate pain.
Find comfortable labour positions that are beneficial for comfort and advancement.
Communicate and Advocate
Report the birthing individual's preferences to the healthcare providers.
Inform the birthing person about updates from the medical team.
Help clarify decisions and offer reassurance during critical moments.
Breathing Techniques During Crowning
The crowning stage during childbirth requires controlled effort to reduce the risk of pelvic floor injury. Effective breathing techniques during this phase can minimise tearing and improve overall outcomes. Here are some breathing techniques that can be helpful -
Open Glottis Pushing
Keeping the glottis (middle part of the larynx) open allows air to flow past the vocal cords. This creates an audible sound during exhalation. It reduces the strain on the pelvic floor, lowers urethral mobility post-birth, and minimises tearing risk.
💡Tip - Mothers must push for 5 seconds per effort rather than the traditional 10 seconds. Limit to 2 pushes per contraction if possible.
Make Sounds
Vocalisation like sustained “A”, “O” and “U” or even sounds like growling can naturally maintain an open glottis. This decreases perineal tearing by encouraging controlled exertion.
💡Tip - The birthing support team can join in to create comfort.
Blowing
Use puffing breaths or soft “ahh” sounds instead of forceful pushing. This reduces the urge to push intensely, reducing strain on the pelvic floor.
Diaphragmatic Breathing (Belly Breathing)
Mothers must inhale slowly through their noses, allowing the abdomen to expand. Exhale through pursed lips, relaxing the belly. This promotes relaxation and efficient oxygenation, helping manage intense pain.
Slow-Paced Breathing
At the start of a contraction, mothers must take deep breaths in through the nose and exhale slowly and rhythmically through the mouth. This helps maintain a calm surrounding and reduce stress.
💡Tip - Focus on a specific point and increase concentration, which will provide a sense of control during contractions.
Managing Pain during Crowning
The crowning stage is intense, but effective pain management can make it more manageable. Here are concise strategies to handle the pain:
| Pain Relief Method | Description |
| Epidural | A regional anaesthetic is injected in the epidural space (between the spinal cord and spinal canal wall) to relieve pain in a particular body part. |
| Local Anaesthetic | Numbs the perineal area before interventions like episiotomy. |
| Warm Compresses | Applied to the perineum to reduce discomfort and improve relaxation. |
| Breathing Exercises | Help manage pain naturally and maintain focus. |
Medical Interventions in Baby Crowning
In certain cases, medical interventions may be unavoidable to ensure the safety of both mother and baby. Some common medical interventions are -
Episiotomy: A surgical cut made to enlarge the vaginal opening, often used to speed up delivery or reduce significant tearing.
Instrumental Delivery: Use of forceps or vacuum devices to assist in delivering the baby.
Such interventions are typically performed when there is a risk to the life of the baby, such as reduced oxygen supply or if labour is stalled. If this situation arises, remember to not panic because medical professionals carefully assess the situation before proceeding.
Preparing for Baby Crowning
Preparation plays a key role in managing the crowning phase confidently. Prenatal education and birth plans are particularly valuable.
Birth Plans: These documents allow parents to outline their preferences for labour, such as pain management, preferred birthing positions, and interventions.
Prenatal Education: Classes offer valuable information about what to expect during labour and provide practical coping techniques, such as breathing exercises and relaxation methods.
Both tools help parents feel informed and reduce anxiety about the birthing process.
Potential Complications
Although crowning is a natural process, complications may arise. Thus, being aware of potential risks helps parents stay informed and reassured.
| Complication | Description | How it Can Be Managed |
| Perineal Tears | Tears in the vaginal tissue are caused by stretching. | Managed with prompt stitching and care. |
| Prolonged Crowning | When the baby’s head remains stuck. | It may require instrumental delivery. |
| Fetal Distress | Reduced oxygen supply to the baby. | Restore oxygen supply, such as repositioning the mother or emergency delivery. |
| Shoulder Dystocia | The baby’s shoulder becomes stuck in the mother’s pelvic bone. | Requires urgent manoeuvre to free the shoulder without using excessive force. |
| Fetal Macrosomia | The baby is too large (over 9 lbs.), increasing the risk of getting stuck in the birth canal. | Often diagnosed prenatally, the delivery plans may include a cesarean section or close monitoring during labour to avoid oxygen deprivation or injuries. |
Post-Crowning Care
Once the baby is delivered, immediate care focuses on the well-being of both mother and newborn.
Newborn Care
Immediate assessment of breathing and heart rate using the Apgar score.
Cleaning and wrapping to maintain body temperature.
Mother’s Care
Addressing any perineal trauma through stitching or other necessary interventions.
Providing guidance on postpartum recovery, including managing discomfort and initiating breastfeeding.
Post-crowning care is essential to ensure both the mother and baby begin their recovery and bonding journey healthily and comfortably.
Conclusion
Baby crowning is a significant milestone in childbirth, marking the final stage before delivery. With proper preparation, knowledge of the process, and supportive techniques, parents can approach this moment with confidence and calm.
Understanding signs of crowning, effective breathing methods and available pain relief options can enhance comfort and reduce complications. A supportive birth team, prenatal education, and a flexible birth plan further contribute to a positive experience.
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