The Birth Itself — Transition, Pushing, and the Moment of Birth

Everything before this point has been building toward it. Transition, pushing, and delivery are the most intense part of labour — and often the shortest. Here’s what each phase feels like in water, and what to expect.

Transition

Transition is the shift from the first stage (your cervix dilating) to the second stage (pushing). It happens around 7–10cm dilation and is usually the most intense part of labour. It’s also typically the shortest — 15 minutes to an hour for most women.

What it feels like: contractions become very strong and very close together, sometimes with barely a break between them. You may feel overwhelmed, panicky, or out of control. You may say “I can’t do this,” ask for an epidural, or say you want to go to hospital. You may feel nauseous. You may become irritable — snapping at your partner, your midwife, or both.

This is classic transition behaviour and it’s a good sign. It usually means your cervix is almost fully dilated and pushing is close. Experienced midwives recognise it immediately.

How to cope: your birth partner stays calm and close. Quiet presence, a cool cloth, eye contact if you want it. One contraction at a time — the only manageable unit is this one contraction, then the next. If you’ve lost your breathing pattern, your partner or midwife breathes audibly with you — slow, low, steady. The water is doing its work. Transition passes.

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The urge to push

The urge to push replaces transition, and it brings its own energy. Most women describe it as a relief — after the chaos of transition, there’s finally something purposeful to do.

It’s unmistakable: a powerful, involuntary downward pressure that your body produces whether you consciously push or not. In water, the buoyancy may mute the intensity slightly, and the relaxation of the water may slow things a little. This isn’t a problem — a slower, controlled descent of your baby’s head reduces the risk of tearing.

You push with contractions — the urge builds with each wave, and you bear down at the peak. Between contractions, everything stops. You rest, breathe, and wait. Most women in water adopt an upright or semi-upright position for pushing: kneeling, squatting with the pool handles for support, or on all fours. These positions use gravity and open the pelvis.

Your body knows how to push. You don’t need coaching or someone counting to ten and telling you to hold your breath — that approach is outdated. Following your body’s own rhythm is more effective and less traumatic to the perineum.

Some women prefer to “breathe the baby out” — long, slow exhales with each contraction, allowing the uterus to do the work without forceful pushing. The descent is slower but more controlled, and water birth is particularly well-suited to this approach. It’s an option, not a mandate — some women feel an overwhelming urge to push hard, and that’s fine too.

Second stage can last from a few minutes to a couple of hours. First-time mothers tend toward the longer end; experienced mothers often push for only a few contractions.

The moment of birth

The baby is born into the water and stays submerged for a brief moment. You or your midwife reaches down and brings the baby gently to the surface. The baby is placed on your chest — skin-to-skin, still in the water, with the face above the surface. The baby takes its first breath.

The whole sequence — head emerging, body following, baby brought to the surface — typically takes seconds. It is usually calm and quiet, very different from the dramatised version of birth most people carry in their heads.

The baby must come to the surface promptly after birth — there’s no benefit to delay. Once the face meets the air, the breathing reflex triggers, and the baby shouldn’t be re-submerged after that. The cord is still attached and pulsating, delivering oxygen, so there’s no rush — but there’s no reason to wait either.

Your partner can catch the baby if you’ve discussed it with the midwife beforehand. Many families want this moment, and midwives can guide you through it.

The water may be discoloured with blood and amniotic fluid. That’s completely normal.

After the birth, you stay in the pool holding your baby while you both adjust. The cord is left intact until it stops pulsating — usually 3–5 minutes. Your midwife will assess the baby’s condition, check your wellbeing, and eventually you’ll get out for the third stage or deliver the placenta in the pool, depending on your birth plan.