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In the second stage clinical features

painful contraction is stronger and more frequent;

bearing birth efforts: the expulsive force of uterine contraction is added by voluntary contraction of the abdominal muscles called “bearing down” efforts. In majority, the pushing down efforts start just prior to full dilation of the cervix. It is of immense help in accelerating the expulsion of the fetus.

         At the height of uterine contraction, the woman closes her glottis, holds her respiration at the height of inspiration,clutches whatever is available and voluntarily contracts the abdominal muscles in an attempt to expel the fetus out of her womb. The face becomes flushed, the neck veins are prominent, the pulse rate is rapid and there is perspiration.

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