When a baby is crowning, the top of the baby’s head has become visible at the vaginal opening and stays there, firmly rimmed by the surrounding tissue. It’s the clearest sign that birth is moments away. Crowning happens during the second stage of labor, after the cervix has fully dilated and the pushing phase is well underway.
What Crowning Looks Like
During contractions and pushing, the baby’s head may briefly appear at the vaginal opening and then slip back between pushes. This back-and-forth is normal. Crowning specifically refers to the point when the widest part of the baby’s head no longer retreats. It stays visible, stretching the tissue around it like a crown, which is where the name comes from.
At this point, the birth attendant can see and often touch the baby’s head. For many people, being told “the baby is crowning” is the signal that delivery is very close. The entire second stage of labor, from the start of pushing to birth, can last anywhere from 20 minutes to several hours. It typically takes longer for first-time mothers. Once true crowning happens, the baby is usually born within minutes.
The “Ring of Fire” Sensation
Crowning is often accompanied by an intense burning or stinging sensation around the vaginal opening. This is commonly called the “ring of fire.” It’s caused by the baby’s head stretching the perineal tissue (the area between the vaginal opening and the rectum) to its maximum. The sensation has been described as feeling like being scratched or pricked with pins, and research consistently rates the pain during this stretching as severe.
The burning typically lasts only a short time, often just a few contractions. Some people find that the intense pressure actually creates a natural numbing effect as the tissue stretches thin, which can partially dull the sensation. If you’ve had an epidural, you may feel pressure but little or no burning.
What Happens Right After Crowning
Once the head is fully out, the baby’s body goes through a series of natural rotations. The head turns about 45 degrees to one side, realigning with the shoulders, which are still inside. This rotation is automatic. The anterior shoulder (the one closest to the front of the mother’s body) delivers first, followed by the posterior shoulder. After the shoulders are free, the rest of the body slides out quickly.
This entire sequence, from crowned head to full delivery, often takes just one or two more pushes. Your birth attendant may guide the baby’s head gently during these rotations, but the movements themselves are driven by the baby’s position and the shape of the pelvis.
Why Tearing Can Happen
The stretching that occurs during crowning is the moment when perineal tears are most likely. The tissue is under maximum tension as it accommodates the widest diameter of the baby’s head. Tears range from first-degree (involving only the skin surface) to more serious third- and fourth-degree tears that reach deeper muscle layers.
A large network analysis comparing different approaches found that skipping episiotomy (a surgical cut to widen the opening) led to a significantly higher rate of first-degree tears compared to routine episiotomy, roughly 4.7 times higher. However, there was no meaningful difference between the groups when it came to more serious second-, third-, or fourth-degree tears. Since first-degree tears are superficial and heal easily, many providers now favor allowing small natural tears over performing a routine cut.
Techniques That Reduce Tearing and Pain
Several approaches during crowning can lower the risk of significant tearing and ease the intensity of the sensation.
Warm compresses are one of the most studied methods. A sterile pad soaked in warm water (around 45 to 59 degrees Celsius) is placed against the perineum during crowning and held there continuously as the baby’s head advances. Research shows warm compresses significantly reduce both second- and third-degree tears and lower pain intensity during and after delivery. In one trial, only 8% of women who received warm compresses reported severe pain, compared to 14% in the group that received standard care without them.
Perineal massage during pregnancy can also help. Starting gentle massage of the perineal tissue around 35 weeks of gestation has been shown to reduce the chance of tears that require stitching. This is something you can do at home in the weeks leading up to your due date.
Upright positioning during pushing, for those without an epidural, is associated with fewer assisted deliveries and fewer episiotomies, though it doesn’t appear to reduce severe tears on its own.
“Hands-off” techniques, where the birth attendant supports without actively pressing on the perineum, appear to lower episiotomy rates. However, the evidence quality is low, and the technique doesn’t clearly affect tear rates overall.
What You Can Do During Crowning
When your provider tells you the baby is crowning, the most helpful thing you can do is follow their guidance on when to push and when to pause. Many birth attendants will ask you to stop pushing hard and instead breathe through the contraction or give small, gentle pushes. This controlled approach gives the perineal tissue more time to stretch gradually rather than tearing under sudden force.
Panting or blowing through the urge to push can feel counterintuitive when your body is telling you to bear down, but slowing the delivery of the head by even a few seconds can make a real difference in tissue outcomes. Your birth team may also be applying counter-pressure or warm compresses to the perineum during this time.
The crowning phase, despite its intensity, is brief. It signals that your baby is about to be born, and for most people, the overwhelming sensation shifts quickly from pain to relief as the head delivers and the pressure drops.