Mine was natural, and it took about 45 mins or so. I didn't really have any contractions (or at least i barely felt them) until about this point, and even then i just felt abit weird like i needed to push it out so i did and out it came. nurses asked if i wanted synto, i said no, but they said because i tore, they'd give me an hour, and if it hadn't come out then, they would give me synto to prevent any nasty blood loss (wasn't a bad tear, but enough to need 7 stitches)