Today we will continue our journey through the first stage of labor. In previous posts, we discussed early labor and active labor but in this post we will learn all about the transition phase of labor.
The transition phase of labor is the typically the shortest portion of labor, but it’s the most dreaded and feared.
Can I ease your fears? Let’s pretend we’re in a coffee shop, sipping coffee (decaf, right?)… let’s get started.
This post is one part in a series called “The Doula’s Guide to the Stages of Labor“. Here are the links to each part in the series.
Transition Phase of Labor
Like I said above, the transition phase of labor is the shortest but the most intense portion of labor. Transition got its name because it is the part of labor where women transition from stage 1 to stage 2. Do you remember what stage 2 is? Stage 2 is pushing. Transition happens right before you start pushing.
Symptoms of Transition
Here is a list of the some of the symptoms or signs of transition.
- Long contractions lasting around 90 seconds (in comparison, the average active stage contraction is around 60 seconds)
- Contractions are getting closer together, around 2-3 minutes apart
- Instead of completely going away contractions sometimes “double peak”
- Because of all this ^ it feels like you’re not getting a break. You may hear yourself say, “I’m not getting a break.”
- Hot and sweaty
- Cold and shaky
- Can’t find a comfortable position
- Contractions increase when changing positions
- Afraid to change positions
- Looking for a way out
- Water breaking
- Discouragement and/or giving up
- Irrational thoughts and behavior
- Asking for pain medication
Coping Through Transition
Having an unmedicated childbirth is totally possible. You can do it!
However, many women receive epidurals during the transition phase of labor because they can’t cope and/or their birth team is unable to help them cope. The following are some amazing ideas to help you through this intense portion of labor.
Remember, you can do it!
One of the best pieces of advice I can give you for coping through the transition phase of labor is to change positions. And change often.
Paradoxically this is also probably the toughest piece of advice to follow during transition.
The thing is, during labor when you get in a position that is working for you, or even if its not, it can be hard to change positions.
When I was in labor and I moved, it would cause contractions. I wanted my contractions to go away, or to be less intense, so therefore I thought that if I just remained still things would be better.
However, in order to end the contractions, labor ultimately needs to crank up, get more intense so that you can push your baby out. At some point, you have to decide to accept labor, accept that things aren’t going to go away, and bravely embrace the sensations of birth because those are what will bring your baby and bring the end.
Labor is such a trip.
Here’s an excerpt of my thoughts during my second birth, a homebirth.
Oh. My. Gosh. I was in so much pain. My contractions weren’t stopping. They would peak and then peak again. I cried out for somebody to help me get up/save me/whatever because I was in so much distress. After that contraction was over I did a little internal self-talk.
“Lindsey, you need to be brave. You need to get up and move”
And so I got up. And I was brave.
My baby was born not long after that.
Be encouraged! By being brave and changing positions you might find a more comfortable position and it also might speed up your labor – which is what we want, right?
PRO TIP: If you change positions and it feels AWFUL, try it for three more contractions. If after three contractions it still isn’t working, try something new. Sometimes, however, after three contractions you will find that it is actually working for you. That first contraction after a position change can be hard to cope through.
Here are some positions to try during the transition phase of labor.
- Sitting on the bed
- Standing and leaning into a birth partner, bed, table or wall
- Sitting on a ball
- Leaning on a ball (standing or sitting)
- Squatting (Squatting and pushing before 10 cm was so helpful for me to progress through transition. Use at your own discretion.)
A common signpost of being in transition is feeling like you can’t do it. You might say…
“I can’t do it.”
“If I have to do this for another ______, there’s now way I can do this.” (Remember, labor math doesn’t exist!)
“Someone help me!”
“I need an epidural. No really, someone get me an epidural.”
You know what? When my doula clients start saying these things I know 1) we are getting close to pushing and 2) I need to increase my support and encouragement.
Encouragement during the transition phase of labor is VITAL. If a woman does not have a team of support to rely on, she will often turn to medication. This does not have to be! Here are some suggestions for encouragement during that last bit of intense labor.
- “You get to meet your baby soon.”
- “Feeling this way means you’re progressing.”
- “You’re getting closer to your baby.”
- Use Penny Simkin’s “Take Charge Routine“
- Reminders that what she’s feeling is normal.
During transition I often felt like something wasn’t working correctly. It seemed like things were hurting far worse than they should and that I wasn’t progressing quickly enough. The cost was far outweighing the perceived benefit. I found it helpful for people to remind me that things were progressing normally, and in fact they weren’t even going slowly. When you’re in labor it is hard to have an accurate sense of time. Reminders and encouragement are so helpful.
During active labor a mom might be more tolerant of external distractions like bright lights, talking, the tv and extra guests. However, during the transition phase of labor things get more intense. Things ramp up which requires a whole other level of focus.
Unfortunately, instead of enforcing privacy and creating a birth space conducive to focus, many women request epidurals to accommodate their surroundings instead of requesting the surroundings to accommodate her.
Mamas! This is YOUR DAY! Of all your days here on earth, this is your day to tell others how you want things to go.
Better yet, have your doula or “birth bouncer” (baby’s father, nurse, etc.) enforce privacy for you.
- Ask observers or other unhelpful people to leave.
- Demand silence.
- Dim the lights.
- Enforce privacy.
- Turn off the tv.
By maintaining a focused birth space it will be easier to cope through transition.
Another important part of coping through the transition phase of labor is to stay hydrated. A simple method of staying hydrated is by offering mom sips of ice water using a bendy straw.
To help keep mom energized, diluted juices and electrolyte drinks can also be used. Chewing on crushed ice is amazing between contractions.
I love using electrolyte cubes for labor!
Staying hydrated during the transition phase of labor is important especially if mom is vomiting. Dehydration is the enemy!
By staying hydrated you will help keep yourself and baby healthy, give yourself energy and shorten your labor time. STAY HYDRATED!
It is really easy to complain during labor, especially transition. However, I found relief when I chose to switch gears and stop complaining.
Frankly, nothing was helping anymore and once I decided there was nothing to be done, I stopped whining about it.
And instead of complaining and whining, I focused my energy on to other things.
With my second birth I decided to get up and move. With my third birth I decided to start squatting.
By changing my tune I eased my suffering, became more productive in labor and helped myself to progress.
Who knew, right?
Try Something New
During my third birth (pitocin augmentations) I vocalized a lot. It was very helpful!
However, I got to a point where I wanted to crawl out of my skin – nothing was working anymore. My doula’s touch irritated me, my vocalizing was not helping things and I was at a loss.
And so, I decided to try something new.
The vocalizing I was doing was NOT working anymore. Nothing really, was working anymore. I became “that lady” in labor. I’m cold… so they put a blanket on me. I’m hot get it off! Push on my back! No stop! No position felt any better. It was awful. It felt like fire. Fire on my belly and fire on my back. Hot, burning fire.
At one point I decided that I needed a different approach and that I was not coping well. So, I decided to sit on the hospital bed and not vocalize at all. Now, to the observer it probably looked like I was feeling pretty good but it was still terrible. It didn’t get better, the contractions were still hell. However, after doing a few contractions like this I felt a little bit less out of control. My contractions spaced out the tiniest bit (which is probably when Tanashia turned the pit up haha) and I got to doze between contractions. This was my big aha moment during my Pitocin experience. I had the courage to change things up when nothing was working anymore.
Trying something new was scary. However, it actually turned out to be helpful. If you don’t know what to do to cope during transition, try something completely new and possibly a bit scary. It worked for me!
Let It Go
My final piece of advice for coping through the transition phase of labor is to just let go. Channel your inner Elsa and just LET IT GO.
As a doula observing births and as a mom experiencing labor, I have found that once we decide to stop fighting labor, but embrace and work with it, our bodies relax and things progress.
Let it happen.
Let your body open.
Let your baby come down.
Transition Phase of Labor – YOU GOT THIS!
Ladies, YOU CAN DO THIS!
Don’t let anybody tell you that transition is too difficult to deal with without an epidural. (Sure, epidurals can be used wisely and compassionately. Epidurals absolutely have their place… But that’s another blog post.)
You can absolutely, positively have a natural birth! You can make it through transition without an epidural. By using the tips, tricks and strategies above you will be well on your way to rocking an unmedicated birth.
Rock on, mamas!
If you had an unmedicated birth, please leave a comment and let me know how you coped through transition. I can’t wait to read all about it!