How to Get Through Transition Without an Epidural
It is 100% possible to get through transition without an epidural! This article is FULL of wonderful information about how to do just that. Let's go!
What is Transition?
Birth becomes most challenging right before pushing, during the transition phase of labor. Transition is typically the shortest portion of labor, but also the most dreaded and feared. Contractions are long, strong, and close together.
This post is third in the series "The Stages of Labor: How to and Helpful Tips". The first stage of labor has three parts:
- Part 1: Early Labor
- Part 2: Active Labor
- Part 3: Transition
Today we continue our journey through the first stage of labor. In previous posts, we discussed early labor and active labor, and in this post we'll learn all about the transition phase of labor, especially how to get through it without epidural.
Transition Without an Epidural - You Can Do It!
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. Stage 2 is pushing. Transition happens right before you start pushing.
Symptoms of the Transition Phase of Labor
If you are experiencing the following symptoms, you may be in transition! Good job, you're getting closer to meeting your baby!
- Very long contractions lasting around 90 seconds
- In comparison, the average active labor contraction is around 60 seconds and early labor is only at 30 seconds
- Contractions are close together, around 2-3 minutes apart
- Instead of completely going away contractions sometimes "double peak"
- Women feel like they're not getting a break. You may hear her say, "I'm not getting a break."
- Hot and sweaty
- Cold and shaky
- Nausea and vomiting
- Crying
- Unable to find a comfortable position
- Contractions increase when changing positions
- Afraid to change positions
- Looking for a way out
- Asking for help
- Water breaking
- Discouragement and/or "giving up"
- Irrational thoughts and behavior (ex: I decided I was going to break my water myself after a failed attempt by my midwife)
- Asking for pain relief/medication
How to Give Birth Without Epidural
Having an unmedicated childbirth is totally possible. There are many ways to decrease the sensation of pain and cope well during a natural childbirth. You can do it!
However, many women receive epidurals from their health care provider 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 add to a birth plan that will get you through this intense portion of birth without epidural.
Remember, you can do it!
1. Change Positions
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 sometimes caused additional 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 get 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.
Thoughts From My Birth
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 and save me 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 moved. 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?
TIP: The first contraction after a position change can be hard to cope through. 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 after three contractions you may find that it is actually working for you. Yay!
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)
- Peanut ball
- Toilet
- Shower (The shower is the PERFECT place to be in transition. It's so helpful for labor pain!)
- Tub
- Squatting
Head on over here to read more about positions to try during labor for a faster, more comfortable birth.
2. Encouragement is Key
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 no 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.
What to Say
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"
- "You are doing it! Right now!"
- Reminders that what she's feeling is normal.
- Read Mother Rising birth affirmations or bible verses for birth
Check out this article for more ideas of what to say and what not to say to a woman in labor!
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.
3. Maintain Focus
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 things get more intense, which requires a whole other level of focus.
Unfortunately, instead of enforcing privacy and creating a birth space more 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.
- Request silence.
- Dim the lights.
- Enforce privacy.
- Turn off the tv.
It is easier to cope through transition and give birth within a focused birth space.
4. Stay Hydrated
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 between contractions and with 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. Of course, 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!
5. Stop Complaining
It is really easy to complain during labor, especially transition. However, I've repeatedly 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 attitude I eased my suffering, became more productive in labor, and helped myself to progress. Who knew, right?
6. Try Something New
During my third birth (pitocin augmentation) 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.
Here's another excerpt, this time from my third birth where I tried 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!
7. 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. Allow your body to open. Let your baby come down.
Giving Birth Without Epidural - YOU GOT THIS!
Ladies, YOU CAN DO THIS!
Don't let anybody tell you that transition is too difficult to birth without 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. Birth without epidural is 100% possible! By using the tips, tricks and strategies above you will be well on your way to rocking an unmedicated birth.
Rock on, mamas!
Read the Comments!
For those that had unmedicated births, please leave a comment and let us know how you coped through birth without epidural. If you're pregnant, read the comments. Ladies, these comments are GOLD. Read all about how to have a natural childbirth. You can do it!
I have had 4 natural,non medicated births. All went perfectly fine. Last was the quickest (the more you have the quicker they go!) I told the midwife I was scared with him. She replied omg what are you scared of you've done this 3 times before. I said exactly! Lol no coped pretty well really. Best position to be in, on your knees with arms on the bed head. Gravity helps but you're on the bed for if you get tired. And just breathe. I never did the classes just copied what I remembered in movies lol actually works SO well! Don't eat heavy meals of you feel heavy or close to 'the arrival' and try to empty your bowels. Get them to play music in the room . Midwife put easy listening on their little screen using Pandora in the birthing room. Made it so much better and dimmed the lights. Ps don't bother with a doctor midwife are the go, obviously doctor is nearby in case something goes wrong but midwives are amazing! !!
I gave birth to my 4th baby just over 4weeks ago. His labour was as different as it could possibly be from my previous ones. They were all over 24hrs. His was 3hrs from waters breaking, no contractions for the first 30mins.
I didn't realise I was going through transition as I thought I had hours and hours of labour to go. I was in the birth pool in my kitchen and my contractions were double peaking. I started to feel terrified that I wouldn't get my homebirth as I couldn't handle the pain for 12hrs! But I focused and went into myself. Focusing only on the music that was playing and rocking in the pool, breathing and moaning, pushing out the pain. I didn't speak to anyone between contractions. I focused entirely on myself and my body.
the pain was intense but my baby boy was born and delivered by my husband as the midwives were on their way (we hadn't called them soon enough as were sure there was still a long way to go!)
It was an incredible experience. And im incredibly proud of my body for delivering my 10lb baby boy quickly and easily with no pain relief at all.
I am a first time mom preparing to give birth in March. I am wanting/planning to have a natural birth/labor and all these stories from other moms are SO encouraging! I'm book marking this post so I can continue to come back and reread these comments closer to my due date.
Another good tip is meditation/visualization. I had both of my boys with no medicine. I didn't even get an IV!
I have 4 sons, 3 of which were born at home. My first homebirth was very difficult as I really underestimated what the pain would be like. My 2nd homebirth was so fast it was almost disorienting. My husband missed the baby slipping earth side in the amount of time it took to line the garbage can. My last birth was this past November. I was overdue for the first time and so ready to meet our son that I was so excited to be in labor. It was fast and nearly painless. By the time I had boys 3 and 4, I realized that giving into birthing and visualizing my body opening to allow my baby earth side reduced fear, perceived pain and labor duration. I felt totally in control with my last and caught him myself. It was amazing and such a high note to end my birthing years. I birthed four boys in 17.5 hours. There were many very intense moments but I truly believe the ability to let go of fear and visual helped me to progress quickly and without much pain. I'm so thankful for such amazing midwives that helped me trust my body and believe in myself.
I haven't had our baby yet, he's due May 3rd, 2017, but your article helped ease my mind when thinking about having my first child. I've always known that my goal, when it comes to child birth is to have a natural unmedicade birth. Hey, my mom did it, I know I can too!!
My midwife recommended Penny Simkins birthing class which starts in a few days. My husband and I are anxious to learn as much anxious we can.
Wish me luck!
Is this an online class? In person?
Thank you thank you so much for this article! It honestly got me thru my natural birth with my second son almost all by myself. I lost my mucus plug the night before and the contractions statted at at 2 am. They were 20 mins apart and by 6 am they were 9 mins apart. I thought i would have atleast 12 hours of labor but by 8 am they were coming at 4 mins apart. Most of the time i was breathing and meditating and doing great managing the pain because my son was home and i didnt want to scare him. The min my husband left to drop him off at school i was screaming and thst felt great. I realised the baby will be here soon so we started to the hospital at 9:10 am. We got to the hospital at 9:30 and i was in transition the whole time from 8:30. I got to the hospital and literally jumped on the bed and the doc checked me and said i was ready to push. The baby was out in 5 pushes..though i had an episiotomy becuae of a previous tear it was such an amazing experience. I would tell every mama who is considering a natural birth that we can do it. Our body is made to handle this and by preparing ourselves thru out the pregnancy by staying fit at eating healthy and RED RASBERRY TEA LEAF really helped speed up the labor for me. If i can do it anyone can! Thank you Lindsey!
As a mom of five boys, I just knew I had this birthing thing down packed, Each and every time. My water never broke so, I certainly couldn't count on my water breaking as a sign that I was in labor. With each and every birth, in the We hours of the morning anywhere from midnight to 6am, those contractions would kick in, and once they got closer together and more intense, I knew it was time. I would arrive at the hospital and the nurses would always be quick to say, "oh you're probably only a few cm", quickly I would say, "hey, this is baby number _ so, I know my body, It's time to go". Thankfully I usually arrived around 4cm. Allowing my time at the hospital to be short. I would bring my DVD player/laptop with my Martin DVD's because making me laugh was a great focal point to get my mind off of the pain. Changing positions was always great, and I would walk until I couldn't walk anymore. It helped that during my last two births I was able to squat and push the baby out because of a pelvic condition (natural gravity) those babies just about flew out. Rubbing of the lower back and fanning me (from my husband helped). During one labor I was freezing cold. While others I was hot. I've always been pretty calm, no screaming or yelling (well except for baby number 3 who was 8 1/2 lbs, while my other birth were 7) lol. I love all these great tips you've included. Another thing I wanted to do before all births was make sure I ate good because I knew once I was in labor, there would be NO eating at all.
My entire 2nd labor start to finish was 3 hours..first contraction to last push. I hit transition before my OB was ready and dressed. When he came in, I asked for the drugs. I hadn't felt pain like that in my life. (My first child was born via C-section) All I could think about was wanting to stop the pain. But when I asked for the drugs, the doctor calmly said I didn't have time, that my son was moments away and I needed to bare with the pain just a little longer. Hearing that sent me into an almost animalistic mindset. Something instinctual set in and I bared down and started to push. 4 good pushes later, my beautiful son was born. I am pregnant again with baby #3 and going for another natural unmedicated birth, this time in the water.
WOW! Yesterday I heard a birth story that was a 40 minute ordeal. Incredible. Congratulations and I hope you have a water birth!
I had my first baby in August of last year. It was a quick labor, but very painful! Every time I said,"I can't do this!" My husband would say, "You ARE doing it!" That simple sentence helped me so much! I have honestly always been so terrified of epidurals, so that helped me not give in in the moment! Also, I went into it with the mindset that it wasn't even an option to get an epidural. So when the intense pain came, my only option was to breath(or scream) through, and know that my baby would be here soon! I was only admitted in the hospital for 2 hours and 50 minutes before my daughter was born, and only pushed for 12 minutes. 3 contractions!
My first birth was an unwanted scheduled c-section (which is a whole other comment in and of itself). For my second baby, I knew I wanted the birth I'd planned for the first: a natural birth. By the time I presented myself at the hospital, I was 6cm and had been in labor for 21 hours. My contractions had been coming 2 minutes apart at home, but slowed to 4 minutes at the hospital. My super supportive midwife convinced me to let her break my waters (after a long discussion with her and my doula, I agreed. My midwife is VERY VBAC friendly and spent a while reassuring me that this would not derail my plans).
After my water broke, my contractions got a lot more intense- transition! I tried changing positions, vocalizing, staying silent... nothing seemed to ease the pain even a tiny bit. I requested a repeat c-section AND drugs, but my husband, midwife, and doula all talked me out of it, each using their own methods. My husband and I had a secret code word and he knew not to take my requests for drugs/intervention seriously unless he heard me utter the word (I didn't!).
My doula suggested I get up and sit on the toilet for a few minutes- she said emptying my bladder would make more room for the baby. I think she just made that up to get me to move! While sitting on the toilet, my doula and I had a moment where she stared into my eyes and told me it was happening (I doubted my body's ability to "really" labor and denied I was in labor pretty much until the end). Suddenly, I felt like I needed to go #2.
My midwife came to check me... and ended up announcing "She's crowning!" So a small parade of us went from the bathroom to the bed- I led the parade, with my midwife behind me, hands underneath me to "catch" the baby, my husband rolled my IV behind me (I'm GB+), and my doula was somewhere in the mix as well. They helped me into the bed, I pushed twice, and within three minutes, my 8lb, 12oz baby girl was born- a successful unmedicated VBAC that has been most healing for me!
During my first pregnancy I had an awful experience because I went to the hospital too early and had a c section. Watching videos of people going through natural birth helped because I became more aware of what to expect and methods of coping. I read so many books and article and listened to birth stories. I understood that it was not going to be easy. I also learned that staying active during the early stages of labor instead of rushing to the hospital was best. I spent the morning cleaning doing laundry washing dishes and took naps. When the contractions were just 5 minutes apart I headed to the hospital and continued to labor in the parking garage. I knew it was time once it was difficult to walk or stand on my own. I was admitted at 7 cm and by the time they check you in and ask a million questions about insurance I was entering transition. Breathing and imagining my baby coming out helped me get through this stage. I ignored everything around me until it was time to push. I refused to talk to the doctor until I felt ready to push to minimize negotiating or offering me other services like pitocon or epidurals that I did not need. My husband supported me every step of the way and allowed me to do it my way. Staying away from the hospital till the very end and be admitted once the nausea hits saved me from having another c section.
Love this srticle! I am pregnant with our 4th! Due end of Aug. early Sept. my first was over due and I had an epidural. So glad I did. My last 2 were completely medication free and 2 totally different experiences. My 2nd, at 39 weeks my water broke. We lived 59 miles from the hospital. I labored, fearfully in the car and got to the hospital, got on the bed and in 15 min had her. IV and led free. With my son, out 3rd, I had preterm labor. He was really low. I went I. For my 38 week check up. Turns out I was able to have my water broke to be induced (no pitocin thank the Lord. Had that with my first) I begged for a epidural during transition. I was 9cm. I had complete hip and back labor with him and it turns out he was shoulder dysctocia. The most comforting thing I heard was when my nurse checked me and told me "no epidural for you your 9 cm" my husband said "you got this. You can do it" put the confidence right back in me and I was able to suck it up and keep going ( not hat I had a choice) but you know what I mean. So, yeah. Wanting to do med free again and my son just turned one. So my last birth is still very fresh in my mind and painfully fresh at that. This article is helping me get my head back in the game. Which I am totally doing during this time of pregnancy you. Thank you!
i had all 3 of my babies naturally my 2 girls i was on a hospital bed then with my little boy i decided i wanted to squat but i ended up having a water birth which now that its over with i can say it was amazing although i wouldnt of agreed at the time it was all over in 2 hours but felt like 12 to me and i forgot all about the transitional stage until reading this post it was the hardest thing iv ever been through i remember jumping out of the birthing pool demanding pain relief and my partner telling me i didnt need it i was doing great but i was begging and begging then all of a sudden i just pulled myself together and just got through it but this was only 20 months ago and iv just found out im pregnant again i am terrified i dont think im physically or mentally strong enough to go natural a 4th time i dont know if its because im older and softer but im scared!
My fourth was born with no medications, I choose to labor at home as long as possible. I knew I was transitioning and ready to get to the hospital when I started swearing. I never swear. My husband thought I still had some time and spent forever getting the car ready, checking the oil, filling all the fluids, etc. When he came pack inside to get me I about chewed his head off! It was near impossible to move during this stage for me, I could only move when I wasn't contracting. I was having contractions ever 2 minutes and by the time we made it to the hospital I was 10cm and the nurse felt her head. I barely made it to a room and was put on the bed before my body was pushing. I couldn't control the pushing. I was begging for pain relief, I had three epidurals before because all three were induced for different reasons. I had no idea how painful natural labor was. I felt like I was being torn into two pieces and burning up from the ring of fire. It was my hardest, fastest and easiest to recover from. And I plan on another unmediated delivery when I have our 5th in October. Laboring at home was the trick for me. I escaped from reality and just focused on my body and my baby. I did not want to talk to anyone nut my husband and I was so annoyed my mother wouldn't stop talking to me. I wish she had taken the kids somewhere that morning.
I'm sorry but that made me laugh reading about how your husband was checking the oil and filling the fluids. I'm sure he meant well, but his energy was mis-directed! You did it before and you can do it again. You got this!!