Transition
Transition is by far the most challenging, although the shortest, phase of birthing. This is when you might begin to feel overwhelmed and your focus might falter. This is the phase usually depicted in the media. These contractions are stronger and longer and finish dilating the cervix. They usually last 90-120 seconds with breaks of about a minute or two in between. Generally this phase only last for 30 minutes to 2 hours. You may also experience a time distortion in this phase that makes it seem to go more quickly. You may not remember much of this period after the birth. You may feel out of focus and a bit foggy here. Nausea can also set in as well as involuntary painless shaking from the intensity. You are especially vulnerable to suggestion here, which can be used for good or evil.
Transition is the storm before the calm that is pushing. It is by far the hardest part of birthing, but also the shortest. It is here that your focus might falter. This is the stage where you may doubt your ability to birth your baby and feel like you need medications. You may feel worried about how far you have left to go and how much more intense it will become. You will be suggestible and at this time are most vulnerable to accepting interventions whether they will be helpful or not. It is at this stage that your birth companion must be vigilant to your emotional needs and be the voice of reason should a cascade of interventions be suggested.
Find hope in the fact that if you do experience these feelings, remember that this means you are almost there. Labor does not keep getting harder and harder. Once the contractions get to a certain level, they don’t get any longer/stronger. Focus on the fact that in between each wave, you feel perfectly normal. Let them do their work. In this phase your dilation will go from about 7 centimeters to 10 centimeters of full dilation and 100% effacement.
WHAT & HOW YOU MAY FEEL
Contractions that are Longer and More Intense
Nausea
Time Distortion
Hot/Cold Flashes
Uncontrollable Shaking
Intense Pressure
Rupture of Membranes
Loss of Modesty
Loss of Appetite
Irritability
Loss of Resolve
Need for Emotional Support
BEHAVIOR & ATTITUDE
Feeling Out of Control
Foggy
Averse to Distractions
Disoriented
Self-Doubt
OTHER SIGNS & SYMPTOMS
Vomiting
Rectal Pressure
Inability to Find Comfortable Positions
Unable to Talk
Difficulty Breathing
MANAGEMENT STRATEGIES
This is the time to pull out every trick in your bag. You can benefit from any and all of the relaxation techniques and comfort measures. If you at any time you say, “I can’t do this”, what you are really saying is that you need to be reminded that you can, and are, capable of birthing your baby. Bring yourself back to the present. If you begins to fear what is to come and if birthing will become more intense, then your anxiety will rise as your relaxation decreases. If you say anything along those lines, it’s a good indicator that you are almost ready for the pushing phase that usually offers much relief from the intensity of transition.
If you can actively recognize that you are in transition, you will be able to handle the phase much more comfortably because you know it will soon be over. Hold your focus on the fact that with each contraction, you are one step closer to holding your child. This stage is fast and furious and will soon be over. Time may also seem distorted which can also help you manage this piece of your birthing.
WHAT YOU MIGHT DO
Change Positions Frequently
Focus Your Mind on the Present
Use Water
Get on Hands and Knees
Remember to Breathe
Use Visualization
Focus on the Baby
WHAT YOUR Birth COMPANION MIGHT DO
Cold Compresses
Massage Techniques
Emotional Encouragement
Cue Phrases
Tell Her She’s Almost Done
Keep Her Focus on the Present
Keep Her Environment Calm and Quiet
Whisper Affirmations
This is the stage where an unsupportive care provider may undermine your efforts. Needless interventions may be suggested or even forced upon you, knowing that you cannot resist nor make good choices. The birth companion is essential at this time in preventing this from happening. If such interventions are suggested, have the birth companion start by asking why it’s being suggested, what the options are, and if the situation is an emergency. If not, then take your time to evaluate your choices.