What to Expect: Transition

by Julie Snyder (Pregnancy.org Staff)

"Transition is the phase of labor just before the pushing stage. At about 6 or 7 centimeters of dilation, some of the symptoms of "transition" appear. During transition, contractions become very strong, and often their duration and frequency are less predictable." ~Linda Jenkins, RN, childbirth educator

This is almost my favorite part of labor. Perhaps to understand my statement better, you should understand that I am not a particularly patient person. After a few hours of mellow tightening and then a bit of slightly more intense activity, I am ready to get with the program. The part of labor that some call transition, signals to me that it won't be very much longer before I will get to finally hold my baby. This period of labor lasts about 10 peaks of intensity for me, usually no more than 15-20 minutes. Intense, but fast.

Signs of Transition

Four things mark the beginning of transition for me.

  • First, I am done. I really can't do this today. I'm ready to go home and come back another day and finish having this baby (or during my home births, I was ready to send everyone else home, turn over and go to sleep)
  • Second, I start shaking, especially my legs.
  • Third, modesty isn't an issue any longer.
  • Fourth, I can't talk through contractions.

Emotional Markers of Transition
The "I can't" syndrome is a common emotional marker of transition. You may feel like you can't go on without drugs. Or you may feel you just can't have a baby at all today. Or you may ask your partner to rub your back and suddenly you can't stand to be touched. You may find you are irritable and rude as well.

A friend of mine exhibits a second common emotional marker of transition -- restlessness. "I want to walk, wait! No, I want to lay down. No, I don't I want to lay down; I'd rather sit on the birth ball. I don't want to sit on the birth ball, I want to lay down. No, I want to walk..."

Some women become very focused. They can appear confused to those around them. I found this stage surreal, time and space didn't seem to be quite where each belonged. Someone would talk to me. I would understand what they were asking, but it was as if I didn't have a channel to communicate. They were all preoccupied with the intensity of the experience.

Physical Signs of Transition
Physical signs of transition may include shaking or trembling which may resemble shivering or could be stronger. Nausea and vomiting can also occur. In addition to these, some women will feel hot and cold flashes or have cold sweats. Other women might begin burping or hiccupping as the body prepares for pushing.

Working through Transition

There are many ways to view the transition period. I chose to consider each wave of contractions as bringing my baby one step closer to my arms. I welcomed the work my body was doing while envisioned myself standing on the beach with a wave rolling, rolling in, finally washing over me and ebbing. And it has washed my baby closer to shore. At the same time, I felt a lot of pressure in the pelvic floor.

Let's look at some comfort measures for the transitional period:

  • For you: Move around, change positions with every contraction if you want to or just be still if that feels best. Relax and listen to your body. Remember, while it is intense it will be over soon. And that baby is worth every second!

  • For your partner: Help her remember to breathe and encourage her to relax if she is tensing up with contractions. For some women, it is encouraging to be reminded that it's almost over and the baby will soon be here. Some comfort and focusing ideas you might suggest include:

    • Water -- a shower, a tub or even warm cloths
    • Support her while standing, even dancing slowly together
    • Sit on a birth ball or the toilet to relax the perineum
    • Gently stroke her face or another part of the body
    • Talk her through the visualization you've has chosen

Just as quickly as transition started, it ended for me. My body takes a rest before pushing -- between five and fifteen minutes. Some women might not realize they're ready for the last phase of labor until they hear their attendants say, "You're dilated to 10." Now to push that baby out! (The good news is that for most women, pushing feels great!)

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