Coping At All Stages - Transition

"For my first, not applicable.

For my second, my midwife had me lay on my left side to help me keep dilating. It was very painful. My doula curled up face to face with me and never left my side... once I was 9cm, I was in the birth pool and my body began pushing on it's own. I had a large cervical lip though, and I had to learn to not push when my body wanted to so that she could push the lip back.

For my third, two minutes later, another contraction... then another... I woke in full active labor and immediately moved through transition. Contractions continued to be a full minute long, intense, and 2 minutes apart."~ Allison

"They kept telling me I was almost done - but I felt they were lying to me. It took me a long time to get from 6-7 to 7cm. I felt like I needed a break and wasn't getting it, but I was actually getting a minute break, then had a minute contraction. I used my breaks to worry about the next one. I made the mistake of looking at the clock and feeling like it should have been two hours since they last checked me (they said I was in transition and should be ready to push within a few hours) but it had only been 15 minutes since my last check. My nurse again asked if I was sure I didn't want an epidural. I asked for another cervical check. I was 7 at my last check (15 minutes prior) and was 8cm at this one. I felt like it had taken hours to make that change. It was only 15 minutes. I got the epidural at that time. The epidural took about 30 minutes to finish everything and another 15 minutes to feel completely numb. When they checked me after those 45 minutes, I was 10cm and ready to push. I 'epiduraled' my way through transition." ~ Amili

"The birth assistant did some acupressure and I got in the birthing tub for the next several hours, squatting and shifting weight from one leg to the other..." ~ Chelsea

"Around the time that my contractions were about 3 minutes apart and were lasting for 90 seconds, I started to feel nauseous with each one. I would start to shiver, and that's when I knew another one was coming. My doula would see me throw off my sheet, stand up on my toes and shiver. In response, she would rest her hands on my hips and say 'sink into it, let the wave lift you up and over the top. All you have to do is go limp and breath.'. I threw up into my husband's hands. I still feel bad about that one. The pressure in my butt was huge. I felt like I was constipated and started to dread the next one. I started shaking my head 'no' when I felt them come on. My husband looked me in the eye and said 'yeeeessss baby, yeeeessss.' I nodded and started 'yeahing' my way through them. I think if I stayed in that negativity I wouldn't have made it. Things were really intense, but doable until transition. Transition was the hardest part. It only took an hour and half though. I kept asking how long it had been and how much longer. My doula and husband kept replying 'just long enough and only as much time as you need..' I know I was checked a few times but can't remember how far open I was..." ~ Liv

"Midwife arrived an hour and twenty minutes before J was born. Photographer arrived (forty minutes before J was born. She was startled to see me upon entering because the lights were dimmed and I was crawling around on the living room floor wrapped in TDD’s oversized, dark navy bathrobe like a drunken bum.... A contraction would move through me and I’d think, Wow! This is so interesting! " ~ Holly

" I had had enough of all fours and just wanted to go back to the toilet. We got back there and, as soon as I sat down, my water popped with a huge splash. I remember my doula checking her phone often and it irritating me. I thought she was checking the time and I thought, 'if they tell me what time it is or how long I've been doing this I swear I'll deck them.' I learned later she was worried my midwife wouldn't make it and was updating her. With my next contraction, I was sitting on the toilet and moaning like I was having the hugest orgasm ever. My husband took that cue to kiss me after every contraction and rub my breasts and brush my hair with his fingertips. My doula was giving me this counterpressure throughout, but I acutely remember thinking 'my god, she's got her fist in my butthole'. She didn't really, but she was giving me counterpressure on my lower sacrum and the baby was sitting in my bum, making it feel like one giant pressure. With my husband making out with my top half and my doula pressing on my bottom half, it was erotic and sensual but not sexual. The contractions were strong, but the pressure was stronger. Every contraction felt like an expansion and I needed to make a huge amount of space by opening my legs and mouth and butt. I pooped again, then rested, no contractions, for a long time. I kept asking if this was normal. Cole said yes, that it's usually the calm before the baby and then text updated our midwife for the last time." ~ Trinity

" I started shaking and throwing up with every contraction. My butt and hips hurt and I was miserable. I opted for some IV pain medicine, which did nothing but make me feel drunk. My doula grabbed my attention during one of my contractions and said 'you're almost done. you are doing this.' When that contraction was done, she would say, 'you never have to do that one again.' That became my mantra. I didn't really have a moment where I was like 'I can't do this' probably because of the Demerol. I did notice, though, that I wasn't getting as much of a break. My hubby noticed I had a bunch of blood when I stood up for one of the contractions. He asked if that was normal. My doula said, 'it's even more than 'oh that's normal', that's 'ooh, exciting''. All of this happened in about 40 minutes that passed since they checked me and said I was 4cm..." ~ Kelly

Transition is usually the shortest stage in labor. It is tucked in an (average) 45 min - 2 hour gap between active labor and pushing. Around 1/3 of women experience a very intense transition, 1/3 experience a moderate transition, and the remaining 1/3 don't realize that they are going through transition. In the event that it is intense, some symptoms include:
  • nausea and vomiting
  • hot and cold flashes, the shakes, and goosebumps
  • short temperedness, introversion, and doubt
  • emotionally feeling anxious,  fearful, or requesting to be done/get medication/have other help
  • loss of time or ability to reconnect with those around her
  • raising up on heels to cope with pressure
In addition to any or all of the above, and even in the absence of the above, physiologically, transition generally is marked by: 
  • contractions 2-3 minutes apart
  • cervix 7-9cm
  • contractions lasting 60-90 seconds
  • sometimes double peaking
  • pressure in the sacrum, vagina, or buttocks
In addition to these symptoms, if your water hasn't yet broken, it commonly will around this time and be followed by an urge to push. It's also not uncommon for women, even those who haven't had any bloody show to this point, to have bloody show at 7-9cm. 

Some women begin having the urge to push at this stage, or increased pressure. With pressure, as stated earlier, some women become fearful of making themselves more 'open' by keeping heels on the floor, bending knees, or sitting on the toilet. Pro tip: make that pressure bigger by relaxing your bum like your passing gas. Good reminders that the pressure you're feeling is baby and a good indication of progress can allow a woman to relax her bum. All else fails, the toilet will help with that conditioned response to relax around the pressure. 

Women who may have been coping brilliantly well throughout labor, oftentimes request for pain medication, for something (else), or for help at this stage. If you are planning and hoping for an unmedicated birth, here are some Pro tips to forge through the transition stage: 
  • Connect - If you've been closing your eyes and internalizing, and you feel the sensations of transition are becoming overwhelming, try opening your eyes and making eye contact with someone in your birth team. Research shows that closing your eyes amplifies sensations. 
  • Stay Positive - If your mantra becomes 'oh no' or 'not another' or other negative words, having someone change your head shakes to head nods, your "no"s to "let goooo"s and your "that was BAD" to "that was PROGRESS" can help refocus your energy.
  • Cocoon In - If you're intimate partner is there, having them come in close and speak affirmations to you, touch you purposefully (no petting, patting, or tapping), and cheer you on gently and quietly can help quiet any fears in your mind. 
  • Keep The Goal In Mind - If your goal was an unmedicated birth, you are almost there. This stage is usually the shortest and means you can almost see the checkered flag. If your goal was an unmedicated birth, your mini goals are acceptance and surrender. If you haven't done either of those, work on that - communicate your needs to your team so that they can help you too. 
  • Stay Present - Many women worry about 'if it's this big now, how much bigger will it be an hour from now' or 'I can't do this much longer' or other such projection into the future. Don't worry about the future - stay present and do what you can right in this moment. 
What did your experience of transition include that you weren't expecting/prepared for? What were you glad for? What worked and what didn't?

Up next, pushing... .

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