What is transition in labour?
Transition is literally the transition between the first and second stages of labour. Active labour contractions have been dilating the cervix and it’s open and ready for the second stage, when a series of involuntary contractions push baby through the vagina to be born.
Transition is often described as the challenging and hardest part of labour. It’s also the shortest and signals to you and your birth team that your baby will be born soon. Many women will doubt their ability to go on at this stage, requesting medication or worrying about how much longer it will take.
It’s during this stage of labour women tend to become very vulnerable to suggestions and are more likely to accept interventions they previously didn’t want.
What Is Transition In Labour And Why Is It A Challenge?
Transition is a time of upheaval and big changes. Up to this point, a woman’s body has been flooded with oxytocin and endorphins, likely making her quite sleepy and relaxed. During this stage of labour, it’s important to keep adrenaline levels low so as not to interfere with the flow of oxytocin, the love hormone which promotes effective contractions.
At transition, the mother’s body releases a flood of adrenaline, waking her up so she is alert and lucid. Adrenaline occurs at the most intense point of labour, which is why transition is often a crisis point for most labouring women. In the wild, adrenaline triggers the fight or flight response, so mammals can move themselves and their young quite soon after birth, to avoid predators.
Women birthing in hospitals or environments which aren’t conducive to undisturbed labour, can feel fear and antagonism during this stage. The very nature of childbirth means where you give birth and with whom are very important decisions.
Signs of Transition
Like other stages of labour, every woman’s experience of transition will be different. For some, the shift from active to pushing is unremarkable. Other women experience any number of signs of that distinctive phase between stages.
Emotional Signs Of Transition
A very common emotional sign of transition is the ‘I’m done/I can’t’ stage. You may suddenly wake up out of the endorphin soaked haze you’ve been in for some time, and just decide you can’t have this baby today. Or you need drugs right now. You might be incredibly irritated by everything and everyone around you.
Some women become incredibly focused and almost withdraw into themselves. They may find it difficult to communicate although they will say later they could hear and understand what was being said, they just couldn’t respond.
Restlessness is another common emotional sign of transition. Not knowing to put yourself, wanting to be touched then hating it, wanting company then telling everyone to leave.
Physical Signs Of Transition
Many women experience some physical sign of transition. The most common are:
- Shaking or trembling
- Sweating, having hot or cold flashes
- Dry mouth
- Burping, hiccupping, dry retching
- Nausea and vomiting
- Feeling strong pressure in your bottom
- Long, frequent and intense contractions
Transition usually only lasts minutes, often less than an hour, and it’s important to remember it’s a signal the birth of your baby is getting closer.
Tips For Coping With Transition
Many women worry how they will deal with transition. Being prepared for all eventualities is a good start. If you take a birth class, make sure your partner is educated on this stage of labour as their support is going to be very important!
Practice relaxation techniques to help you through this stage. This might be focusing on your breath, having a massage, or listen to your partner’s voice. The key is to let go and accept.
You can’t skip transition if it happens to you – work with what you’re given. Often the intensity of the pressure in your bottom can be overwhelming to begin with and many women tense or pull away from the sensation. Breathe down and relax into it. An excellent way to practice this before labour is when you are on the toilet. Letting go is natural when we are on the toilet, practice breathing down and relaxing while you are there.
Partners and birth support people can connect with you with their words. Often women describe transition as feeling out of control and lost. Loving, supportive words can ground you and help you feel reassured. Holding a hand or even being stroked on the back or face can also give you a sense of support.
During transition, you’ll probably feel quite hot and cold alternatively. Make sure you have plenty of fluids ready and even a snack if you feel like it, especially if you haven’t eaten for a while. You may need the energy to push. Your partner can wipe your face and neck with a damp face washer to cool you down.
Often at this time, women can voice concerns the baby is stuck or won’t come down. It may be you need to change positions, open your pelvis a little more or go to the toilet to empty your bladder. Moving during transition can be difficult if you have shaky legs or feel nauseous, so make sure you have assistance.
For many women, this is the time you may meet your primal self! Many women roar, grunt, moan or wail without consciously being aware of making any sound. These noises are powerful signs you’re close to birthing your baby.
When transition hits, it can bring with it a surge of fear and uncertainty. These emotions are powerful but they aren’t permanent and you’ll soon leave them behind as you start to work with your body. Transition is a signal birth is close and it won’t be long before you meet your baby. Having a good birth team who supports birth as a natural process can ease you through this challenging time in labour.