Dilation Stage: Transition Phase
Transition is the point at where you are leaving the dilation stage of labor and entering the birthing stage. This is where you dilate the last one to two centimeters and baby descends into the birth canal. This phase may last from fifteen minutes to a couple of hours.
If you have done any research regarding labor and childbirth, you have likely come across the description of the transition phase. What you have read has probably frightened you and may even be something that has caused you great anxiety. Many women describe transition as being the worst part of labor.
While transition can be very difficult and maybe even a little frightening, knowing what is happening and being able to recognize the signs of entering transition can help you enter this phase with much more confidence and maybe even excitement.
What is transition like?
Contractions have likely become the most intense as you have experienced so far. They are coming almost on top of each other with very little resting in between. They are also lasting about ninety seconds to two minutes.
You may begin to experience the urge to push. Pushing before you are fully dilated can cause a lip to form. This is when the baby’s head is pressing unevenly on your cervix and one part starts to swell. Your provider or nurse can tell you if this is occurring. If you are told you do have a lip, you may want to try a different position to labor in a few contractions to see if the baby’s head will get into a better position. If you are feeling the urge to push, try breathing out the urge, instead. If you cannot help but push, try only doing micro-pushes or grunts.
You may be experiencing the most intense pain at this point. Do your best not to fight what your body is doing. Keep trying to stay with your rhythm and ritual.
Trembling in your legs and whole body is common. You may feel nauseas and even vomit, you may have cramps, experience temperature fluctuations, and your skin may feel very sensitive. Your body is close to exhaustion and you are being flooded with hormones. This does not mean anything is wrong.
At this point, you may have the urge to have a bowel movement. This is very normal. The baby descending feels very much like having a bowel movement. This is actually a good sign that the baby is very close to being born.
You may get to the point where you do not feel like you can go on. You may demand medication. You may become very irritable. Or you may withdraw, cry, moan, or even nap between contractions. Everyone experiences transition a little differently. Do not let stories you have read or been told make you worry about how you will behave.
During this phase, your body is producing a large amount of adrenaline. We normally try to prevent adrenaline during labor because it inhibits oxytocin which is what causes contractions. However, during this phase of labor, adrenaline is getting you ready to face the next stage…birthing your baby. The adrenaline is going to give you the energy to push your baby out. You may feel too exhausted at this point but in a few minutes your body will be prepared to do what it was designed to do.
“Stress hormones cause the fight or flight response, which gives people great strength and stamina when they must exert themselves—for example, when they are afraid, in danger, or about to take part in competition or a demanding feat like pushing a baby out. Thus, the unpleasant symptoms of transition are followed by a second wind and the strength needed for the hard work of pushing a baby into the world.” ~ Penny Simkin (The Birth Partner)
This may be a time to call on the things that get you pumped, like the music you work out to.
How your husband can help
Your husband may feel a bit helpless during this phase. He knows you are going through something very intense and he doesn’t know how to help. You may want to consider hiring a doula to help him help you through this stage.
Here are a few things he can do to help:
- Help her maintain her rhythm and ritual
- Don’t try to help her relax anymore…help her get pumped. Suggest playing an intense song or one she likes to dance or exercise to normally. Something that makes her feel like a warrior, like Wonder Woman, like Xena.
- Stay calm and confident (even if you have to fake it)
- Stay close by. She needs to know you are there and your baby will be here soon, you don’t want to miss it.
- If she starts to act like she is panicking, be firm and confident with her and “take charge.” Be kind and gentle but tell her what to do like, “Look at me. Take in a deep breath. Blow it out. You are doing great. I am so proud of you. Keep looking at me. We are going to get through this together.”
- Remind her that everything she is feeling and experiencing is normal. Remind her this is the most difficult phase but also the shortest. Everything is almost over. She will be holding her baby very soon.
- If the birth plan was created with the intention of no pain medications, do not mention them. If she starts asking for them remind her that she can use your pre-discussed “code word” for pain medications.
- If she has the urge to push, call for a nurse or the care-provider.
- If she is told not to push, help her to not push by coaching her in her breathing or grunting.
- Don’t take anything she says personally. Don’t try to explain yourself to her. She does not mean to sound critical or harsh. Laugh about it later.
Transition is the toughest part of the dilation stage. You are tired, exhausted, in pain, and just ready to be done. Your body is doing everything it needs to get you ready to push your baby out. Let it do its thing. Breathe, get pumped, in a few more contractions you will be holding your beautiful baby.
This article is part of a series on the stages of labor. If you are interested in other articles related to this subject, you may find them on my Stages of Labor Resource Page.
If you are in the Denton, TX area and are interested in hiring a doula for your birth experience, contact me today to schedule a free consultation. If you enjoyed this article, you may be interested in checking out my Comfort Measures in Labor Resource Page.