The Truth about Transition

Written by: student midwife, Jaclyn G. Hauge

            Transition is a normal and predictable phase during labor.  It is the shift between the first and second stage of labor and an indication that you will soon be ready to introduce your baby to the world.  It’s during transition that I begin to fill with excitement and anticipation.  I know that birth is imminent and that the waiting, hard work and sensations of labor will soon be over for the woman.  It’s also a point in the birth process where I have to work my hardest.  So, why is this? How can one event illicit such opposing feelings? Frankly, it’s the physiology of birth.

            Labor and birth is a positive feedback mechanism initiated by our body.  Our bodies begin the process of labor and then continually intensify it in order to expel the fetus and return to its normal state.  Simply put, the body doesn’t stop working until the job is done.  Transition can be the greatest reminder of this.  Transition exaggerates labor, intensifies sensations, and is the overture to the grand finale of birth. 

            With the onset of early labor moms are excited, coping famously, talking, cleaning, laughing and joking.  They really don’t need a whole lot of focus, they just go on with their day, noticing a surge every 5-7 minutes.  A few hours later once active labor begins, the intensity of surges increases, moms start working a lot harder now.  They may stop during a surge, focus their breathing, and might ask for some help.  Birth partners can be very helpful during this time reminding moms to release tension, focus their breath, and massage their backs, hips or legs.  

            Somewhere around the 7-8 centimeter mark, transition begins.  At this point, the last bit of cervix is beginning to melt away, making room for the passage of the baby. Surges begin to increase in frequency, approximately every 2-3 minutes with 30-60 seconds in between.  Along with the frequency, the intensity also escalates.  Women begin to sound more “primal”, and operate on instinct. Moms move their bodies, they get up, they get down, move to the toilet, then to the bed, then maybe to the tub.  Needless to say women in transition are also very indecisive.  One minute they’re burning up, the next they’re shivering and calling out for a blanket.  Some women experience vomiting, others experience involuntary shaking of the limbs.  They may feel as though nothing helps, and the woman who liked guided meditation during active labor may not want talking at this time. 

            As exciting as this time is for me, women have difficulty seeing the finish line in the distance.  They might feel like they’ve done all the work they can do.  They may begin to doubt themselves.  Usually once a mom says “I can’t do this”, most of the work is done and it’s almost time to push.  It’s hard to convince a woman that what she’s experiencing is all normal.  This may be her first baby, and she’s never felt this way before. It may be her third and she remembers the sensations all too well.  Women may try to back away from transition, they may be scared of what’s to come.

Luckily, transition doesn’t last forever.  On average transition occurs in about 40 minutes.  The most important thing to remember is that the feelings, emotions, and sensations of transition are normal and they are positive. Transition is working with you, it’s helping you to welcome your baby.  So, don’t fear it, embrace it and take solace in your midwives when they say “you’re doing great, this is normal, you’re almost done.”