Labor's "transition" phase means change is coming—but it won't always be easy. (For Spectrum Health Beat)
Labor’s transition phase means change is coming—but it won’t always be easy. (For Spectrum Health Beat)

In childbirth classes, we talk about the different stages and phases of labor.

There are three stages of labor, and the first stage, which is also the longest, is what we’ll take a look at here.

For the sake of covering our bases, however, I’ll quickly point out that the second stage, often referred to as the pushing stage, involves the birth of your baby, while the third and final stage starts at the birth of your baby and ends with the delivery of the placenta.

With that out of the way, back to the first stage.

Stage 1

Stage 1 contains three phases: early phase, active phase and transition phase.

These three phases take you from the point that labor begins to the point where you’re completely dilated—10 centimeters—and ready to push.

It would be nice if all women dilated 1 centimeter on the hour, or something like that, but it doesn’t always happen that way.

Some moms stay at one dilation point for a while before moving on, or they may jump more quickly. I joke that it would be great if a sign could drop down from the ceiling and read, “You have now entered the next phase of labor.”

But that’s not how it happens.

Each phase gets shorter, but also progressively intense.

And because I’d like to focus more on the transition phase, I can safely summarize the first and second phases of Stage 1 like this: The first phase starts at the onset of labor and lasts until the cervix is about 5 to 6 centimeters dilated, while the second phase starts at about 6 centimeters dilated and lasts until 8 centimeters.

Then comes the transition phase.

Changes

I always try to remind my new parents-to-be that the transition phase is the toughest but the shortest phase. These contractions typically come every couple of minutes and last about 60 to 90 seconds—and the phase itself typically lasts about 30 to 90 minutes.

Transition. The word even sounds tough.

One author noted how transitions, or changes, in our lives are usually hard. They are wonderful after the change is done and finished, but tough to endure.

Kind of like labor.

Normal feelings and symptoms you may have in the transition period—dilation from 8 to 10 centimeters—include:

  • Feeling like there’s no break. (There really isn’t much of one between contractions).
  • Feeling shaky. I remember my legs trembling as my body was doing so much internal work.
  • Feeling unconcerned about other things. You just want to have a baby. I joke in class that a TV crew could come in and say they wanted to film your birth live and put it on TV, and you wouldn’t care—you want to have a baby, and soon!
  • Feeling abdominal or intestinal discomfort, such as burping or passing gas. You’re making more room for your baby. I joke that OB nurses have seen everything—because we have.
  • Feeling less modest. (Again, mom wants to have her baby.)
  • Feeling disoriented, as though time is distorted. Mom may often ask her partner what time it is, but it isn’t because she doesn’t remember—it’s because she’s trying to figure out how much longer this baby is going to take!
  • Feeling nauseous. (Yes, you might actually vomit.)
  • Feeling needful of a lot of emotional support. This is where coaches are so important. Mom needs you to tell her how great she’s doing and that you’re proud of her. Tell her how close she is to having the baby in her arms. And, of course, tell her that you love her.
  • Feeling like “I just can’t do this anymore!” This is so very normal, and it’s common for mom to ask for pain medication at this point, even if she didn’t want it prior. I tell the moms in my classes that when you feel like you just can’t do it anymore, you are so close to being able to push and have that baby in your arms. You are almost there!

In her soon-to-be-released book, “Natural Hospital Birth: The Best of Both Worlds,” medical anthropologist and doula Cynthia Gabriel explains how the transition phase “demands complete surrender.”

“During transition, the rational mind is wholly subsumed,” Gabriel writes. “Some women describe transition as an out-of-body experience.”

You should let your partner deal with the external world, while you focus inward.

I remember more than one mama who said during labor, “I’m going home,” and then started to take the fetal monitor off because she didn’t want to do this labor thing anymore.

This is common.

Here’s what the laboring mom can do to get through the transition phase:

  • Use vocalization. Low tones are especially helpful at relaxing the body.
  • Change positions often.
  • Voice what you need. One word will do. If you say “drink,” we all know what you need. This isn’t the time to worry about niceties and manners.
  • Let go of the fear and know that it’s normal, but focus on the fact that you are going to meet your baby soon. Remember that birth is a process that takes time.
  • Take each contraction one at a time, then relax between. I remember dozing between contractions in the transition phase—yes, it’s possible—then suddenly, as I’d start my breathing pattern with the next contraction, my eyes would pop open.
  • Focus on your breathing or visualization. A great visualization: the contraction bringing your baby to you, or your cervix opening like a rose bud.
  • Hire a doula.

Transition isn’t easy, but it is doable.

Prepare ahead of time with many options for your labor toolbox.