The phase that means your baby’s nearly here

The tran­si­tional phase of labour is the most in­tense part of the birthing ex­pe­ri­ence, al­though it is also the short­est. Here’s how to recog­nise the signs and man­age this stage so you can bring your baby into the world.

Mother & Baby (Australia) - - Contents -

How to man­age this labour stage

There are three stages of labour, right? The first stage when your cervix opens up, the sec­ond stage when you ac­tively push your baby out, and the third stage when your body squeezes out your pla­centa. Whether you’re lis­ten­ing to your mid­wife, read­ing up on labour or chat­ting at your an­te­na­tal class, that’s the gen­eral con­sen­sus. But there’s a part of labour tucked away in there that’s so sig­nif­i­cant, it should be a whole stage in it­self. It’s called the tran­si­tional phase, and it hap­pens right at the end of the first stage.

Mid­wife An­nie Fran­cis says the tran­si­tional phase is when an enor­mous amount of phys­i­cal and emo­tional changes hap­pen. “If you un­der­stand just what’s hap­pen­ing through this pe­riod of change, you’ll be able to help your body have a bet­ter labour,” she says.

BABY IN TRAN­SIT

When you’re in the first stage of labour, your body ex­pe­ri­ences a reg­u­lar pat­tern of en­ergy as your uterus con­tracts, and the mus­cle fi­bres grad­u­ally get shorter and tighter to pull your cervix open. But, once your cervix has di­lated, or opened, to 7cm wide, an­other en­ergy starts get­ting in­volved as your body gears up to get into push­ing mode. And it’s this phase, when your cervix is be­tween 7cm and 10cm di­lated, that’s called the ‘tran­si­tional phase’. At this point, you’ll have two strong forces at work in your body: the reg­u­lar con­trac­tions that are open­ing your uterus up, and the mus­cles at the top of the uterus that are gather­ing to­gether and gear­ing up for the push­ing stage.

“In the early stage of labour, the top of your uterus fits snugly around your baby’s bot­tom,” ex­plains An­nie. “But as your baby starts to move down, the mus­cle fi­bres gather to­gether into a thick chunky pad at the top of your uterus. When you reach the sec­ond stage, this pad will pat down on your baby’s bot­tom to help move her through your cervix and into the world.

“These are big phys­i­cal sen­sa­tions and by un­der­stand­ing what’s hap­pen­ing, you’ll be bet­ter able to cope with them,” con­tin­ues An­nie. “You’ll have got used to

“Dur­ing the tran­si­tional phase women are often told not to push, but some ex­perts say you should go with your body’s in­stincts, so lis­ten to what your mid­wife says is right for you.

the con­trac­tions and you’ll be rid­ing them like a surfer rides the waves. But when the tran­si­tional phase kicks in, these new sen­sa­tions are like strong cross-currents that might make your surf­board wob­ble!”

And this causes many women who’ve coped re­ally well with labour so far to sud­denly feel like they’re all at sea.

“You might feel shaky or nau­seous, or a lit­tle zoned-out like you’re in a trance,” says An­nie. “A lot of women feel they can’t cope when they reach this phase, and ask for an epidu­ral or more pain re­lief. But often this re­quest isn’t just a re­sult of the phys­i­cal sen­sa­tions of labour, it’s about the emo­tions you’re feel­ing too.” And while pain re­lief might be the right op­tion for you, there are a lot of other things you can do to help you through this tran­si­tional phase.

HOW TO HELP YOUR BODY

If you were climb­ing a mountain, the tran­si­tion phase would be the last slope be­fore you got to the top. It’s the hard­est bit – but it doesn’t last long, and the view from the top is worth it. To speed you up this last slope, you sim­ply need to trust your body and go with the flow. “The best thing you can pos­si­bly do dur­ing this phase is to go with these sen­sa­tions,” says An­nie. “Let go of your ra­tio­nal, an­a­lyt­i­cal brain and let your older, prim­i­tive, ‘an­i­mal’ brain take over. And do what­ever feels right for you. Strip off. Roar like a lion. Don’t worry about it. Your body knows what it’s do­ing and it will do the right things.”

The thing is, these days we are used to be­ing in con­trol – we deal ev­ery day with our jobs, our re­la­tion­ships, our money. We’re used to know­ing what’s go­ing on in our lives and keep­ing a firm hold on the reins. And you might strug­gle when you get into the tran­si­tional stage of labour, and your body is taken over by a force you can’t con­trol. It’s all too easy to tense up, to feel wor­ried or over­whelmed and to be knocked right out of the calm zone you’ve hap­pily been in so far. “Giv­ing birth is driven by hor­mones,” says An­nie, “led by oxy­tocin flood­ing through your body. If you get wor­ried or tense, your body will release adren­a­line and too much will dis­rupt this flow of help­ful hor­mones.”

So, know­ing how to man­age this tran­si­tion calmly leads to an eas­ier labour. The good news is that sim­ply know­ing that this is a tran­si­tion phase in the first place, and un­der­stand­ing what your body is do­ing and why, helps a lot. Know­ing that what you’re feel­ing is nor­mal means it’s far less likely to knock you off course.

Make sure your birth part­ner knows what to ex­pect too, and knows how to help you through it. “He needs to tell you that once the tran­si­tional phase ar­rives, you’ve done the long­est part of the jour­ney, that you’re nearly there, and it won’t be long un­til you meet your baby,” says An­nie. This sort of re­as­sur­ance and em­pow­er­ment can re­ally help you stay in your zone. Your birth part­ner plays a cru­cial role in help­ing you stay strong, so ask him to stay grounded and be a pos­i­tive source of calm en­ergy. Make it his re­spon­si­bil­ity to keep your en­vi­ron­ment calm and quiet too. He also needs to an­tic­i­pate and be re­spon­sive to your needs, in­clud­ing of­fer­ing you reg­u­lar sips of wa­ter and small snacks. So, in­stead of ask­ing, ‘Would you like a drink?’ he knows to pop the straw into your mouth so you can take a sip if you want once the con­trac­tion passes.

One use­ful tac­tic dur­ing the tran­si­tional stage is to get on your very own timescale. For­get about what the clock says, and in­stead fo­cus on the tim­ing of your

If you were climb­ing a mountain, the tran­si­tion phase would be the last slope be­fore you got to the top. It’s the hard­est bit but the view from the top is worth it.

con­trac­tions. Think about mov­ing through each con­trac­tion, and then wav­ing good­bye to it for­ever. There are lots of dif­fer­ent ways to think about this ‘tim­ing’ – some women like to count the sec­onds of each con­trac­tion out loud; oth­ers like a more vis­ual ap­proach such as pic­tur­ing a flower slowly open­ing as the con­trac­tion builds. Hav­ing your birth part­ner breathe with you through a con­trac­tion also helps – some­times when you’re in this zone you can’t fo­cus on speech, but the sound of some­one else breath­ing can help you keep your own breath­ing on track.

Lis­ten to your body and try mov­ing into dif­fer­ent po­si­tions in be­tween con­trac­tions too. This can give you a fresh in­jec­tion of en­ergy, and you may find it much eas­ier to go with the flow in an­other po­si­tion. Let your part­ner know this is some­thing you plan on do­ing at this point, so he or she can sup­port you. Many women find that get­ting into a birthing pool is re­lax­ing and sooth­ing. Or try sit­ting on the toi­let. We nat­u­rally re­lax on the toi­let and now is the time to let ev­ery­thing out!

Do all this and you’ll sail through those choppy wa­ters just fine. Em­brace this spe­cial phase in your labour: it’s the mo­ment that marks a huge tran­si­tion in your life, mov­ing from be­ing a preg­nant woman to a mum on the way to hold­ing her baby in her arms. “Above all, re­mem­ber that you can do this,” says An­nie. “Your body is very good at giv­ing birth. Trust it.”

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