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.
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.”