What is the "transition" part of labor like?

[Anonymous]

I had a natural birth a month ago and was truly blown away by the transition period. I had no problems whatsoever getting from 0-9+cm but the last cm or so just about killed me. I felt like the contractions were literally cutting me in half and I was begging for an epidural. Everything I learned in Bradley class went completely out the window and I just screamed and screamed. I thought I would die or pass out from the pain and I was so, so nauseated. Good thing is that I was ready to push. Pushing offered just the slightest bit of relief from the pain. I ended up pushing out the baby (#1) in 8 contractions because I pushed like a maniac. I knew the only thing that would stop the pain was to birth the baby.

I have no desire to ever experience that again!

[Anonymous]

10:11 again. I wanted to weigh in again just to add that at no point in labor did I feel like I was going to die, or that contractions were killing me, etc. I was very lucky and had a fairly short labor, but it was entirely manageable the entire time. I'm not a freaky hippy crunchy granola person who'd really rather give birth in the woods, and in fact thought until I got pregnant that I'd be one of those women who wanted an epidural before I even went into labor.

I am definitely NOT judging anyone and know that I'm very lucky to be one of those for whom labor is pretty easy. It won't be that way for everyone, but it does happen for some!

[Anonymous]

i think that how transition feels depends a lot on where and with whom you are birthing. i was in water both times, free to move about as i pleased, with great labor support who kept reminding me that i was normal and healthy and fine even though i felt like i wasn't. this made it very manageable for me.

but i can imagine that transition might be more traumatic or painful for someone who is, for example, laying in bed, or hooked up to monitors, or had pitocin, or who doesn't have good labor support, or any number of other variables. and i imagine pain is just very different from woman to woman.

[Anonymous]

With both my labors, as transition started, I don't remember the pain increasing so much as being emotionally overwhelmed. With my second, I said to my husband and midwife, "I'm done, I'm not doing this anymore, I want to stop." As if I had a choice at that point! After that emotional dip, with both, THEN pains got incredibly stronger. I remember for most of my labors feeling like I was "managing" my contractions, but during transition (the last 1.5cm or so), just holding on to my husband for dear life and howling. The sensations were so overwhelming, I just went into my body completely and didn't even interact with anybody. Then, comes the overwhelming feeling that you are about to take the biggest poop in the history of the world, and you are ready to push!

It's funny, rereading what I wrote, it might sound like a bad experience, but it was AWESOME! I still get energized and empowered when I think of how fantastic my births were. Transition SUCKS, and I had two really long labors, but still had great births.

[Anonymous]

Anonymous wrote:i chose with this last birth to not have any dilation checks. i didn't want all the expectations and pressure that come with knowing how dilated one's cervix is. i loved it. i was able to experience the stages of labor without associating them with a number or having any expectations of myself or a timeframe. i know it's tempting during labor to be checked but really for me i wouldn't have been happy with much other than "10" so i figured there was no point. and i think this might be part of why transition was easier the second time, because i just got through the contractions, and never knew how close or far i was from "the end".

Can you do this with a first labor? How do they know when its time to start pushing? I'd love to do this, but am not sure if I'd be allowed, or if its as good an idea when you don't have personal experience to get you through it...

[Anonymous]

The burning is actually the stretching, not the tearing.

I had horrible tearing with my first and no tearing with my second. The burning was far worse with the second, whose birth I controlled better. Didn't feel a bit of the tearing with the first. The baby's head numbs you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:i chose with this last birth to not have any dilation checks. i didn't want all the expectations and pressure that come with knowing how dilated one's cervix is. i loved it. i was able to experience the stages of labor without associating them with a number or having any expectations of myself or a timeframe. i know it's tempting during labor to be checked but really for me i wouldn't have been happy with much other than "10" so i figured there was no point. and i think this might be part of why transition was easier the second time, because i just got through the contractions, and never knew how close or far i was from "the end".

Can you do this with a first labor? How do they know when its time to start pushing? I'd love to do this, but am not sure if I'd be allowed, or if its as good an idea when you don't have personal experience to get you through it...

NP here, but you certainly can.

There's something that many people don't tell you -- when it is truly time to push your body just DOES it. It is like an upside-down vomit, a heave. I did not actively push out either of my kids. In fact, with my first I was terrified and actively did NOT want to be pushing, yet I did. It is as if you're having a bowel movement -- you can try really hard not to go but eventually your body just does it on its own.

I had no cervical checks with my second. I just labored, then at some point my body PUSHED once during a contraction, then again during the next, etc.

[Anonymous]

Hello again! I saw someone replied and wanted to second what they said, and add some!

First I think this post is really interesting ... it challenges the traditional way we tend to think of dilation and how it relates to labor "progress".
http://motherwitdoula.blogspot.com/2010/01/and-while-were-on-subject-of-numbers.html

I think one of the hardest parts about having a baby in the hospital today is how much emphasis is placed on dilation. Women labor at different paces but hospitals expect your labor to follow a certain pattern or else they often want to "speed things up". So for me, one of the main reasons I wouldn't want my cervix checked is that I wouldn't want someone using my dilation against me, so to say, and suggesting interventions that I may not need, and that if they didn't know my dilation, they wouldn't suggest.

That said, it is probably very hard (but not impossible) to refuse dilation checks in the hospital. Most hospitals have probably rarely encountered women who refuse these checks. It has almost become a situation where women don't believe their body can give birth without being checked. With my first birth I never thought to question dilation checks. Now after attending births as a doula, I have seen so many women get pressured into interventions or get dejected and ask for an epidural, right after getting checked. They may hear that they are 5 cm and just give up -- nevermind that they might have dilated the rest of the way in five more minutes, and nevermind that the checks are subjective (I've seen a mom get checked by one nurse at 11am and be 3cm, by another nurse at noon and be 7 cm, by the OB at 1pm and be 5pm, by the attending at 2pm and be 10cm, etc...) If women never had this information they might just continue to focus on their labor, getting through each contraction one by one, and living in the moment rather than trying to calculate how far they've come or how long they've got to go--which is impossible anyway, since everyone dilates at a different pace.

I had a home birth and had agreed in advance with my midwife that I did not want any checks unless she felt there was a problem with my labor or its progress. She could tell by my behavior that labor was progressing (and as the article above suggests, women's behavior is often a much better indicator of where they are at in labor, than dilation is). But if you talk with your provider in advance of the birth, maybe you could find out how much flexibility there is.

On one hand, it's your body, and if you don't want anyone sticking their fingers inside of you, you should have the right to refuse that. On the other hand, hospitals have protocols, and when women challenge them, sometimes doctors and hospitals get frustrated. But I wish more women would assert their wishes in this regard!

Another option is to tell them they can check you but you don't want to know the number. However if they felt you weren't progressing "fast" enough" this could still become an issue if they start to recommend intervention.

I think that women who want a natural birth have a much better chance of success if they refuse, or at least limit, dilation checks. As the previous poster indicated, birth works regardless of whether someone is checking. It is a process between the mother's body and the baby's body -- no midwife or doctor required unless there's an issue. You will know when to push because YOU will know. Your body will tell you loud and strong -- you don't need someone to tell you if you are not medicated.

I understand there are times when a cervical check is helpful, but I think that the frequency with which they are done often derails women's birth wishes unnecessarily. Plus every check introduces the possibility of infection which wouldn't otherwise exist, especially if your water is broken.

Phew sorry for the long post. Good luck!

Anonymous wrote:

Anonymous wrote:i chose with this last birth to not have any dilation checks. i didn't want all the expectations and pressure that come with knowing how dilated one's cervix is. i loved it. i was able to experience the stages of labor without associating them with a number or having any expectations of myself or a timeframe. i know it's tempting during labor to be checked but really for me i wouldn't have been happy with much other than "10" so i figured there was no point. and i think this might be part of why transition was easier the second time, because i just got through the contractions, and never knew how close or far i was from "the end".

Can you do this with a first labor? How do they know when its time to start pushing? I'd love to do this, but am not sure if I'd be allowed, or if its as good an idea when you don't have personal experience to get you through it...

[Anonymous]

W/re the dilation checks -- discuss it with your doctor in advance. It's part of my birthplan that I will only get checked at my request, and I had the doctor sign off on the birthplan at my 34wk appointment. That way, even if he's not there (which I know he won't be), the nurses are following his orders and not just my in-the-moment requests.

Just like anything, you are the patient, paying for a service. Many of these standard practices are standard, but arent medically necessary. Be informed, and advocate for yourself.

As for transition, can't tell you yet....am due any day!

[Anonymous]

I was at a hospital on pitocin without pain meds so transition was definitely very, very intense. Like others mentioned, I was in a bit of a zone/time warp and really focused on getting through each contraction (lots of counterpressure on my back and moaning). But, just when I felt like I couldn't take it anymore, it was time to start pushing!

I'm planning a home birth this time so it will be interesting how things vary.

[Anonymous]

here's a great post about trusting mothers, rather than dilation, to know when to push!

http://motherwitdoula.blogspot.com/2010/02/being-pushy.html

[Anonymous]

I had two unmedicated births. In both transitions, I had some shaking, I vomited, and I felt like I just wasn't getting a break any more -- the contractions just seemed to go on and on and on. Both times I semi-jokingly said I was ready for my epidural (semi-joking bc I was at a birth center and that was not an option). Time was totally warped, but I know transition was much longer with my second--that time, I started to get frantic, and my husband really helped to calm me down. It was true for me that the more I was freaking out (making high-pitched wails instead of low-pitched moans, tensing instead of relaxing, etc), the more it hurt.

Both times, transition ended when I suddenly, spontaneously pushed. (LOVE the "upside down vomit" comparison, PP, that's exactly how I describe it too!) I looooooooved the pushing, both times, because it was active and it meant the end was in sight -- pushing was easier than transition for me.

[Anonymous]

Transition (without any medication) is all encompassing but there was no shouting or screaming. You are so intensely involved in it and it only that in a way you aren't consciously thinking. I knew I was very far along and had no plan to get an epi at that point so I didn't think about it. If you are still asking yourself, "should I?" I think the very question would make it harder because it makes you think about trying to escape it rather than riding it out.

The idea of having to push if you don't have an epi is laughable to me. I couldn't not push no matter how hard I tried. They wanted me to wait until they could confirm I was at 10 cm (for reasons I understand) but I just couldn't do it. I could push less but the pushing wasn't something I controlled.

[Anonymous]

Anonymous wrote:Hello again! I saw someone replied and wanted to second what they said, and add some!

First I think this post is really interesting ... it challenges the traditional way we tend to think of dilation and how it relates to labor "progress".
http://motherwitdoula.blogspot.com/2010/01/and-while-were-on-subject-of-numbers.html

I think one of the hardest parts about having a baby in the hospital today is how much emphasis is placed on dilation. Women labor at different paces but hospitals expect your labor to follow a certain pattern or else they often want to "speed things up". So for me, one of the main reasons I wouldn't want my cervix checked is that I wouldn't want someone using my dilation against me, so to say, and suggesting interventions that I may not need, and that if they didn't know my dilation, they wouldn't suggest.

That said, it is probably very hard (but not impossible) to refuse dilation checks in the hospital. Most hospitals have probably rarely encountered women who refuse these checks. It has almost become a situation where women don't believe their body can give birth without being checked. With my first birth I never thought to question dilation checks. Now after attending births as a doula, I have seen so many women get pressured into interventions or get dejected and ask for an epidural, right after getting checked. They may hear that they are 5 cm and just give up -- nevermind that they might have dilated the rest of the way in five more minutes, and nevermind that the checks are subjective (I've seen a mom get checked by one nurse at 11am and be 3cm, by another nurse at noon and be 7 cm, by the OB at 1pm and be 5pm, by the attending at 2pm and be 10cm, etc...) If women never had this information they might just continue to focus on their labor, getting through each contraction one by one, and living in the moment rather than trying to calculate how far they've come or how long they've got to go--which is impossible anyway, since everyone dilates at a different pace.

I had a home birth and had agreed in advance with my midwife that I did not want any checks unless she felt there was a problem with my labor or its progress. She could tell by my behavior that labor was progressing (and as the article above suggests, women's behavior is often a much better indicator of where they are at in labor, than dilation is). But if you talk with your provider in advance of the birth, maybe you could find out how much flexibility there is.

On one hand, it's your body, and if you don't want anyone sticking their fingers inside of you, you should have the right to refuse that. On the other hand, hospitals have protocols, and when women challenge them, sometimes doctors and hospitals get frustrated. But I wish more women would assert their wishes in this regard!

Another option is to tell them they can check you but you don't want to know the number. However if they felt you weren't progressing "fast" enough" this could still become an issue if they start to recommend intervention.

I think that women who want a natural birth have a much better chance of success if they refuse, or at least limit, dilation checks. As the previous poster indicated, birth works regardless of whether someone is checking. It is a process between the mother's body and the baby's body -- no midwife or doctor required unless there's an issue. You will know when to push because YOU will know. Your body will tell you loud and strong -- you don't need someone to tell you if you are not medicated.

I understand there are times when a cervical check is helpful, but I think that the frequency with which they are done often derails women's birth wishes unnecessarily. Plus every check introduces the possibility of infection which wouldn't otherwise exist, especially if your water is broken.

Phew sorry for the long post. Good luck!

Very true, good post.

[Anonymous]

I'm poster 13:57 who was literally blown away by how painful transition was--I felt like my body was going to crack in half. However, it didn't help that I spent transition in the car and then in a wheelchair and finally in a hospital bed for about 5 minutes. I don't recommend this sequence of events. In retrospect I think I could have handled the transition period (or at least handled it better than just screaming bloody murder) if I had been in the same spot I was from 1-10cm (my home). The rest of labor was no problem. Painful, yes but I could deal. Riding through traffic in transition almost killed me (and my poor husband who was driving). And then having to sit still for an IV placement, etc. (I was GBS +) and answering the &%^%*ing admission questions---"what is your name, date of birth, etc" --well I almost died from the pain and couldn't get in the zone or relax or deep breathe or anything. I just screamed in pain and honestly wished I would just die on the spot.
I think I would have done much better with a home birth because I was in the zone at home. Changing locals at 10cm (30 minutes away) sucked.

As to this----

Anonymous wrote:The idea of having to push if you don't have an epi is laughable to me. I couldn't not push no matter how hard I tried. They wanted me to wait until they could confirm I was at 10 cm (for reasons I understand) but I just couldn't do it. I could push less but the pushing wasn't something I controlled.

I couldn't agree more. It was like every fiber in my being was involuntarily trying to eject the baby and my body just pushed. I don't remember ever thinking "I should push", it just happened. And happened fast----about 10 pushes and baby was out (and this was baby #1 so it was all new territory for my body).

I agree that if you are not getting anesthesia than there is no need for vaginal exams. I had none and I knew exactly what to do when. Or should I say, my body did.