Empowering Women Through Transition in Labour

Posted 25 Sep 2023

Childbirth is an extraordinary journey, each completely unique and also with distinct phases. One of the most intense and significant phases of labour is the transition phase. In this comprehensive guide, we’ll delve into what is transition during labour, including its physical and emotional aspects driven by adrenaline, and explore the intriguing “rest and be thankful” stage. We’ll also discuss effective strategies to support women through these phases of labour, including the complex emotional landscape that can resemble anxiety, and the common desire for medication or escape during this phase.

Understanding Transition in Labour

Transition is the final phase of the first stage of labour, following the early labour and active labour phases. It typically occurs when the cervix is dilated from 8 to 10 centimetres, signalling the near culmination of labour before the onset of the second stage (breathing/bearing down and birth).

Key Characteristics of Transition

  1. Intense Surges: Transition is characterised by powerful and frequent surges that last about 60 to 90 seconds each. These surges can be incredibly intense, with minimal rest between them. The intensity is often likened to climbing a steep hill just before reaching the summit.
  2. Cervical Dilation: The cervix opens fully during this phase, from 8 to 10 centimeters, preparing the way for the baby to move down the birth canal.
  3. Emotional Intensity: Women often experience a wide range of emotions during transition, from excitement and anticipation to fear and self-doubt. This emotional rollercoaster is entirely normal and partly due to the surge of adrenaline in preparation to soon meet your baby.
  4. Physical Symptoms: Common physical sensations include nausea, shaking, a strong urge to push, and sometimes hot flashes or chills. The adrenaline surge heightens the body’s alertness and prepares it for the imminent birth.
  5. Short Duration: Although it feels like an eternity, transition usually lasts from 15 minutes to a few hours. It’s intense but relatively short-lived, and it signifies that the second stage of labour, the actual breathing/bearing down and birth, is on the horizon.

The “Rest and Be Thankful” Stage

The term “rest and be thankful” is an intriguing aspect of labour that some women experience, often occurring between the active labour and transition phases. It’s like a brief respite, a pause in the intensity of surges. During this stage, surges may become less frequent, allowing the labouring woman to catch her breath and mentally prepare for the final push.

Characteristics of the “Rest and Be Thankful” Stage

  1. Reduced Intensity: Surges may become less frequent, giving the woman a break from the intense, rapid surges of the active labour phase.
  2. Sense of Relief: Women often describe this stage as a moment of relief and gratitude, as they can briefly gather their strength for the upcoming transition phase.
  3. Psychological Break: This phase provides a crucial psychological break, offering the woman a chance to regroup, gather her energy, and focus on the impending birth.

Primal Sounds

During transition, it’s common for women to vocalise their sensations with primal sounds. These sounds can range from deep moans and gutteral groans to loud cries. These vocalisations often serve as a natural way for women to cope with the intensity of their surges and channel their energy effectively. Birth partners and support teams should encourage and normalise these sounds, as they can be a powerful outlet for managing pain and expressing the emotions associated with labour.

Emotions Resembling Anxiety

The surge of adrenaline during transition can create sensations that closely resemble anxiety. Women may feel overwhelmed, restless, and even fearful. It’s important for birth partners and healthcare providers to recognise these feelings as a normal response to the intense physical and emotional changes taking place. Offering reassurance and support, along with practicing calming techniques, can help women manage these anxiety-like symptoms.

Desire for Medication or Escape

The intensity of transition may lead some women to request pain medication or express a desire to “escape” from the situation. It’s essential to approach these requests with empathy and understanding. While it’s crucial to honour a woman’s choices and provide information about pain relief options, it’s equally important to remind her of her inner strength and resilience. Many women find that they can endure the intensity of transition with the right support and coping strategies.

How to Support Women Through Transition and the “Rest and Be Thankful” Stage

Navigating transition and the “rest and be thankful” stage successfully involves a combination of physical comfort measures, emotional support, and effective communication. Here are some strategies to help women through these phases, including when they experience anxiety-like symptoms or seek medication or an escape:

1. Continuous Support

Having a trusted and supportive birth partner, pregnancy coach, doula, or midwife by their side can provide comfort and reassurance throughout these intense phases.

2. Encouragement and Reassurance

Offering positive affirmations and words of encouragement can boost a woman’s confidence, especially during the transition phase when emotions run high.

3. Comfort Measures

Providing physical comfort measures such as massage, counter-pressure, warm compresses, and position changes can help alleviate discomfort.

4. Breathing Techniques

Teaching and encouraging controlled breathing techniques can help manage pain and anxiety.

5. Creating a Relaxing Environment

Maintaining a calm and soothing birthing environment with dimmed lights and calming music can ease tension and promote relaxation during transition and the “rest and be thankful” stage.

6. Active Positioning

Encouraging the woman to change positions as she needs can help her cope with the intensity of surges and facilitate the baby’s descent.

7. Providing Nourishment

Offering small sips of water, and snacks can help keep the woman hydrated, especially during the “rest and be thankful” stage.

8. Support Decision-Making

Respecting the woman’s birth plan and choices is vital. If unexpected circumstances arise or if she expresses a desire for pain medication, provide information and support as she makes informed decisions about her care. If decisions need to be made you can utilise the effective B.R.A.I.N technique to support you in informed decisions making.

10. Patience and Reassurance

Remind the woman that both transition and the “rest and be thankful” stage are temporary. Encourage her to take one surge at a time and reassure her that she’s moving closer to meeting her baby with each one.

Conclusion

The transition stage is a pivotal phase in the labour journey. Understanding it’s characteristics, including the anxiety-like symptoms due to adrenaline, and the desire for medication or escape, and employing effective support strategies can profoundly impact a woman’s birth experience. As birth partners, doulas, midwives, or healthcare providers, our role is to empower women, foster their confidence, and ensure they feel safe and supported throughout the entire labour process. By embracing these strategies and acknowledging the complex emotions and sensations that can arise during transition, we can help women transition smoothly and positively into the exhilarating moment of welcoming their newborn into the world.

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