Transition is the most difficult but shortest phase of the first stage of labor.
Recognizing transition is extremely important in being able to cope with it, although there may be no definite transition experience. Know the signs so that you won't be surprised during labor.
Signs of onset of transition
You may experience any combination of the following:
- Feeling of pressure on the rectum giving the urge to push
- Severe backache
- Pain or ache in thighs
- Involuntary contractions of muscles of abdominal wall
- Sensitive to touch, particularly over abdomen and lower back
- Uncontrollable shaking, especially of extremities, sometimes quite violent
- Nausea, vomiting
- Feeling very warm or very cold
- Feeling very irritable
- Amnesia and/or drowsiness between contractions
- Heavy show, usually streaked with blood
- The membranes, if still intact, will probably rupture at this time followed by a gush of amniotic fluid.
Contractions during transition:
- Contractions may be irregular with more than one peak (double-header).
- Contractions will definitely be much stronger, lasting longer with shorter intervals between them (1-1/2 to 2 minutes long, with as little as 30 seconds between them).
Your feelings during transition:
- Strong sensitivity to attitudes, words and noises
- Fear of being left alone, even for brief periods
- Need for companionship
- Great need for gentle understanding and firm, simple directions
- Anxiety about progress of labor and well-being of self and baby
- Dependency upon those with you in whom you have complete confidence
- Inability to feel comfortable in any position for more than a few seconds
- Feelings of despair, "I can't take it any more," "This will last forever."
To help during transition:
- Recognize that these intense responses and sensations during transitions are normal. They are what we expect at this time. They are signs of good progress.
- You may be able to relax only between the contractions, but try to relax as much as possible.
- Report any changes to the nurse, physician or midwife in attendance when you become aware of them, especially any urge to push.
- During contractions, concentrate on breathing and focus.
- Between contractions, rest in the most comfortable position.
- You will probably need to change position frequently. Do so between contractions.
- Apply hot packs to low back, abdomen and/or perineum.
- Remember that normal transition is short and intense. It is the bridge from the first to second stage of labor, when your head will be clear and the contractions will be less difficult. Take contractions one at a time, since each one might be the last. Remember that this is the transitioning stage and the baby will soon be here.
- Make sure the mother does not lose her ability to respond to coaching or suggestions. Continue to support her.
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