Transition is the most difficult phase of labor for most women; however, it is also the shortest phase generally lasting ½ hour to 1½ hours in length.

Physically, mom is experiencing contractions 2-3 minutes apart, lasting 60-90 seconds, and are very strong in intensity. Contractions may even "piggy-back" which means one contraction may start to fade away and another one comes along immediately. During this phase she may notice increased bloody show; nausea, vomiting, burping, or hiccups; shaking; hot/cold feelings; fatigue; and sensitivity to touch. Additionally, she may indicate increased pressure on the perineum and/or rectum.

Emotionally, mom can become restless, irritable, discouraged, and confused. She may find that she focuses inward as she works with her labor. She may have a hard time communicating her wishes. This is the point in labor when she usually needs the most support.

During transition, labor support is crucial for the mom's physical and emotional well-being. Partners should remain with the mom; give firm, clear, positive, and simple directions; remind her to change her positions; assist with breathing patterns; offer a cool washcloth for her brow and lip balm; and keep her hydrated with water and/or ice chips. Remind her to take one contraction at a time and not to give in to the panicky feelings. If Mom Panics: call her by name, take her face in your hands, develop and maintain eye contact, breathe with mom or talk her through the contraction, try variations in breathing patterns, and give lots of reassurance that she is near the end! Remember, any questions for mom should be asked BETWEEN contractions and not during. Watch for signs that she has to push (grunting or pushing sounds). If she indicates she needs to push, tell her to lift up her chin and pretend she is blowing out birthday candles one by one. She needs to be checked by her caregiver to see if her cervix is completely dilated. If not and she pushes prematurely, her cervix could swell or tear.

Once the caregiver gives the OK, mom is ready to begin the second stage of labor-pushing.

Phrases and Words of Wisdom From the Partner

There are many more phrases you may use during the labor. The important thing is to keep talking. You cannot repeat yourself too often, especially when reminding her to relax and concentrate. Remember, all words MUST be positive!

References:

1. Bobak, I., Jensen, M. Maternity & Gynecologic Care: The Nurse and the Family. (1989) St. Louis: Mosby Publishers.
2. Nichols, F., Humenick, S. Childbirth Education: Practice, Research & Theory (2000) Saunders & Co.
3. Whitely, N. A Manual of Clinical Obstetrics (1985) Philadelphia: J.B. Lippincott Company.
4. Reeder, S., Martin, L., and Koniak-Griffin, D. Maternity Nursing: Family, Newborn, and Women's Health Care. (1997) Philadelphia: J.B. Lippincott Company.