Transition. (End of First Stage)

 

What’s Happening: Cervix dilates fully from 8 to 10 cm. Contractions are only 2-3 minutes apart, and may 60-90 seconds. Physically and emotionally, this stage of labor is very intense for mothers.

Duration: Range: 10 minutes to 2.5 hours. Average is about 1 hour in first time moms. 

Mom’s mood: Because of the intensity of transition, mom’s moods may be volatile. She may be irritable, hostile, confused, disoriented; she may feel trapped and want to go home; may fear she is dying; often very dependent; discouraged or exhausted. It is common for her to say: “I can’t, I can’t.”

Mom’s Physical State: Again, because of the physical intensity of labor, mom may shake all over, her limbs may tremble, she might have nausea and vomiting, prickly feeling to skin, extreme sensitivity to touch, may feel very hot then very cold, may be belching or passing gas, perspiring, or having muscle cramps.

What Partner can do:

·    Assistance with comforting specific physical concerns (e.g. warm blankets, cool cloths, massaging a cramp, etc.)

·    Be sensitive to cues, and try to follow her lead; her needs may change from moment to moment, so what was working before may no longer work.

·    Give short, simple directions. Don’t ask a lot of questions: if you need to ask something, make the question specific. Offer 2 options to choose from; don’t ask “what can I do for you?”

·    Don’t leave her alone. Stay within arm’s reach.

·    Keep your face close to hers; with direct eye contact.

·    Breathe with her to help her focus on breathing techniques. Hee-Hee-Blow; variable.

·    Most important: reassure her. Let her know she’s OK, that these are normal signs of transition, and that labor is nearing its end. Be supportive, and stay as calm and grounded yourself as you possibly can.

Take Charge Routine

Sometimes a mom will have a really hard time with transition. Her support person should move in very close and ask her to keep her eyes open so they can establish clear eye contact. He then should speak calmly and authoritatively, giving specific instructions about breathing, to help her focus again.

She may not be able to calm down, relax and focus at this point, so this should not be your goal. Just work to find some effective coping techniques and a ritual for handling the contractions.

 

Janelle Durham, 2004

 

Second Stage of Labor