If you are currently pregnant or have had a baby in the past….the word transition takes on a whole new meaning. For most women this is the ‘big scary’ – the part of the labor that so many women fear so deeply that they plan to offer up their veins and their spine to prevent feeling it, often planning before labor even begins simply because they have heard enough about this from friends to scare them into doing whatever it takes not to experience it.

I hear so many women ask the questions, “How can I prepare to cope with it?”, “How can I avoid it?”…but I wish more women asked the question, “Why is it so difficult for so many women?”

I have seen women who apparently breeze through transition, and I’ve seen women who are traumatized by the experience. While there is no answer that is universal, there are often generalizations – and IN GENERAL I see two major contributing factors that most often determine the degree of difficulty a woman might have with transition.

The first (and probably most common) source of challenge is this: It is often the one time in her labor that she is truly fighting her body AS WELL AS being encouraged to fight her body’s urges by her birthing team. She has spent hours “releasing”, “breathing through”, “relaxing”, “letting go”…..these are all things that are commonly said to women as they labor for their babies. Drop your shoulders…open up for your baby….relax your jaw muscles as a relaxed mouth is a relaxed vagina…relax relax relax.

In transition, your body is beginning to tighten down, pressing the baby down with contractions rather than just pulling the cervix up against the head. If the urge to push is similar to the urge to vomit in that your body says “GET OUT!”, only pushing down rather than up…then we can say that in transition your body begins to gag. Her belly tightens up, she becomes “grunty”, her noises become primal and guttural and everything shifts downwards.

So the mother, laboring in peaceful relaxation, is suddenly writhing – with her team telling her to let it go, don’t fight it, RELAX! Except…wait a moment…her body doesn’t WANT to “relax”!! So she struggles, trying to relax…it’s not working, her body is tightening. She fights to relax…grunts down…gets mad at herself because she can’t relax! Until finally she yells, “GUYS…I CAN’T DO THIS! HELP ME!

What can’t she do? Her team usually looks at her and says, “You can do this…you’re almost done!” because they don’t understand that she is fighting her body’s urges, she can’t RELAX. Encouraging her to relax will cause her to feel like she’s not doing it “right”, that she can’t do it anymore.

There is often a period of time before she gets that uncontrollable urge to push in which she CAN’T relax…and I have to wonder why she is being told that she needs to. She breezed through labor because she relaxed and allowed her body to work, let her breeze through transition by allowing her to follow her body’s natural cues and work with her body instead of against it!

Another common reason I see women struggling with transition is expectations of control. She will say with an embarrassed look, “I was so out of control.”

What’s wrong with that? Feeling out of control is almost a necessity when it comes to birth – giving up control to your baby and your body, becoming primal, flowing with the feelings as they come. Being out of control doesn’t mean you didn’t do a good job….it means you did it exactly right! Being vocal, grinding your hips…all can be wonderful things in labor!

But I have noticed that there can be a difference in perception between losing control, and giving up that control. One is having it stripped from you as you scrambled to keep it – and the other is offered up willingly for your baby, feeling safe enough with your birthing team and your body and your baby to WILLINGLY give up that control, surrendering verses being conquered.

So a second time mom says that she is afraid she will lose control just like last time…I usually encourage them to prepare to GIVE that control up, willingly. Surrender to the primal, gift it to their baby.

Does this eliminate the challenge of transition? Of course not…birth is dramatic, and I think it should be. But I will say that when I encourage women to listen to their bodies (rather than relax), help mothers realize that they are safe and strong and capable and create an environment where the mother can be comfortable enough to give up control…..RARELY do I hear mothers say “I can’t do this”.

And for those mothers, transition is usually just a blurry line somewhere between labor and pushing, where she’s not laboring but not exactly pushing yet….rather than an entity all its own.


  1. Dianne wrote:

    Another great post Stephanie! I get so frustrated when I’m laboring with a mom in a hospital and she’s told to stop pushing/grunting because she’s not completely dilated and will ruin her cervix. One I’m thinking of recently, mom was 6cm when checked 30 min. prior and just a few contractions later was grunting. The above was said to her and she looked at me like, “You’ve got to be kidding!” I whispered for her to just listen to what her body was telling her and she pushed her baby out a couple contractions later! Yes, listen to your body…It’s usually telling you the truth.

    Saturday, October 8, 2011 at 1:59 pm | Permalink
  2. Angela wrote:

    Bravo!! When speaking of labor I often relate that there will come a time during labor for most women when they can’t relax as they had previously. It’s norma, as you so eloquently outlined. When we reach that point I try to focus on encouragement for them to follow their body’s cues, what your body may be telling you to do might seem strange to your rational brain, but get out of that brain and go “cave woman” just follow.

    Then we focus on relaxation between contractions. Letting those shoulders down, letting that tension go,it’s often a brief respite, but even just a minute of relaxation can be very refreshing. And if she can’t achieve that, then we just focus on one thing, “let your eyebrows relax” (gentle touch right across the brows. Often her eyebrows relax, her jaw follows, and the rest of her body just surrenders. Then we rev up and take on the next contraction.

    Saturday, October 8, 2011 at 3:25 pm | Permalink
  3. Diana wrote:

    Heck, I’ve never managed to relax through ANY contraction, let alone those in transition! LOL!!

    Great article! 🙂

    Saturday, October 8, 2011 at 3:54 pm | Permalink
  4. Kelli wrote:

    Personally at this point I found it helpful to give up control of my body but focus on relaxing mentally, I think the term for me should be “Stay calm” instead of relax. I’ve even told Joe that for future births he just needs to remind me to stay calm and then to remind me to be gentle once I get to pushing.

    Tuesday, October 11, 2011 at 4:52 pm | Permalink
  5. Maren Meacham wrote:

    Wow reading this I had a flashback to Atticus’s birth. I am one of the dramatic ones. It is what I need to do in order to birth my baby. It is hard work and I am going to do whatever I feel like to get him or her out.

    I have never feared transition but have said the famous “I can’t do this” phrase. Saying it for me allows me to let the idea of control go.

    Thank you again for another wonderful post!

    Friday, October 14, 2011 at 1:28 am | Permalink
  6. Karen Joy wrote:

    I really like that idea of surrendering control — GIVING it up, for yourself, for the baby — rather than having it stripped from you.

    I’ve had five dear children, and transition has always been quick for me, and always welcome (other than my first — it freaked me out) because I realized how very, very close I was to having my baby here. I read recently, though, that during transition, the body releases adrenaline, which, prior to transition, is the enemy of a peaceful birth — it is the endocrine-opposite of oxytocin. So, we women are flooded with that “masculine” hormone that induces a feeling of fight or flight, and even aggression and power, and I think it can be disconcerting to a lot of women, who typically don’t have as much adrenaline in their systems as men do… It can be a confusing time, confusing emotionally… but I like the idea, too, that adrenaline is what enables people to do feats of superhuman strength — like lift a car that has rolled on top of someone else. Or, like BIRTH A BABY. Adrenaline, released during transition, allows us to have that amazing strength and endurance for the second/pushing stage of labor.

    Great post.

    Saturday, October 15, 2011 at 1:27 am | Permalink

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