This is typically described when the cervix is between 8-10cms.  Transition can be tumultuous and explosive for women.  They are generally tired, after having laboured for a number of hours, and can find this time very challenging.  Waves (contractions) are coming very close together, and lasting for probably around 60secs.  She

appears to not get much of a rest between these waves.  This is a common time for women to ‘lose the plot’!  They ask for drugs, will tell you they can’t go on, don’t want to have a baby anymore, want to go home, why is it taking so long, and very often tell their partner that this will be the one and ONLY baby they will be having!  Women can be frightened by the intensity of transition.  They can make a lot of noise and feel ‘out of control’.

Men are also likely to be very worried and anxious about her behaviour during transition and may well agree that drugs are definitely the answer, secretly hoping that he may also be offered some ‘medication’.

Some women are very calm during transition, and all you may notice is a change in her breathing.  These are the women who have really worked on clearing and healing their mind of fears during pregnancy and are experiencing an enjoyable labour.  She may seem very focused or a common description is ‘in the zone’.  They become very quiet, wanting to be alone (toilet is a wonderful safe & comfortable place).  This is a beautiful state to witness.  You can see and feel that a woman is not aware of reality, she appears to be on another planet.  It is a bridge between the last dilating waves and the beginning of bearing down in the second stage.  With a baby in a favourable position transition should not last for very long.  For some women it only lasts for 5-15 mins.  For others it can last and hour or two (this is unusual and may be due to the baby being in a posterior position).

Transition is a particularly sensitive time – while the final opening is taking place, women have an awareness that they are on the threshold of giving birth.  Like the moment before orgasm, a woman needs to be without disturbance or distraction so that she can give in to the involuntary impulses which will bring her baby into the world.

Women who are fearful can feel nauseous or even vomit, trembling all over and feeling hot.

It is common to feel frightened during transition.  Many women feel they cannot go on or that they will die.  These fears are irrational and often not even conscious.  Michel Odent calls this ‘physiological fear’ and believes that this fear just before giving birth has a useful function in raising the level of adrenalin.  He suggests that

whereas in labour adrenalin could inhibit the work of the endorphin-like hormones, now it has a useful function in  helping to trigger off the involuntary expulsive reflex of the second stage.  In his observations, if a woman is left more or less alone to experience this fear, a quick and efficient expulsive reflex usually follows.