You’ve read about it. You’ve talked about it. You’re totally prepared for it…right? Until it actually happens, no couple can be totally ready for what they will feel, say, and do during childbirth…especially when she gets to transition. Transition, the shortest of the three phases of the first stage of labor, is the most intense as well as the most physically and emotionally demanding phase. For those that have been planning a natural childbirth, it is also a time when many women want to change their birth plan and ask for pain medication. The good news is that since transition is the shortest phase, when she finally gets to it (at about 8-10 centimeters) she is almost there!!
The following is a list of the top ten things I have discovered to be very common among women working through labor, especially if she is doing it naturally! If you have experienced or assisted someone through labor, you might remember these moments with a chuckle. If you are about to embark on a natural birth, either personally or as a coach for your wife, partner, sister, daughter, niece, or best friend, my hope in writing this list is to alert you to these very thoughts, feelings, and actions that you/she will probably experience.
It is easy to get scared when your loved one is in so much pain she wants to change her birth plan. Not to say, of course, that a woman shouldn’t have that right. There is a great chapter in the book The Birth Partner by Penny Simkin that describes this very phenomenon and suggests reviewing the “Pain Medications Preference Scale” and discussing the use of a “code word” before going into labor. I highly recommend this book as part of your childbirth preparation. However, if more couples knew about these thoughts, feelings, and actions, they might realize what their labor & delivery nurse, midwife, or doula already know…that she is acting totally normal!
10) “I don’t know how much longer I can do this!”
Many L&D nurses are used to hearing this phrase typically as a woman begins the transition phase. When you hear it, know that reminding your loved one of how much progress she has made and how little she has left to go will probably help her cope. Many women mistakenly feel that if their labor took hours and hours to get to this point that it will take a comparable amount of time to get to the second (or pushing) stage. Except in the rare case of arrested dilatation, this is NOT the case! She is way more than half way there, in fact, she is almost done!
9) “I’m done!”
Wanting to “give up” and just have it be over with is also a common desire of a woman going through natural labor. It may be helpful to remind her that the pain she is in right now does not feel as bad as holding her baby will feel good!
8.) Throw Up/Burp Frequently
Vomiting is a common sign of the transition phase, whether or not a woman has been eating throughout early labor. Some coaches find this hard to handle. Think of it as a way of “making more room” for the baby J. In fact if something was rhythmically squeezing your insides, you would probably throw up too! And let’s be honest, with a new baby around, you are bound to see a lot more throw up! Since vomiting, like holding your breath or making a bowel movement, is a vagal response, it inadvertently helps your cervix dilate and hence, is a great sign to a labor & delivery nurse! The body does awesome things to help the process along!
7) “No really, I have to poop!”
As the baby descends further into the pelvis with each contraction, the pressure on the rectum becomes incredibly intense. So intense, in fact, that it feels exactly like the need to have a bowel movement. I can’t tell you how many times I explain to a patient who is in early labor that if she feel rectal pressure “like she has to poop” that she has to call me first and NOT just get up to the bathroom. But time and time again when my patients begin to feel this pressure what doe they do? They almost always get up and try to poop! Many a woman I have found on the toilet straining to pass a BM and when questioned, try their best to convince me, “No, you don’t understand, I swear I have to poop!” Okay, okay, if you had just eaten a meal and it was during early labor, I would agree. But you are 8 centimeters now so TRUST ME! It is the baby! (SEE: Top 10 DOs & DON’Ts of Pooping During Labor & Birth)
6) Shake/Tremble
The hormonal rush a woman experiences during labor, especially natural labor, is overwhelmingly intense. These hormones will cause all women to being to shake as they approach full dilation. This shaking, in fact, continues for at least an hour post partum, even after a cesarean section or medicated labor. Many partners and family members try to pack a woman with blankets to help her out only to find that she insists on not only ripping off the blankets, but sometimes even her clothes! In reality, it is unlikely that she is cold and if you continue to ask her if she is, she will just start to get irritated with you. It’s normal to shake, I promise J
5) “Can’t you just take/cut the baby out of me!?”
Even the most level-headed, experienced mom can sometimes feel so out of control that she begs for a c-section. Trying to rationalize with her is not going to make it better. As an L&D nurse, both you and I know, as well as she, that a cesarean might seem like less pain now, but it is a hell of a lot more pain later! It might be helpful to gently remind her that she is almost done and that everything she is doing to regain control of her breathing is helping the baby. But please don’t try to reason with her…you are just going to upset her!
4) Cry
Whenever a patient of mine begins to cry, my heart always starts to break. It is at this moment that most L&D nurses, partners, and other birth coaches wish they could trade places with her, if even for a moment, to just give her a small break! (Alas! If only it was possible!) If my patient begins to cry, I try to gently persuade her to save her tears for happy times when the baby is born and that crying is only going to give her a headache and make her feel more terrible.
3) “Don’t touch me there/like that!”
Many birth coaches are hurt to discover that the techniques that were working wonders in early labor only make their loved one upset and annoyed during transition. In my experience the major culprit is rubbing her belly! I know, I know…all the Hollywood movies show the father of the baby rubbing mom’s belly as she moans through her contractions. Looks loving and almost romantic right? WRONG! (At least during transition anyways!) To all the well intentioned fathers and birth coaches out there, my humble advice to you is this: unless she asks, don’t rub her belly…seriously, don’t!
2) Ignore You
The only time I start to feel bad for the partners and labor coaching working with my patients is when their loved one starts to ignore them. In reality, it is a fantastic coping mechanism! Fact: Women often do not know what they want during transition. They feel out of control and utterly uncomfortable in every way. So when you ask her if she wants a sip of water or a cool cloth on her forehead or to change position what does she do? She ignores you! It is hard for me to explain that this is normal while in the labor room so since I have the opportunity now, I would like to let all birth coaches know that your loved one is no longer with us. She is in her own world so she can make it through! Hence don’t ask her any questions, especially silly questions! My humble advice is to just do what you think will help and she will tell you otherwise if it is not working. Many women can only talk in one work responses at this point anyways: “No!,” “Stop!,” “Drink!,” “Stronger!,” “Softer!,” “Oww!” So just hold the straw up to her face; if she wants to drink she will! If not, she’ll tell you! And while I am on the subject, please don’t take offense if she is short with you. Just do what she asks with an understanding smile and for the love of God please don’t sass her back! She is, after all, having a baby!
1) “This is the last/only time I am going to do this! No more babies for me!”
If every labor and delivery nurse had a dollar for each time we heard a woman say this during labor, we could bailout this country single-handedly! This comment makes me chuckle every time I hear it. Let it be known that once she has that baby in her arms, she is going to forget all about the pain. What she will remember is how well loved and supported she felt during the whole process. And if you have done your job right, she is going to want a lot more kids someday!
Nursing Birth 