false/early transition signs?

[sweeetpea]

I am seeing this with a number of clients. While still fairly early in labor, mama shows the "classic" signs of transition - shakes, nausea, contractions right on top of one another, even rectal pressure - only to be 4-5 cms dilated. I have seen this more common with OP or malpositioned babies, but not always. This is really disheartening to some of the mamas, since they are hoping to be almost done. Often labor stalls a bit after they've heard the "bad" news of 4-5 cms.

Anyone else seeing this and have any thoughts other than baby's position being a contributing factor?

[laoxinat]

I am not a midwife, but a long time lay-student of birth and have attended several births. What I have come to understand is that the symptoms of transition are much more indicative of progress than the dilation of the mom. IOWs, just because she's 'only' 4-5 cms doesn't mean she won't be at 10 in a matter of minutes. I would avoid VEs until a mom is pushy, and even then as quick as possible. Others here have far more experience than I do, obviously . but that's my $.02...

[thixle]

I have to agree- a VE can cause the cervix to pause, or even shrink up a little. Just don't tell them a # and they probably will be pushing in no time.

[BirthFree]

Well and sometimes... not always... I see Moms who know the way things work for themselves in labor, emphasizing certain signs with hopes of being done. That sounds bad... and I don't mean in any sense of the word that they are "faking" or ANYTHING of that sort. But does that make sense.

Sorry, I'm not sure that came out correctly... hoping it did!

[DoulaLes]

Oh--I have a completely different theory! This has happened to ALL of my clients who have had some type of surgery or procedure on their cervix. ( ie. leep, cryo, etc..) I now ask about this in ALL my prenatals and if it has been done on them, I make a note to myself and then when in labor when mom is acting appearing like she is in transition but is only at 3cm, I make sure they remind their care provider ( if they had not reminded them before hand which I always encourage them to do!!) For woman who do talk it over with care providers and want to be proactive, they can do EPO to soften any scar tissue. For moms who do not do that beforehand, it usually takes a breaking of the scar tissue band on the cervix for dilation to occur "normally."

I have had 5 clients with this so far--and with the ones that we reminded the care provider and they broke the band, then the births went back to "normal." ( meaning mom began to dilate quickly and looked like she was in transition because she really was!)

Soo--all that to say, if you see this happening, you may want to ask about any previous procedures that may have affected the cervix.
This has just been my experience!

[bobandjess99]

This just happened to me in my birth!!!!( 8 weeks ago)

I never had the textbook transition signs in my firat birth (both have been UC), so I was really taken aback during this labor when I get the shakes. It was BAD..I felt AWFUL, my whole body was shaking uncontrolably...I was so upset, it disoriented me badly, but then, after i got back on top of myself, I was overJOYED, because I thought "YES, transition, it's almost over!!" Well...another HOUR goes by....I'm lke..hmmm......so I check myself (something I am very comfortable doing) and I'm at like 5-6 cm's!!!!!!! I was SSSOOOO upset....the shakes subsided, but the pain got worse and worse....and it was still several more hours before ds was born.....I never had any cervical procedure, never had a vaginal exam by anyone other than myself, even, so that can't be a factor for me. (Well, dh has inspected it with his..umm..special inspecting tool....)LOL.
It was HORRIBLE. I'm certain than for someone a little less committed to natural birth, it would have been so easy to just give up at that point...hell, if *I* could have, I'd have thrown in the towel and asked for an epidural, but alas...I was at home, with no access to drugs......

[Alison Cole]

I had a midwife once tell me that primips have two transitions -- the first comes when they move in to active labor (4ish cms) and the second at the 8ish cms we would think of as "true" transition. Sort of a reckoning with the powerful forces of labor. I'd be interested to know if you're seeing this mostly with primips.

[time4another]

That was true for me with my first DD Alison...

[MsBlack]

I agree with Alison--

Some women, especially 1st birth, have this 'early transition' which to me signals that labor is now getting serious. I seldom see it in women who have already had at least one natural birth, but it can happen to anyone and certainly to any woman who either never labored (scheduled csed) or labored w/epidural. The symptoms ease off as mom integrates the new level of intensity....and I seldom check for dilation at this point (seldom do VE anyway).

Have a few times seen these transitiony signs with a well moulded baby-head who is able to descend quite low with cervix stretched tight over her/his head with little dilation. Now that is a tough one--usually only knee chest reduces the intense urge to push, and it is a marginal reduction at best.

[Malga]

I had a midwife once tell me that primips have two transitions -- the first comes when they move in to active labor (4ish cms) and the second at the 8ish cms we would think of as "true" transition. Sort of a reckoning with the powerful forces of labor. I'd be interested to know if you're seeing this mostly with primips.

:

I have seen this with primes.

[scifimom]

Very interesting, I just sat thinking of the worst cases I have seen of this and they have all been first labors, I want to ask them about cervical scarring now lol.