Transition questions

[Swandira]

I had a conversation about birth today with a friend, and it made me wonder if I'm all that unusual. I've had an epidural with both previous babies, and while the first one was great, the second didn't go well for me at all. It was too heavy (I couldn't move my legs for quite a while) and my pulse and temperature shot up uncomfortably for about an hour. It was really scary! The second time, I had waited until transition to get it (actually, I waited through about an hour of transition, and then when the doctor checked me and I was still at 7, I got the epidural. It still took me another 2 1/2-3 hours to get to 10 cm after that, which is actually much faster than I had been dilating until then.

So my question is this: is it normal for transition to go that slow? (My friend today said she'd never heard of a transition longer than 45 minutes before. Surely I'm not the only one?) I know, I had an intervention, but I had been dilating very, very slowly before the intervention, and after it I only dilated slowly. KWIM?

I'm really, really hoping to avoid the epidural this time, but honestly I doubt I'd be willing to sit through several hours of transition, especially if I'm already 24 hours into labor when it starts!

I'm not trying to start a "pissing contest" over whose labor was worst and who endured the most; I just want to know if there's any more I can do. I've read practically all the natural-childbirth classics; I took Bradley classes; I had a great doula at both births; I stayed mobile; I stayed hydrated. What more can I do to get things to move along so that I can tolerate transition without drugs? Because the transition that I've experienced was interminable and blindingly painful with shaking and dry-heaving and memory loss. I could take that for half an hour, maybe, but for several hours it just doesn't seem worth it. What can I do? Tell me this isn't a hopeless situation where I'm destined for either a medicated birth or hours of unbearable suffering!

Nealy
mama to T, 5; L, 2:; and EDD 12/20/08

[bobandjess99]

usually, transition is quite quick....but all births vary. I was personally in transition longer than other parts of my labors...i get "stuck" at 9....i was in transition for 7 hours with dd and about 3.5 with ds.

[kathan12904]

Like all parts of labor, transition will vary greatly from woman to woman. I've heard many pregnant mom's be discouraged by the observation that "it took you this long to get to 6cm, imagine how long the rest will be" Not all labor moves at the same pace. You are more likely to have later labor take less time than early labor because your body is more well practiced and your hormone levels are higher, but try to keep in mind that there is no rule book and if there was one, it would be inaccurate at least half the time. Time frames on labor and labor phases are always an average and that means that if the book says transition takes 2 hours, you know at least one woman took 2 minutes, and another woman took 4 hours, as long as she was allowed to labor the way her body wanted. Not to mention, not every woman gives birth as soon as her cervix is fully dialated. I had to wait a couple of hours between full dialation and birth b/c my big headed baby needed longer to mold and turn to come down and be born. Thank goodness I wasn't on anyone's timeclock.

[veronicalynne]

Originally Posted by kathan12904

Like all parts of labor, transition will vary greatly from woman to woman. I've heard many pregnant mom's be discouraged by the observation that "it took you this long to get to 6cm, imagine how long the rest will be" Not all labor moves at the same pace. You are more likely to have later labor take less time than early labor because your body is more well practiced and your hormone levels are higher, but try to keep in mind that there is no rule book and if there was one, it would be inaccurate at least half the time. Time frames on labor and labor phases are always an average and that means that if the book says transition takes 2 hours, you know at least one woman took 2 minutes, and another woman took 4 hours, as long as she was allowed to labor the way her body wanted. Not to mention, not every woman gives birth as soon as her cervix is fully dialated. I had to wait a couple of hours between full dialation and birth b/c my big headed baby needed longer to mold and turn to come down and be born. Thank goodness I wasn't on anyone's timeclock.

Do you mean that you didn't feel the urge to push as soon as you got to 10? I am just asking because when I got to 10 the ob/nurses were bugging me to push even though I didnt feel the urge yet. I had the urge before I got to 10 but it stopped and then started again. I thought I rememberd reading that there can be a pause when you get to 10 until the urge to push starts...is that true?

Swandira, wow your transition sounds worse than mine (no pissing contest here). I know I just rode the waves or tried to....and went inside myself. In my case, I was sooo determined not to have an epidural (in my case, they are awful for me and baby and led to c/s). Oh, I also chose to have the (what is it called) nitrous oxide (?)....to be honest it didn't help with pain at all but was something else to focus on. I hope someone here can give you some good advice to help you with transition.

[stacyann21]

I thought transition was from 8-10 cm? Anyway, I arrived at the birthing center at 8 cm and it took a little over 3 hours to get to 10 cm. I didn't think anything of it (nor did my midwife). Sure, it was very painful but having an enormous syringe filled with anesthetic inserted into my spinal cavity never crossed my mind.

[mikayla's mama]

I too thought 8-10 was considered transition. I had one epidrual/pitocin labor and transition drug on (not sure exactly how long I was in so much pain for so many hours), not including the over 4 hours it took to push her out.

My second labor, completely natural was about 30 minutes from 8-10cm, that's including the 7 minutes to push her out... so maybe 20 minutes.

My first was malpositioned so that affected the rate of dilation with her head not pushing the right spots.

[Jilian]

Transition varies and can take up to 3 hours depending on the person. I think there are a lot of mental/emotional issues that can greatly effect how quickly you progress. You need to be completely relaxed and "loose" in order to progress effectively. So if something is bothering you (fear, anxiety, etc) you will likely be tense so your body will be fighting the contractions and not letting them do their jobs. That is why some women will take a loooong time to progress. And some women will progress faster with an epi in this case, because it helps them to let go.

Ina May Gaskin addresses this issue nicely in her books. As a labor doula I've seen it in action. The mind is the biggest inhibitor of labor.

[Swandira]

OK! So if what happened with my last birth, with the uncontrollable shaking and loss of time and the vomiting and searing pain with contractions one on top of another was not, in fact, as bad as it gets (everyone says it gets worse at the onset of actual transition, which, if it's not at 7, I suppose I've yet to experience unmedicated -- assuming I'm correctly remembering the dilation I was "stuck" at), then I'm even more discouraged now! I really want to have a birth that is as simple and uncomplicated as possible, and I learned last time that the epidural does not always lead to "simple and uncomplicated" for me.

My friend who made me feel like a martyr yesterday suggested I should probably just plan to get an epidural at 4 cm this time and skip the whole problem, but that doesn't sound like me. At 4 cm I'm uncomfortable, but nowhere near wanting anesthetic assistance. Also, that would require me to be in the hospital for hours and hours, which I have done twice before and would prefer to avoid.

I wish I could believe that it's just anxiety that causes me to labor for so long, but it just doesn't make sense that that's the only factor or even necessarily the main one. I know several tenser people than me who have had much shorter, less complicated births than me. I'm sure that the more relaxed my attitude, the shorter it would be for me, but I've always been really calm and laid-back in my early labors, and still the progress was extremely slow.

The problem is that last time, there was something that happened at 7 cm or so that changed my experience so much! It suddenly became -- in the space of three or four contractions -- practically intolerable. I couldn't find any way to get even remotely comfortable, and the contractions were coming so fast, and it just went on and on and on until I just gave in and requested the meds. Just about all the natural-childbirth books tell you that when it gets to where it seems you can't go on anymore, you can take heart, because it's almost over then, but that turned out not to be the case for me! In fact, it seems I was nowhere close. I feel sort of betrayed, but of course that's what happens when you rely on books to tell you what to do.

I feel as if I'm just whining and complaining. I know no one can tell me how to cope with my own experience, or whether I'm going to have a similar or different labor this time. I know there's no easy answer and that I may have to deal with either a long and miserable labor or possible drug-related complications. Maybe what I want is to hear someone say, "I had two (or more) practically interminable and highly unpleasant labors, and then my next one was more normal, and here's why!" But I suppose it's unlikely that anyone out there has a magic answer for me. I just kind of hope against hope that there might be one!

Nealy
mama to T, 5; L, 2; and EDD 12/20/08