How to Get Through Transition During a Natural Birth

When I was pregnant with my first baby I planned a natural birth...

...but I was really nervous about how I’d get through transition. I wasn’t sure how I’d deal with it when things got really intense. I did get through it with that baby - and I’ve now managed transition during a natural birth seven more times!

Changing positions can ease the intensity of transition and help your baby move into the best position to push. Vocalize when contractions are hard: keep your tone low to help your body open. It’s okay if you lose control of your breathing when it’s intense. Breathe in through your nose and out through your mouth between contractions, like an athlete.

You’ve probably heard stories of transition: back-to-back contractions, screaming, and even throwing up. While all of those can be part of this stage of labor, there are things you can do before labor ever begins and techniques that both you and your birth partner can use to help get transition over and done - before you know it.

What to Expect During Transition

While nothing can fully prepare for you for labor, you can do a lot to feel ready. As “natural” as birth and transition are, labor goes a lot more smoothly when you’re prepared and have skills!

Transition is often unmistakable because contractions feel very intense and seem to come one right after another.

With my fourth baby I went from 3 cm to fully dilated within just a couple of hours. I didn’t believe I was as far along as I was, but remember saying to my husband, “these are not stopping.” He asked me if I wanted to get into the birthing tub and I’m so glad I did. My water broke on the next contraction, and our baby was on the way with the next!

Here are some signs of transition:

Longer, more intense contractions with little break in between
Nausea and vomiting
Sweating
Shaking, trembling, or shivering (this is caused by birth hormone surges and is normal)
Feeling scared to move
Feeling like you can’t get comfortable
Feeling like you want to “give up” or ask for an epidural
Snapping at people
Loss of modesty
Intense pressure
Water breaks

Some of the things you’ve heard about transition are true - for example, women do throw up during transition. I had this happen with my second baby, and I’ll be honest, it felt really good once it was over with! Midwives often say that throwing up can help a woman’s body open up for a baby.

Yes there’s an ick-factor there, but natural birth is the real deal and you can handle whatever transition brings. I did feel much better after getting sick - and I started pushing my baby out just a few minutes later (my midwives handled clean-up like champs… I never noticed!).

Tips to Handle Transition During a Natural Birth

There are a number of techniques you can use to get through transition, including a couple before labor begins:

Practice breathing during pregnancy
Practice cue words for relaxation during pregnancy
Dance during your pregnancy
Use the bathroom at the start of transition
Change positions
Circle your hips
Get in the birthing tub
Sip juice, Emergen-C, or another drink with carbs and electrolytes
Rest during the short time between each rush
Think about your baby
Lean on your partner
Moan loudly and deeply, but avoid shrill screams
Use your breathing techniques BETWEEN contractions
Let it “get heavy”

Tools for your partner can use to help you get through transition during a natural birth!

Partner: tell her she’s almost done
Partner: tell her she’s doing great - or better, tell her she IS DOING IT!
Partner: help her breathe between contractions (model for her)
Partner: use cue words she practiced
Partner: wipe her face off with a cool cloth between contractions

(NOTE: Want a Perfect Birth Plan Template? Use this template and step-by-step videos to write a birth plan that gets your birth team on your side for a beautiful birth experience! Get the birth plan kit here.)

Transition Techniques to Start During Pregnancy

The best way to handle transition during a natural birth is using skills you practice before labor. Don’t worry - these won’t take much time to learn or practice, but it does work best if you practice daily.

Breathing

Forget the labor breathing you see in the movies - breathing like that during transition is more likely to make you pass out than to get your baby out! Instead, you want to breathe in through your nose, and out through your mouth, just like an athlete does.

Start paying attention to how you breathe now. You probably breathe in through your nose and out through your nose most of the time. But anytime you’re feeling short of breath, change to breathing in through your nose and out through your mouth.

Use this to slow your breathing down. It brings a lot of oxygen to you (and your baby) and it works to get breathing under control effectively.

It’s helpful for your birth partner to pay attention to breathing, too. Transition is intense and something as simple as catching your breath might feel impossible.

If your partner models good breathing, all you have to do is copy it. It may sound silly, but having my husband breathe so all I had to do was copy was a real life saver during every transition stage!

Cue Words

Relaxing on cue is an incredible tool while giving birth, but this one won’t work if you don’t practice it frequently. My top recommendation: practice when you go to the bathroom.

Here’s the unvarnished truth - your baby is coming through the birth canal, so your pelvic area is where things really need to be relaxed during birth. I like the word “soft” better than relaxed, and even today, if I think the word “soften” my muscles relax.

Plus, bathroom breaks happen frequently when you’re pregnant 😉

Pick your cue word and the next time you go to the bathroom, think or say that word while intentionally relaxing all of your pelvic muscles. It might help to tighten those muscles up first so your brain knows what you want to relax. Do this consistently each time you go to the bathroom and you’ll condition yourself to soften when you hear it.

During transition you can think this word to yourself, say it out loud to yourself, and/or have your partner say it. It may not help at the height of transition, but repeat it between contractions.

It’s also helpful as you push your baby out, especially during crowning. I said (or yelled) my cue words out loud as I pushed my babies out and they helped.

The program that helped me the most with this was Hypnobabies - click here to read more about my experience with it.

When and How to Change Positions to Get Through Transition During a Natural Birth

Changing positions helps any time labor feels too painful. Truthfully, transition is really intense, but changing positions can help you handle whatever is coming next. Another benefit of changing positions: you help your baby get perfectly lined up for a faster delivery.

Hands and knees is a great position because you can easily rock back and forth or spiral your hips. Standing also allows you to move a lot, but some women find it very intense. Here are some positions to try:

Hands and knees
Standing and leaning against the wall or your birth partner
Supported squat
Kneeling
Semi-squat with one knee down (hint: this is a great position for birthing)Side-lying on your left side

Props for Transition

Props can help you get in better positions for transition, too. Here are a few to consider:

A birth ball: Sit on the birth ball to help provide support and gentle counter-pressure. Rest your head on the side of the bed. Or, kneel in front of the ball and lean on it.
A birth tub: Water is incredible during labor, and especially helpful for handling transition during a natural birth. The water offers gentle pressure and holds all of that baby belly for you
A shower: Standing in the shower with the water running over you may help while things are very intense. Kneeling can also help - I did this with my first baby and stayed until the water got cold!
The toilet: Some women really like being on the toilet - most find it easier to relax their pelvis. This position helps line up the baby up to descend right into the birth canal.

Sometimes counter-pressure is suggested to help with transition, and that’s a good strategy for a little while. But if things don’t seem to be moving, try to change position. Sometimes that helps the baby move down into position and the counter-pressure isn’t needed anymore.

What To Do If You “Lose It” During Transition

Many women fear “losing it” during labor or transition because they think that’s a sign of failure. But the truth is you can get back in control even after difficult contractions.

This is where having the help of your partner really shines. Your partner can help you breath and help you change positions (always wait and change positions between contractions - and it’s okay if it takes you a couple of contractions to get ready to move).

Breathing to Get Back in Control

If you’re feeling out of control, the fastest way to get back in control is to breathe. Remember how an athlete breaths when she’s doing intense work and needs to keep her breath under control: in through her nose, out through her mouth. You do the same.

Copy your birth partner if you need to (remember, I still needed to on baby #8!)

It’s also OK for things to feel very intense. It’s normal to feel nauseated and throw up (let your birth team handle it - you just feel better). It’s normal to have the shakes, feel very hot, or have the chills. Transition doesn’t last long and often the short time between contractions is a moment to breath and rest.

As soon as pushing begins your contractions will space out and you’ll have a time to breathe and really relax (that’s the time many women feel calm and “other-worldy” or like they’re connected to their babies and all birthing women). Keep the focus on being almost to that place of more rest…

…and pushing your baby out!

Quick Energy Gets You Back in Control

Sometimes you just need more energy during transition. Transition and pushing are both times to get quick, simple energy. Some midwives like a spoon full of honey. I don’t like honey, so I always opted for Emergen-C drink. Fresh fruit works, too, but it’s normal to lose your appetite during transition. Juice is a good choice - but in a pinch you can always have a sip of a sugary soda! At this point, energy is energy!

Have a sip of something with sugar and let someone wipe your face with a cool washcloth - you’ll be surprised how much it helps.

You and Your Baby Are In This Together

Don’t forget that you and your baby are in this together. I still remember the podcast episode I did with Nikki Knowles - she helped a mama who was really having a difficult time handling transition. Seeing an ultrasound picture of her baby was enough to help this mama re-focus on the REAL truth of birth:

You are working with your baby and you will soon meet your baby.

Transition is tough, but keep in mind that you and your baby are in this together. Your baby is NOT sitting inside, doing nothing. He or she is actively working with your body during birth: slight twisting, turning, pushing with his/her feet to move down and through the birth canal.

That’s why changing positions can sometimes bring so much relief - because your baby needed you to shift so he or she could move down into position. Sometimes if things feel “stuck,” a change of position can make a real difference.

You and your baby are really doing this together <3