Transition Stage: Give Thanks and Be Thankful Stage (covered in our birth preparation workshop)

Some women don't know they go through it. For others it's a marked change. Your contractions may stop for a while. DON'T PANIC. Ujai breathing will help restart them.

Your uterus is about to change. Until now you've had drawing up contractions, now it's going to go into expulsion contractions; a change in muscle action.

You may feel shaky, sick, cold, or want to go home. DON'T PANIC, RECOGNISE THIS MOMENT WILL PASS. YOUR LABOUR IS PROGRESSING. Partner: re-assure the woman you love that you're nearly there.

This can be the point at which couples give up. It is important for the birthing partner to be prepared for this stage and to reassure the labouring woman that all is well and happening as it is meant to. Just saying 'this is transition' can be helpful, with lots of reassurance. The contractions during transition are the most overwhelming. THIS TOO SHALL PASS.

Positions

Supported, kneeling over pillows, or lying on side. Follow the breathing journey, keep your mouth soft, and find a point of focus such as your loved ones eyes, or use a mudra (finger tips and thumb touching) - whatever works for you.

Breathing Journey

Combine Ujayii and Golden Thread to move through the labour. Use Ujayii to sustain the plains and restore calm and use Golden Thread during contractions and to reach up and over peaks of pain.

Feel free to vocalise sounds naturally: moaning, grunting, whatever wants to come out! 'OOOH' SOUNDS HELP BABIES MOVE DOWN.

Use what works: gaze directed within, or out. If you feel drawn to the idea, create a birth mandala to focus your gaze on as the contractions intensify. Keep a mudra for your focus point (e.g. fingertip and thumb touching).

Second Stage: Crowning, Breathing Baby Out

Once fully dilated and you feel ready to push:

Try to keep the jaw loose at all times when in this stage of labour. Tightening the jaw contracts the muscles of the perineum. Also remember 'butter buttocks'. If you relax your buttocks you allow for space for the baby's head. Get the space between vagina and rectum as loose as possible.

Positions: Get gravity's help!

Kneeling opens up the pelvis fully and aids baby's descent. Have support. Squatting can be comfortable if supported; again you will need two helpers to support you when bearing down. Not a good position if baby’s head is large and it can be tough on your tissues.

Crowning:

Kneeling on all fours with your head down and bottom up will slow down a second stage that is happening very fast, and helps you get back in control as well as allowing vaginal tissues time to soften and stretch so they're less likely to tear.

Leaning forwards (over a ball) also slows down the second stage a little (breaking position) and if baby's head is big, midwife can guide your baby out. Your partner can support you with crossed forearms when you need to bear down.

Breathing.

The longer you can extend the breath out, the further the baby is able to move down the passage during one contraction.

Birthing Breath (Cafetiere Breath)

With the birthing breath, you allow your conscious awareness to descend down the body with each out breath. Begin by taking an in breath as deeply as you can and focus on moving down your spine on the out breath. Wherever your mind focuses at the end of your exhalation is where you begin from with your next inhalation. Keep moving down the body with each out breath until you are focused in the cervix, birth canal and perineum. This is where you focus on expanding with each forthcoming exhalation.

You are effectively using your out breath as you would the plunger of a cafetiere. The diaphragm works with the abdominal muscles, pushing down on the uterus and expanding (relaxing) the pelvic floor muscles to ease your baby through the birth canal gently.

Try voicing your breath with a 'haaah' sound that feels good and helps abdominals work with bearing down contractions. Extend the exhale as long as you can to increase the pressure of your uterus.

When baby is crowning and you are asked to break from pushing, you can use the 'feather' breath (the sound 'hooh') - very gentle and soft small out breaths, or 'purring' breath to disengage abdominal muscles from pelvic floor.