You’ve worked your way through early labor and active labor, and now you’re in transition. If you’ve decided to forego the epidural up to this point, there are some positions you can do during transition labor that can help you through this phase. In this article, we’ll share the signs that you’re in transition and explore six of the best positions to try during this time.

These positions can help you cope with intensity while supporting your body as it prepares for the pushing stage.

These positions can help you cope with the intensity of this stage while supporting your body as it prepares for the pushing phase. As a birth doula who has supported hundreds of families, I’ve seen firsthand how much these positions can help when transition becomes overwhelming.

Understanding Transition Labor

Transition labor is the final and most intense phase of the first stage of labor.¹ It’s the phase that follows early labor and active labor, right before you begin to push. This is when your cervix is dilated 7 to 10 centimeters, and contractions last about 60 to 90 seconds, with 30-second to two-minute breaks in between. Thankfully, this is usually one of the shortest phases in labor, lasting anywhere from a few minutes to two hours.^1,2

Signs of Transition Labor

If you’re wondering if you’re in transition, here are some signs to look for:

• You’re 7 or more centimeters dilated.²
• You’re having around 90-second-long, intense contractions.^1,2
• You feel nauseous and are vomiting or dry heaving.^2,3
• Your body is shaking uncontrollably.³
• You go from feeling hot and sweaty to cold and chilly.²
• You feel like you can no longer handle labor, and you tell your support team that you can’t do it and need drugs.
• You might be crying, having irrational thoughts, or behaving irrationally.
• You feel rectal pressure (like you need to have a bowel movement) because your baby’s head moves lower in your pelvis.^1,4

Related: What To Do in Transition Labor

Best Positions for Transition Labor

These positions utilize gravity, pelvic movement, and relaxation to help you remain as comfortable as possible during this powerful phase of labor.

Once your doctor or midwife has checked your cervix and confirmed you’re in transition, you’re almost at the end! Certain positions can help you reach 10 centimeters in a shorter time. And since this phase is the most intense part of labor, every second counts. Here’s what you can do:

1. Sit on a Birthing Ball

Sitting on a ball helps open the pelvis and encourages your baby’s descent while giving you a break from standing.

Sitting on a birthing ball (also called an exercise ball) during transition labor can be very helpful. It allows the laboring woman to take a break from being on her feet and helps apply pressure to her cervix, which helps her dilate more.^5,6 While sitting on a birthing ball, you can bounce on it, move your hips in circles, and do figure eights with your hips. These movements can help open your pelvis and position baby’s head directly over your cervix.^5,7 It also feels really good to vocalize during labor, so don’t be afraid to relax your jaw and use your voice to make low tones as you go through each contraction.

2. Stand and Lean Forward for Support

This image shows just one of the many ways you can labor while standing. This position is optimal for allowing gravity to do its work. It also allows for side-to-side or rocking movement, which helps with baby’s rotation and descent.⁸

3. Labor on the Toilet

Relaxing your pelvic floor on the toilet can help your body release tension and make dilation easier.

There’s something about sitting on a toilet in labor that seems to work wonders! Whether you’re actually using the toilet (emptying your bladder helps make more room for your baby to move down) or just sitting on it, the position is helpful in active labor and transition.^1,10 I think it’s because we naturally relax our pelvic floor while on the toilet. The more we relax our muscles, the faster things can progress!⁷

4. Reverse Sit on the Toilet

If you want to continue laboring on the toilet but need more support, consider sitting in reverse on it. You can place a pillow on the back end of it and rest your head and arms on it. You’ll still receive the benefits of relaxing your pelvic floor, but you’ll be able to get a little more rest as you get through transition labor.⁹

5. Labor in the Tub

Warm water provides natural pain relief and helps your muscles relax between intense contractions.

Hydrotherapy feels incredibly soothing during labor. Getting into a tub during labor can really help ease the pain. It also promotes relaxation and relieves tension, both of which help with labor progress.11,12,13 Depending on the size of your tub, you can either lean back in the water, sit on your knees and lean forward, or lean against the side of the tub. This is a favorite position for many women during labor transition.

Related: Natural Pain Relief Options for Labor

6. Labor With a Peanut Ball

A peanut ball can assist with dilation and help your baby rotate into an optimal position.

What exactly is a peanut ball? It’s an exercise or therapy ball shaped like a peanut that can be used during labor.¹⁴ Many mothers have sworn by the peanut ball, saying it helped them dilate quickly. These may even help reduce your chances of having a C-section!^15,16 There are several different sizes of peanut balls and various positions you can do with them.

You are so close to meeting your baby, and the intensity of transition means your body is doing exactly what it needs to move you toward birth. Use the positions that feel best, trust your instincts, and lean on your support team. You’re stronger than you realize, and you’re almost there, mama.