Preparing the Body for Labor

Here are a few stretches and exercises that are great to get the body ready for labor.

Squatting

Squatting is great for stretching the perinal muscles (the muscles used when giving birth).  It aids in increased flexibility during labor and delivery. Squats should be started as early in the pregnancy as desired and at least by 36 weeks to have the maximum impact during labor. 

Kegel Exercises

Kegels or the squeezing and strengthening of the muscles inside the vaginal are also great to help strengthen in vaginal vault and can make for a decreased second stage (pushing stage) or labor.

Tailor sitting, cross-legged sitting or a butterfly position

Each of these types of stretches also stretch the pelvic area and aid in flexibility during labor and delivery.  They should be done with caution and ease because due to hormonal changes, it's easy for a pregnant woman to over stretch ligaments connected to the pelvis in pregnancy.

Weekly Exercise
Women should do 150 minutes of moderate physical activity a week, either brisky walking, jogging, spinning, swimming, or exercises like these to promote circulation, decrease swelling and warm off complications like preeclampsia, diabetes in pregnancy and a large (macrosomic) infant.

Daily Exercise - 30 min a day - of low intensity steady state activity is one of the most important steps a woman can take to ensuring a healthy pregnancy, avoid going overdue, and decrease the need to be induced. 

Walcher's Position

 

Walcher's position is a technique used in labor to open the pelvic brim. It's a great position that can be held through 2-4 contractions for maximum effect.  This technique can do wonders for a baby that may be need a bit of assistance rotating and getting into the birth canal.

It is very helpful with a baby that is not coming into the pelvis such as an asynclitic presentation or in the OP (occiput posterior aka sunnyside up position) and may need to be held longer than 4 contractions for maximum effect.

It can easily be done with a woman with an epidural by dropping the feet of the bed and putted a rolled up blanket, sheet or mat under her hips just at the pelvic brim.  The woman should feel like she is arching her back.

Click here for some photos and more about Walcher's technique.

Positive Birth Affirmations

 In my last post, I wrote about the importance of positive affirmations and using them to change your belief about something. Here are some positive affirmations about birth.

• I can do this. I am doing it
• I am capable
• I am powerful
• I am awesome
• I am a strong and capable. 
• I trust my instincts to know.
• I birth with confidence.
• My birth is a sign of my feminine strength.
• I do all things with God's Strength.
• I feel my own power
• I relax.
• I ride the waves.
• My body allows the baby to descend.
• My body is perfectly and wonderfully made
• The experience of labor and birth is a great gift.
• I will breathe slowly and deeply to relax my muscles and bring oxygen to our baby.
• This is what my body was designed to do.
• Relax, breathe, open.
• My body is opening wide.
• I welcome my baby.
• I am a strong, beautiful woman. I accept myself completely, here and now.
• I am completely relaxed and comfortable.
• I am doing this exactly right and exactly as nature intended.
• My body knows what to do. 
• I trust my body to birth my baby.
• I trust God. 
• I am excited to give birth.
• I trust in my ability to birth my baby.
• During labor and birth, I am completely relaxed.
• I am deserving of a easy, uncomplicated birth.
• I visualize my baby moving gently through the birth canal.
• I visualize an easy, peaceful, joyous and pleasurable birth.
•  My baby is happy and healthy.
• I embody Joy
• I embody Comfort
• I embody Acceptance
• I embody Trust
• I embody Truth

300,000 women will be giving birth with you today., You are one of them. You belong with them. You are one with them.  Relax and breathe and trust yourself and you team.

Labor: How will I know?

Many women who have never experienced labor wonder how they will know labor has begun.  While labor is different for every woman, here are a few things to keep in mind if you think you may be in labor. Full term labor is different from preterm labor. For information on preterm labor, see the previous post. If you are 37 weeks or more along in your pregnancy, this may help you determine if you are in labor.

What are contractions?

Contractions are actually the contractions of the uterus, or a shortening and tightening of the uterus. The uterus is a muscle and contracts just like any other muscle will. In early labor, uterine contractions are usually short (less than 30 sec) and painless. In early labor, contractions may come every 2- 15 minutes. When the uterine contractions become strong enough, they will start to open and thin out the cervix (the opening to the uterus). As labor progresses, uterine contractions become longer (over 45 sec), stronger (increasingly uncomfortable), and increase in frequency (every 2-5 minutes)

                                                     Early Labor              Active Labor

Discomfort                                       Slight                       Stronger

Length of contractions                  10 - 45 sec               45-90 sec

Frequency of contractions          2 -15 minutes           2- 5 minutes

Early labor often mimics what you experience when you have your period, or will be like a very strong period.  If you had backache or menstrual cramps when you had your period, this is most likely what you will experience in early labor. Early labor can be off and on. It can start and stop or it can also be steady.  Early labor in a first time mom can last from 2 to 24 hours. Once early labor is over, the mother usually will experience an increase in the amount of discomfort caused by the contractions as well as an increase in the intensity and the frequency of the contractions.

Quick labors or precipitous labors in a first time mom are the exception and not the rule. Many women hear stories about a friend or sister's labor that was only 2 or 3 hours long. A precipitous can happen, but it is much more likely to happen for women who are having their 2nd or 3rd child. Precipitous deliveries are also more common in a woman who is not yet 37 weeks.  The next time you hear of a story when a woman gave birth very quickly, most likely she was not having her first child or she was not yet 37 weeks.

The water breaking: Always contact your health care provider if your water breaks. The water breaking may bring on the start of labor, or it may happen while you are already in labor. You also can have your water break and labor does not start.  The water breaking does not necessarily mean that labor has begun.

If you think you are in labor, it is good to consult with your health care provider for advice.

Transition

Now that's powerful stuff

The term transition or in transition refers to the period of time just before the birth. Some like to quantify transition as having a beginning and an end. They say transition is from 6 or 8 to 10 cm or is the 25-30 minutes before the birth. I tend to disagree. As a mother of 3, I can say my transition was severely different for each, and I'm only one woman. The homebirth midwife who trained me always referred to labor and contractions as a period of changes.  She would often ask her clients to notify her when the next "change" in contractions was coming. She didn't explain how it would be, but somehow her clients knew when that "change" had taken place.  "Transition" she said "is the final change in contractions before the birth." "Some changes happen radically and quickly." She continued, "and some come slowly and steadily."  I like this word change.  It is a neutral word that has neither a positive or a negative spin on it.  It is what it is. Transition is what it is.  It is the actual moment when the body is getting ready to bring a new life into this world.
In my experience as a midwife, I also notice, feel, experience a change in my clients. It is the time when women say things like: "I can't do it." "I can't take it anymore."  "I don't have the strength" or even things like: "I'm dying."  As a provider, I know that the birth is soon imminent, but I see these women lost in the present moment and the beauty of a being completely devoted to it. Sometimes I will remind the woman that this too will pass, but other times I simply take in the beauty of complete serenity to the present.
 In my own personal experience with labor, this was the time when I felt that my entire existence had come down to this moment. It was awesome to be solely focused on what I was doing and unaware of any other time or place.  For me, it was the hardest part of each labor. It was the time when I so desperately relied on my team.  (which also was different in each labor).  The funny thing is, that for me the most helpful thing was being yanked out of the present and into the past and the future.  For my second and third labors, I knew I had done this before and I knew that I wouldn't be in this moment forever. I knew that somewhere in the future was my rapture, my relief. 
Transition is powerful. Transition is awe-ful and transition is the final moments before you hold your precious gift. Remember this when you go there, and if you can't rely on yourself to remember, get a teammate that will do it for you.  Happy, peaceful and blessed birth to you.

Going Natural

Preparing for Natural Childbirth

Almost every single woman in the world is equipped to have a natural childbirth.  However, in modern America, with easy access to pain relieving medication, sometimes it can be difficult to choose a different option during childbirth.  If natural childbirth is something you may consider, here are a few tips to prepare.

1. Preparation: While you can never actually prepare for what to expect in childbirth, just like a runner can't know what to expect running her first marathon, preparation is key to success. 
2. Read:  Read about labor and birth. Read about what happens to the body as a woman progresses  through pregnancy and into labor as well as what happens to the body during labor.  Read inspiring birth stories such as those found in Ina May's Guide to Childbirth, Embracing Birth, and Journey to Motherhood are great ways to emotionally and mentally prepare for childbirth.
3. Get your provider's support: Talk with your provider about your desires and ask how they will be able to support your decision to not use pharmacological pain medication.
4. Assemble a birth team:  While a labor coach or doula isn't for every woman, labor companions/coaches have been known to be very effective in reducing the use of pain medication during labor. Getting your partner involved is also helpful.  Dr. Bradley wrote the book a Husband-Coached Childbirth, which is applicable for any birth partner, relative, sister, friend to read to prepare for childbirth.
5. Exercise: Prep the body for the marathon of labor. Labor is physically demanding and being in good shape will help you feel prepared both mentally and physically. Exercise on a weekly basis
6. Learn how to relax: Choose a relaxation method and practice it before the delivery. Relaxation is key to handling the discomforts of labor. Many techniques are effective such as: meditation, guided imagery, hypnobirthing/hypnosis, deep breathing or focuses breathing, or listening to music or affirmations. Try some methods out before the labor and choose one that works for you.
7. Know your options and restrictions: Talk with your provider about changing positions, using a birthing ball, or hydrotherapy during labor.  Discuss with your provider the use of fetal monitoring during labor or IV therapy that may limit your mobility.
8. Consider hydrotherapy: Water can be extermely soothing for a laboring woman and some settings may require notification ahead of time or you may have to rent a tub.
9. Take a tour: Be familiar with the setting where you will give birth. This will help you to visualize your labor before it takes place. 
10. Plan ahead: Have a bag packed, any insurance paperwork, ID cards, and documents you may need for the labor in one place ready to go.  Have child care options ready for your other children.
11. Enjoy your labor experience and welcoming your new babe into the world.

Always consult with your health care provider before beginning any exercise, class, or meditation program.