I see you out there, trying to learn all there is to know about birth. Maybe you found this article while googling or mad-pinning. You feel that growing pressure to know all the things, then off you go with a flurry of typing and open browser windows and a 2-page list of questions to take to your next prenatal visit.
Maybe you feel that if you just know enough, your birth will be in your hands.
But guess what, my dear: Birth is as unpredictable as life gets. (I know. I totally tricked you with my title. Eep.) I stress the wild nature of birth because I so often see my clients and students spinning in a fury to just. know. enough. It's imperative that we check our motivations.
This doesn't mean you should just give up and not prepare at all, though. To be awake and engaged in the preparation, while still realistic in our expectations, it's important to remember one guiding idea: You can influence birth, but you can't control it. Good preparation adheres to this. So what can you do to prepare for birth? What will influence it?
1) Choose wisely your birth locale and care provider
I am often amazed when I hear women speak dismissively about their choice of the doctor or midwife they are working with: “It's who I've always seen.” or “I don't really like my doctor, but it's too much work to change providers. I'll just hire a doula.”
The provider you work with is one of the most influential factors in how your birth unfolds. As a doula, I see the many ways that a scenario is handled based on the provider's approach to childbirth. For instance, in some hospitals in my area, the mother is not allowed to consume anything but ice chips through the entire labor. At others, they bring her a tray of food at mealtimes as long as her labor is low-risk.
Another example is how a rupture of membranes (water breaking) is managed. Some providers will have the mother come in to the hospital immediately to begin Pitocin. Some providers will have her stay at home for a few hours to see if her labor will begin on its own.
Some providers are more patient while some are more managerial in their style. Some consult with the mother for non-emergent medical decisions while others are directive. Some providers are more cautious and conservative than others. There are some great questions you can run by your doctor or midwife to help determine if they are a good fit for you and what you are wanting from your birth.
If you would like to hash out this decision for yourself, I have a brilliant little workbook called “Start With You” that can help you determine where you would be most comfortable giving birth. It can also be helpful if you would like reassurance that you've made the best decision for yourself, based on YOUR values.
We can include in this heading the fantastic idea of hiring a doula.
When choosing a doula, seek one who has a good personality fit for yourself and your partner. You will be with her for many hours! I think it's also wise to find one who understands and follows the limitations of her scope of practice. She should not be providing medical advice nor acting as an advocate. Her role is to strictly provide emotional, physical and basic informational support.
“Well, this works out.”
2) Strive for health:
(great time to remind you I'm not a medical professional)
The pregnant body undergoes a million little changes as it adapts and grows this new life. What you put into it and how you move it absolutely influences your birth. Modern research is constantly uncovering the value in good food and how that can affect the course of the pregnancy and the health of the baby.
In general, the best approach to healthy eating during pregnancy is to consume a variety of fresh fruits and vegetables, whole grains, low-fat diary and lean meats and selected fish. This is another great conversation to have with your care provider early in pregnancy. Some practitioners will emphasize this factor and even have their patients keep a food-diary. Some may not bring it up, although women are much more likely to eat well and exercise if their doctor/midwife emphasizes its importance.
How you move your body also influences your birth. While more research would be awesome, there is enough to suggest that 20-30 minutes of moderate physical activity a day can improve pregnancy outcomes for women. A mix of strength-training and aerobic activity is suggested.
“I am exercise diva. I walk so hard for the health of my baby. Feel my heart rate. Check my fitbit. I am walking goddess.”
Physical exercise is recommended on an individual basis, greatly determined by each woman's habits before pregnancy. I have had clients begin a mild exercise routine for the first time in their lives during pregnancy (what greater motivation than a baby!). I have also had clients who continued to Crossfit until they went into labor. There is a huge spectrum of possibilities, and definitely one to talk with your doctor or midwife about. They will know what is appropriate for your specific circumstance.
Oh, but #letsbereal, a LOT of us can't imagine getting our asses off the couch when our bodies are already working so hard to grow this kid (NSFW.). Here's some motivation, though:
– Moderate physical exercise can keep pregnancy weight gain down AND decrease the incidence of gestational diabetes.
– Being physically fit helps to prevent pre-term labor.
– There is some evidence to show that exercise in pregnancy can help lower depression during pregnancy.
– An hour of exercise three times a week can shorten the first stage of labor by an average of two hours. Holla!
– Regular exercise can reduce your chance of giving birth by Cesarean.
– And if you're only able to heave your very pregnant body to do some walking, even that alone improves many outcomes.
For some great ideas for a healthy pregnancy, follow my Pinterest board “Fit Pregnancy”
“Optimal Fetal Positioning”
3) Learn about Fetal/Maternal positioning
Your doctor or midwife is definitely paying attention to whether or not your baby is head-down or breech. However, once you check off the “head down” box, there are more subtle things to be aware of.
The way the baby is facing in the mother's body can alter the labor. I have been to many, many births in which the baby's presentation affected the length and intensity of labor. If baby's head is coming through the birth canal in a manner that fits poorly, the labor can be long with slow dilation. Sometimes the baby will not fit even after many hours and a birth by Cesarean is called for.
I won't exhaust a point that has already been extensively covered. Please peruse the Spinning Babies website for more. I have consulted that website for over 10 years to help resolve challenges in births related to baby's position.
Luckily, there are some things you can do now in pregnancy to create space and balance in the body for the baby to rotate and fit well. (Also, luckily, many babies figure out a way to rotate during labor all by their littles selves.)
We also need to be careful how we talk about it. I want to walk the middle ground of motivating you and stressing you out. So far, the research isn't supporting the use of exercises to move baby, though that research is limited and isolated. There is evidence that some labor management techniques contribute to persistent poor positions, though.
I like to think he's singing, not snoring.
4) Practice dealing with discomfort
This is one of the essential tasks in good childbirth preparation. No matter what your plans are for pain medication, birthing a baby has uncomfortable moments. Early labor contractions, the sensations of pushing (that often break through an epidural block) or even the recovery from a vaginal or surgical birth: there WILL be something to cope with.
A great birth class is full of pain-coping. But even on one's own, a parent preparing for labor can begin to practice being uncomfortable. The Birthing From Within book has many exercises that source from a variety of disciplines. For decades women and their partners have benefited from these practicable, effective strategies in their labors (and in parenting, of course).
And if you'd like an online course focused JUST on pain-coping, I can hook you up.
5) Learn some stuff
Read some good books.
Find some interesting message boards, especially look for groups that challenge your own paradigm.
Check these off on your list. Get them done. And from that place of solid preparation (while also holding in your hand the truth that you can't control birth), you can now relax into allowing your birth to unfold as it will. You've done the best any parent could.