Preparing for Labor – Tips from a Pelvic Health Specialist

Are you pregnant and starting to think about your birth plan? If so, congratulations! Pregnancy is a beautiful time in a woman’s life and should be celebrated. Ever wondered what pelvic floor specialists recommend when preparing for labor and delivery? Look no further! All of the information online can be so overwhelming, which is why we created this cheat sheet of our favorite tips!

We recommend working with a pelvic health specialist on the following:

• Optimize your pelvic positioning and general alignment 
  • The more balanced your pelvis (and the rest of your body) is, the better you will feel, and the more easily your pelvic floor can relax, open and lengthen to allow the baby out. Your PT can help you achieve optimal alignment to set you up for a smooth birth experience and identify other areas of tension or dysfunction that are contributing to an imbalance in your pelvis or otherwise.

• Work on your ability to relax and lengthen your pelvic floor 
  • This may be one of the most important things to master! We often hold tension in our pelvic floor “at rest” without even realizing it. If a muscle is tense, and you try to stretch it, you can injure it (think – tearing during birth).
  • Pelvic floor therapy, self-release techniques, breathing exercises, and stretches are all great ways to start relaxing your pelvic floor. A specialized PT can show you where to start!

• Strengthen pelvic floor muscles
  • Not only do our pelvic floor muscles need to be able to length and relax, they also need to be strong enough to support our baby and organs through pregnancy, as well as assist in pushing when the time comes. 
  • Correctly performing pelvic floor strengthening exercises can help with labor and delivery as well as reduce the chances of incontinence postpartum.

• Stay active throughout your pregnancy 
  • Staying active will do wonders for your pregnancy and labor experience. Labor and delivery have been compared to running a marathon, and you do not want to show up to a marathon without any training. 
  • The issue is, women are told to maintain the level of activity that their body is used to once they get pregnant. This is because we do not want to shock your body with a lot of new activity that it is not used to. So if you fall into this category, start with walking and work up gradually. Listen to your body, if you are having an increase in cramping, pelvic pain, back pain, or bleeding, rest and talk to your doctor about the next steps. It is possible to gradually increase your activity and build a program that works for you, even if you’ve never exercised before. 
  • During labor, it is helpful to stay somewhat active in the early stages to help the baby descend into the pelvis. Walking, squatting, bouncing on a ball and stairs are all great ways to facilitate this.

• Practice optimal breathing techniques 
  • Breathing techniques are a great, evidence-based tool for pain management during labor. Even if you plan on receiving an epidural, it is important to remember that the epidural may not always be available (for example, due to timing or to a hospital being understaffed) and that the epidural may also not work. 
  • For these reasons, there needs to be a plan B that is practiced for pain management. One of these techniques is using your breath to get through painful contractions. It is recommended to breathe in through your nose, expanding your rib cage and belly, for 2-4 seconds, and exhale like you’re blowing out candles, for 6-8 seconds. Breathing correctly also allows your pelvic floor to relax, allowing you and your baby to progress as efficiently as possible.

• Learn evidence-based pushing techniques 
  • It is important to practice proper pushing techniques before you give birth. This will give your muscles the experience of relaxing and moving out of the way so the baby can get through. Too often women are told to strain and push while holding their breath. This is not an ideal strategy as it places so much pressure on your tissues and organs, and can cause more harm than good.
  • A pelvic floor PT can review proper techniques with you and evaluate if you are doing them correctly. 

• Learn and practice positioning 
  • There are many positions to work with during labor and delivery. Contrary to popular belief, laboring and pushing on your back isn’t always the most ideal position! 
  • Your PT can review other options such as side-lying, standing, and on hands and knees.

• Practice and plan for pain management
  • It is so important to be prepared with some pain management strategies, even if you plan or receiving an epidural or medication. As discussed above, there are times when the epidural doesn’t work, or when the baby is coming too quickly to receive one. 
  • Some pain management strategies include:
    • Breathing exercises 
    • Counterpressure applied by a partner or doula

• Start perineal massage
  • Perineal massage in the last few weeks of pregnancy can reduce the chances of an episiotomy, reduce the severity of tearing, potentially shorten labor, and reduce the risk of bladder incontinence in the post-partum period. 
  • The perineum is an area of tissue and muscle attachments between the vagina and the anus. This needs to be able to stretch during birth as the baby comes out. This is the area that commonly tears and requires stitches. To reduce this risk, try massaging and stretching the tissues. This can be done by yourself, or with a partner. Your pelvic PT can show you how to do it correctly!

• Plan for the right support person to be there with you every step of the way
  • This can be a doula, a parent, a partner, or a friend.  You want someone there who will support you and help you stick to your birth “plan” as much as possible, and to advocate for you when you are potentially in a lot of pain and/or on pain medications that can impair decision-making. Have several conversations with your support personnel before giving birth with details about your wishes. This is great to also have in writing. 

When it comes to preparing for labor and delivery, knowledge is power, and having a team of providers to support you along the way is key! We are here to answer any questions for you. Contact us today to learn more about how we can help!