The most important preparation for labor is mental. If you are calm and confident, your birth should be smooth.
In the majority of cases, midwives will encourage women to have an active birth. In the Western world, women used to lie on their backs to allow the medical team good access. Now midwives support labors involving upright positions and free movement, and for women in labour to follow their instincts. However, in TV and film dramas there is often a widespread portrayal of women in labor lying on their backs.
Remembering to breathe deeply is so important in labor. It will help to keep you calm and collected, and give you a vital sense of control. It can aid in pain management. Breathing properly also helps to supply your baby with plenty of essential oxygen.
Pain makes us naturally tense, our breathing can become shallow and our muscles tight. If our fight-or-flight response is triggered due to fear, this can slow labour down. At the first sign of labour try to loosen your shoulders, keep your spine lengthened and raise your head up. You may feel comfortable walking around, you may prefer to sit. However you position yourself, establishing a deep breathing routine is essential from the outset.
Exhale fully through your mouth, using a long, controlled, measured breath. Count the seconds this takes and then match the seconds as you inhale, keeping that rhythm going for the entire first stage if you can. Every time you breathe out, let your muscles soften: this will help your cervix and vagina to relax too. Once you have established a firm counted breath you may like to add some words, especially if the pain is becoming more intense. It could be a short mantra such as ‘I can do this’ or ‘This too shall pass’ (using two words for the inhale and two for the exhale) or you could use one word such as ‘relax’, breathing in for ‘re’ and out for ‘lax’. If you like the sound of a mantra, it might be worth choosing one before you go into labour. Having these little psychological devices to support you can be really empowering!
Active birth positions
Remember, active birth positions rely on gravity to help the baby on the way. Try practicing them through pregnancy as they are a lovely way of connecting with your partner, gently strengthening your body and encouraging your muscle memory to learn poses.
These positions should be loose, allowing your muscles to be free of tension and your body to move. Your pelvis should not be constricted in any way. Practice deep breathing while you try out these positions, encouraging the connection between breathing and birthing to become instinctive.
Standing supported squat
Squatting can open up the pelvis by as much as 2cm (about 1″), so is a great position for the second stage of labor. Many women find that contractions in this position are less painful and can increase the urge to push.
The standing supported squat can be done facing away from your partner or facing them. Maintaining eye contact and breathing together can be a nice way to stay connected and for them to help you with your breathing without telling you to breathe! You might like to loop your arm around your partner’s neck or hold on to their arms. Alternatively, you could lean against the wall with a gentle bend in your legs.
Maintaining this position can be tiring for both the mum-to-be and her birth partner, so you could break it up with other postures.
Other ways of squatting
You might like to lean against a birthing ball, which allows for a lovely deep squat and gives you plenty of support. It also means that your birth partner is free to massage your back. Squatting between your partner’s legs can help you to get into a deep squat. If they sit on the edge of the bed or a chair, you can use your elbows to lean on their legs. It can be helpful to use the fabric of their trousers to pull against as you bear down during contractions, so remind your partner to pack jeans in their hospital bag if you think you might try this position during labor.
Straddling a chair means that you can grip the back of the chair during contractions, as well as leaning into it for support. It allows you to rest but still
make use of gravity. This can be a useful position if you respond well to massage during labor, as it allows your birth partner access to your whole back. It can also be used with continuous electronic fetal monitoring.
Lying on your side
If it feels like labor is progressing too fast and you just want to take a rest, lying on your side with a pillow or support between your legs is a nice way to have a breather – gravity will slow things down, plus the coccyx (tailbone) isn’t closed, which it is if you lie on your back. Your coccyx needs to be able to move freely so that the baby’s head has more room to pass through your pelvis.
Lying on your back has other disadvantages. It closes the pelvic outlet by around 20-30 per cent compared to upright positions such as squatting, it makes your birth canal curve upwards, and it can constrict blood vessels. It can also make you feel less in control of your labour.
Walking and standing
Walking, standing and sitting upright (even kneeling) can help you to feel actively involved and speed up labor. But if you have high blood pressure, an upright posture is not advised. When people have high blood pressure their hearts need to work harder. Sitting and standing causes our blood pressure to rise so that the arteries in our hearts and brains continue to receive blood, nutrients and oxygen. In labor our hearts work harder too as adrenalin pumps blood into our muscles. If your blood pressure is already high, it is sensible to try to keep it as stable as possible during labor. These active postures cannot be used with continuous electronic fetal monitoring either. In both scenarios it is better to lie on your side.
On all fours
Whether you opt for a supported kneel (against the bed, with a pile of cushions or a birthing ball) or simply use your hands or forearms to support you, kneeling postures can be restful yet also allow freedom of movement. Many women find a lot of comfort during contractions by rocking backwards and forwards or by making a figure of eight with their hips. Remember that if you keep your hips moving, the baby can find it easier to move through the birth canal. This posture also allows your birth partner access to your back for massage.
An excerpt from Holly Daffurn and Samantha Quinn’s The Natural Baby. From Sept. 1 to Oct 30th, you can get The Natural Baby book at 30% off with the code GREENCHILD30.