Originally posted on the FIT4MOM blog.
Written by: Birth Queen Rachel Nicks
Oh mama, you’re pregnant– congratulations!
What’s next? Well for a lot of mamas, this news brings about a lot of questions. Is it a boy or girl, perhaps twins? What will the baby’s name be? How will you design the nursery? How are you feeling? What should you eat? What size is the baby today?
While many pregnant women are eager and excited to cover all of the bases, many of us are guilty of skipping the details of childbirth education. Sometimes this is due to fear, sometimes it’s not realizing it’s something you need to learn, and sometimes it’s just simply being overwhelmed. The truth is, the birth process is inevitable, which means it is important to educate yourself so that you can make informed and empowered decisions. The goal is for you to be an active participant in your birth plan. Growing up, my mother equipped me with this, “it is your body and your baby and only you know what is best.” Whether it’s your first or your fifth childbirth experience, it is important to educate yourself, trust your instincts, and to speak up.
When it comes to your childbirth experience, being prepared can make all the difference. In order to help get the ball rolling, we’ve compiled a few of the most common questions new mamas have about the birthing process. While this is by no means a comprehensive list of questions, our hope is that this helps you get the wheels turning and opens up the door for further education and exploration.
Would you like an obstetrician or a midwife?
First decision: choose your care provider. Would you like an Obstetrician (OB-GYN) or midwife? While both are highly trained and certified, it’s important to understand the difference. Your experience with an obstetrician will often be more clinical (think of the classic birth scene in a movie). The approach of midwives is more intimate and holistic. Obstetricians deliver in the hospital and midwives can deliver at home, a birth center, or in a hospital. Most women report that the main differences between an OB-GYN and a midwife are that visits with a midwife will be longer (around 30 minutes) and that the focus will be not just on the health of your baby, but also on you and your physical/emotional well being. Some midwives even do all the visits in the comfort of your home– which many mamas love! If you think you may want the support of pain medication, both obstetricians and midwives are able to ensure you receive that support in the hospital. Both providers are open to you having a doula (midwives have traditionally always used the help and support of doulas, whereas many obstetricians are more recently accepting the practice of mothers having a doula present).
Speaking of doulas– would you like a doula?
A doula is a trained professional who provides continuous physical, emotional, and informational support to a mother before, during, and shortly after childbirth to help her achieve the healthiest, most satisfying birth experience possible. What is great about a doula is that they accompany you throughout your pregnancy, your entire birth, and postpartum. Doulas are a wonderful resource to help provide you with resources for your decision-making. During birthing, they never leave your side. They do not make decisions for you, but they can help you navigate your choices during your birth, provide emotional support to your partner, and help you as the mother with pain management by providing a variety of relaxation techniques. Studies have proven that when mothers have a doula present, rates of interventions and cesareans are lower and attachment to baby and breastfeeding rates are higher.
Would you like to manage your childbirth with medications?
As you may know, during the birthing process, pain medication is available if you would like it. Despite some beliefs, you always have the right to ask for an epidural if you would like one. An epidural is a procedure that injects a local anesthetic into the space around the spinal nerves in your lower back from which you will more than likely get immediate pain relief. Once you receive an epidural, your mobility is limited from the waist down. It is still important to try and rotate your position from side to side about every 20 minutes to help move the baby down the birth canal and to try and avoid staying sedentary on your back. Of course, your doctor or midwife will help you by answering any questions you may have about pain medication. If you would like to avoid using pain management and go for natural childbirth, you can inform your team and your nurses not to ask or offer pain medication to you.
Can you eat during labor?
There is an old (and outdated) practice of putting women under general anesthesia to give birth and sometimes women would vomit. As a result, the practice of telling women not to eat during labor was born. It is now known that you can and should eat and hydrate during your entire labor. Think of it like a marathon– runners hydrate and nourish throughout their race. Much like marathon runners, mothers need to do the same. The labor is challenging, but pushing is hard work and you need the energy and strength to push efficiently and effectively.
What about movement during labor and different childbirth positions?
It is important to move throughout your labor to help your baby travel down the birth canal, as well as to help you deal with the discomfort of contractions. Contractions are like a wave: they start low, peak, and then bring you back to shore. Try to ride the wave of each contraction and know that it will end. There is always a beginning, middle, and end. My advice: throw away clocks! While initially, timing contractions can be important to know if the labor is beginning, in the grand scheme of the birthing process, time is not of use to you. Trying to keep track of time can become frustrating and discouraging. Every birth process is different. Dilation is not some perfect formula. For instance, after 10 hours of labor you can be only 1 cm dilated, then get to 6cm in 2 hours, and be fully dilated in another 4 hours.
This is why I suggest that you birth with your body and not your brain. Your brain will try and make sense of things and can cause you to get anxious or to attempt to control the uncontrollable. The most difficult aspect of birth is the unknown. Find tools, relaxation techniques, and breathing techniques that help you calm your mind. Some examples: dim the lights, play your favorite music, get electric tea lights, pray or meditate, wear your favorite bra or gown, or even be fully nude (comfort is key!). Try to rest between contractions and save your energy to push.
When the time comes to push, be encouraged to try a variety of pushing positions. If you have not had an epidural, you will have better use of your legs and can get more creative, but avoid just pushing on your back if possible. Try pushing on your side with one leg up, squatting, or request the squat bar on your bed, which will allow you to pull down on the bar while you squat and push. The pulling action helps you activate your core and makes your pushing more effective. Squatting is typically the most preferred position because your pelvic outlet is the widest and you’re also working with the force of gravity.
How *do* you push during childbirth?
It is important to understand which muscles are needed and which are not in order to successfully push. Get in touch with your pelvic floor muscles and your transverse abdominal muscles during pregnancy. What is your pelvic floor? The floor of the pelvis is made up of layers of muscle and tissue. These layers stretch like a hammock from the tailbone at the back to the pubic bone in front. A woman’s pelvic floor muscles support her bladder, uterus, and colon. During a push, you want to completely relax your pelvic floor, the muscles of the anus, and vaginal muscles all while fully engaging the core muscles (the transverse abdominals). The transverse abdominals wrap around the body like a corset. To get real: the closest thing to a push in labor is like pushing to poop. For many mamas, literally visualizing yourself pooping as you push can be very helpful (if you know, you know).
And if you’re a first-time mama, please know this: poop happens! You want your colon and bladder empty anyway, which will create space for the baby to drop down and enter the world. You will also want to try and soften the muscles of the face and throat as you push. A closed throat equals a closed vagina. Do not be afraid to vocalize as you push, but not high-pitched sounds; think full, low, guttural sounds. Believe in your strength and ability to push your baby out and call on all of your strong ancestors who have done the same for generations! You. Are. A. Warrior!
What are Skin-to-Skin and Delayed Cord Clamping?
Immediately after your baby is born, skin-to-skin for an hour is highly recommended to bond with your baby and set a strong foundation for breastfeeding. There is a hormonal exchange that occurs when the baby is on your chest that is oh so important for your milk production! The weighing of the baby, vitamin-k shot, and eye ointment can wait until after you're finished with skin-to-skin. This will also allow time for delayed cord clamping if you so choose.
Delayed cord clamping is the prolongation of the time between the delivery of a newborn and the clamping of the umbilical cord. Delayed cord clamping allows more blood to transfer from the placenta to the baby, sometimes increasing the child’s blood volume by up to a third! The iron in the blood increases the newborn’s iron storage, which is vital for healthy brain development. Most healthcare providers advise a woman to wait until the cord quits pumping, anywhere from approximately 1-5 minutes
Do I need to take childbirth education classes?
There are many things to learn and consider when looking into the birth process, and not just as a first-time mom. Even if you’ve “been there, done that”, it’s a good refresher to know what you are getting into! Be encouraged to equip yourself with knowledge and tools through childbirth classes and childbirth educators to have your desired birthing experience. This way, you can have birth preferences, knowing what you want and prefer for both yourself and your baby. Be present. Be open. Be confident. And most importantly, never be afraid to ask questions or ask for support.
Come meet other mamas at a class.