Congratulations Mama! You are growing your family. OK what next? Birth. We read about it, but how do you really need to prepare for this experience? I have outlined some tips below. Included is just a brief break down of the recommended steps to take on your 40 week journey. I discuss these tips further in my Birth with Grace class.
1: Recognize where you are right now. Who are you? You may be wondering how this applies to your birth, but trust me, you will face this question. What are your values? In your past, what has been your relationship with stress or pain or new experiences or the unknown? How do you feel loved? Comforted? Safe? Our society usually labels all pain as, “bad.” However, this is an incredible way our bodies communicate to us. Do you have a history of trauma, or a need to leave your body when you feel scared? Now is the time to learn about yourself and your relationship with strong events and emotions. Perhaps it is time to see a therapist to help you work through some feelings or old stories you have told yourself about who you are and what you are capable of. I recommend building your awareness of YOU.
2: Information is empowering. The more you know about what to expect in your birth, the more you will feel you played an active role in the care of yourself and your child. Yes, it is important to trust your healthcare providers, but it is more important to trust yourself. This is part of parenting, ie. information gathering before decision-making. You do need to know some basics about birth and how to ask questions. We are in a culture where it is difficult to say “no.” It is also difficult to question your healthcare provider or even ask for time to consider your options. Remember, this is your pregnancy, your birth, your body, your baby.
3: Go for a walk. Aerobic exercise is incredibly important during pregnancy. According to The American College of Obstetricians and Gynecologists (ACOG), pregnant women should get 150 minutes of moderate intensity aerobic exercise every week. There are so many benefits to maintaining aerobic exercise during pregnancy, including maintaining heart health, reducing back pain, stimulating bowel regulation, promoting healthy weight gain, reducing the risk of gestational diabetes, preeclampsia, and cesarean delivery. Not only is it healthy for you, it is healthy for your baby! It causes more blood vessels to develop in the placenta which is the organ that sustains the life of your baby. If you develop an exercise routine during pregnancy, it will be easier to return to exercising once your baby is born, in a time where you can find so many reasons not to exercise. If you then exercise during postpartum, you will recover faster, lose any pregnancy weight, and also set the example to your children that exercise and health are valuable. So if you think about it, going out for a brisk walk, could literally change the world.
4: Squats and weight training. As women, our calcium begins depleting after the age of about 20 years old. Now add hormonal changes, body and weight changes with pregnancy, and breast feeding for a year or two. There are three things we need to take extra care of since we are women: our heart, our bones, and our pelvic floors! The best way to combat the depletion of calcium and avoid osteopenia or osteoporosis later in life is to add a weight training routine. Also, consider this, your baby is usually born at 8 pounds and then just keep growing. So you will soon be lifting 8+ pounds repetitively throughout the day. Time to start weight training Mama! Get those arms, abdominals, and gluteal muscles ready for baby to get here so that you are able to keep up with the demands of parenting without pain. Which brings me to squats. Every physical therapist loves squats. This is such a functional exercise meaning, it translates directly into everyday life. When you pick your baby up off to the floor? Squat. When you get out of the car? Squat. When birthing your baby? You got it squat.
5: Prepare the pelvic floor. There is a lot of controversy around pelvic floor exercises or as a Laymen’s term, “kegels.” The pelvic floor is the network of muscles connecting the pubic bone to the tailbone. It supports the bladder, uterus, and rectum, and also provides stability for our pelvis and trunk. During pregnancy, the load on your pelvic floor significantly increases due to the weight of the baby. Also, your body releases a hormone called relaxin, which works to soften the joints in your body to allow the carrying and birthing of the baby. Since the inherent support of the pelvis is now softened, and there is added weight, the demand on the pelvic floor is high. Therefore, pelvic floor physical therapists encourage training and strengthening of the pelvic floor. We also know if we practice exercises during pregnancy, the neural connection between your brain and muscles will strengthen, allowing an easier return to exercises and pelvic floor functioning following birth.
6: Do not deliver on your back. This is the most important message I can give you to prepare you for your birth. Labor as much as you can out of bed. We are not meant to be delivering babies while lying on our backs. Even if you have an epidural, you do not need to deliver directly on your back. When lying on your back, you compress the sacral and coccyx (tailbone) bones which closes the outlet your baby needs to fit through. This puts a ton of strain on your body, your pelvic floor, and baby. Due to the increased strain and pressure, the risk of pelvic floor trauma increases. I recommend birthing in kneeling, hands and knees, or squatting. If you have an epidural and cannot move your legs, I recommend delivering in a sidelining position.
By Dr. Grace Abruzzo PT, DPT, CAPP-OB, PYT-C, CD-DONA
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