Preparing for Birth: Tips from a Pelvic Floor PT
Congrats, mama! You are getting closer and closer to meeting your sweet little one. In this final stretch, there is so much anticipation and preparation going on. Of course, there is the practical preparation: organizing the nursery, washing baby clothes, and packing your hospital bag. But what about preparing your own body for delivery?
Well, that’s what we’re talking about today: a pelvic floor physical therapist’s perspective on how to prepare your body for labor and delivery. Below are some tried and true tips to help you mentally and physically prepare for birth!
Preparing Your Pelvic Floor
The number one way to prepare your body for labor is working to stretch and relax your pelvic floor muscles. In order to meet your little one, your pelvic floor muscles must be able to relax and lengthen to create space for him or her to pass through the vaginal canal. While there are numerous exercises that you can perform to help stretch your pelvic floor muscles, here are some great exercises to prepare your pelvic floor for delivery.
All About Positioning
Baby’s position in the final trimester is crucial. The ideal position to allow baby to descend down and through the pelvic space is head down with their face facing your spine. Often baby will get there on their own, however, sometimes they need a little help. You can encourage baby to shift into that position by performing Inversions and Belly Down postures.
Inversions: Place your knees on the edge of a surface about 18 inches tall. Ease your way down to place your elbows on the ground so your shoulders are below your hips. Take deep breaths and hold for about 30 seconds, then carefully return to an upright position. Hold the upright position for 30 seconds before standing up.
Belly Down: Get into a hands and knees position on the floor or bed. From here you can crawl forward and back, do Cat/Cow, or just rock side to side.
Each of these methods use gravity to our advantage to help baby get into that ideal position. You can start performing inversions and belly down positioning as early as 20 weeks. I generally recommend performing these once or twice per day. Be sure to talk with your provider about your baby’s positioning, as it may be beneficial to perform these more often or use different positioning techniques.
Perineal Massage
The perineum is the tissue between the vaginal opening and anus. In vaginal deliveries, the perineum can often tear in varying degrees of severity as baby passes through the vaginal canal. Research shows that perineal massage can help to reduce the risk of perineal tears in vaginal delivery, episiotomy, and perineal pain postpartum. Here’s how to do it:
Using clean hands and a gentle lubricant, insert your thumb or finger into the base of your vaginal opening. Add gentle pressure down and to the sides or make sweeping motions from one side to the other.
Starting at about 35 weeks, you can perform this 3-5 times per week for about 5 minutes. It may be uncomfortable when you start, so be gentle and gradually increase pressure over time.
Image used with permission from Pelvic Guru®, LLC as a member of the Global Pelvic Health Alliance Membership (GPHAM)
Breathing
Labor and delivery is hard, and breath work is a powerful tool to help manage and work through the pain and effort of contractions and pushing. No matter your plan for your delivery (i.e. natural, epidural, c-section), practicing your breathing strategy beforehand is vital. There are two main breathing techniques:
Open Glottis Breathing: Exhale as you relax your pelvic floor and push
Closed Glottis Breathing: Hold breath as you relax your pelvic floor and push
The key for both options is that your pelvic floor muscles stay relaxed the whole time! I encourage all of my clients to practice both techniques, so that they can switch if it doesn’t feel right when the time comes.
Dates
An fun fact from research: eating dates can help prepare your cervical tissue for labor with improved cervical dilation and uterine contractions. Why? Dates contain fatty acids that help produce prostaglandins which make oxytocin receptors more sensitive and help to improve the strength and effectiveness of uterine contraction. Date consumption in late pregnancy can actually increase the rate of spontaneous labor and reduce the length of labor. While the recommended dose varies, most providers recommend consuming at least 7 dates per day in the last 4 weeks (or more) of pregnancy to see any effect. Get creative in how you can work dates into your diet!
Final Thoughts
These are just a few suggestions to help you prepare for your upcoming delivery. Remember: this is not individual medical advice, so be sure to consult your provider to understand what’s best for you and your baby. You can also schedule a birth prep visit with a pelvic floor physical therapist to get more specific in how to prepare your body for labor and delivery. In the meantime, use these tips as a starting point to prep your body to meet your baby! You got this, mama!
Resources
Kordi M, Meybodi FA, Tara F, Fakari FR, Nemati M, Shakeri M. Effect of dates in late pregnancy on the duration of labor in nulliparous women. Iranian J Nursing Midwifery Res 2017;22:383-7.