By Stacy Whitman
Women love to tell their birth stories-chances are you’ve heard your share of them. And as your due date approaches, you may find yourself wondering (and worrying!) what your own labor and delivery will be like. Unfortunately, there’s no way to predict exactly how it will play out. But there are steps you can take, both now and in the birthing room, to ensure that everything goes as smoothly as possible. To help you prepare for the big day, we talked to labor and delivery nurses-the real pros who have seen just about every type of birth imaginable-and got their best tips for a quick, complication-free childbirth.
For pro tips, go to the next page…
Keep up your strength.
We all know that the couch can be a pregnant girl’s best friend. But staying active could give you an advantage when it comes time to deliver, says Amy Downey, RN, a labor and delivery nurse at St. Luke’s Wood River Hospital in Ketchum, Idaho. According to the American College of Obstetricians and Gynecologists (ACOG), regular exercise during pregnancy can improve your ability to cope with the pain of labor, as well as speed your recovery afterward. As long as your doctor approves, you should try to do 30 minutes of activity (such as walking, swimming or prenatal yoga) on most, if not all, days of the week. Since childbirth can be a real test of endurance, it’s also important to eat right and stay hydrated, especially during the last trimester, so you have enough energy to go the distance, Downey adds.
Don’t blow off birth class.
Childbirth education classes teach you what to expect during labor and delivery as well as techniques for easing the pain-information that could help you make good choices and possibly even avoid a C-section. From Lamaze to the Bradley Method to HypnoBirthing, a variety of classes with unique approaches may be available in your area. So before signing up, research the options and be sure the instructor will support you in the kind of birth you want to have, says Lisa Klein, RNC-OB, LRN, MSN, CNS, a clinical nurse specialist in the Women, Children’s and Perinatal Services at Inova Fair Oaks Hospital in Fairfax, Va. For example, if you want a drug-free delivery, look for a class that focuses on natural methods of pain management. If you’re interested in pain relief, find one that covers epidurals and other types of anesthesia. If you’re undecided, you may want to take two classes. You may even be able to find an “express” class that takes place over a weekend, Klein says-a great option if you and your birth partner are pressed for time.
While it’s good to have an idea of the kind of birth you want, you never know how labor and delivery will go. So know your options and go with the flow. “Flexibility is the name of the game,” says Jill Janke, PhD, RN, WHNP, a professor at the School of Nursing at the University of Alaska, Anchorage. “If what you’re doing isn’t working to manage your pain or facilitate your labor, keep trying different things until you find something that does.” Likewise, if you want an unmedicated delivery and you end up getting an epidural, don’t beat yourself up. “I’ve seen many women get discouraged when they don’t stick to their birth plan,” Downey says. “But each labor is different, and what worked for your friend may not work for you.” Remember: It doesn’t really matter how you get there as long as you have a healthy baby in your arms at the end.
Get tuned in.
Staying focused, especially when the contractions become more intense and it comes time to push, could help you handle the pain better and be more productive. “I’ve found that the ability to focus internally has a lot to do with some women’s success,” Downey says. Her advice: Minimize distractions by turning off your cell phone and logging off of Facebook. Instead, turn on some good music and tune into your body. “Music can help you concentrate your efforts inward and ignore all the activity going on around you,” Downey explains. In the weeks before your due date, pick out some CDs or put together a playlist of songs that will help keep you calm and centered. Just don’t forget to bring a docking station for your iPod or check to see if your birthing room will have a CD player.
Research has found that women who spend labor in upright positions tend to have less pain and shorter labors, Janke says. That’s why she suggests staying out of bed as much as possible and letting gravity assist. “It’s the best way to avoid complications,” she explains. During the first stage of labor, walking around and sitting in a Jacuzzi or on a birthing ball are great ideas. Then, when you’re ready to push, she recommends squatting, which can open up your pelvic outlet and reduce the likelihood that a forceps or vacuum extraction will be necessary. It also can protect your perineum so you’re less likely to tear. Since holding yourself in a squat position can be tiring, you can start preparing your leg muscles now by practicing it a few times a day, Klein says.
If you want to keep labor from stalling, don’t stay in one position too long, Downey advises. Instead, keep shifting around as often as you can, or at least every 30 minutes. “The descent of the fetus happens much more readily when you keep moving,” she explains. If you’re stuck in bed because you’re being induced with Pitocin or getting an epidural, you can still get really creative and try different things, Downey adds. Talk to your labor nurse, midwife or doula to find out your best options.
Soak it up.
Sitting in a tub of warm water can help you relax and lessen the pain of your contractions. The buoyancy of the water also can make it easier for you to move around and change positions. Many hospitals and birthing centers now have tubs and Jacuzzis in their birthing rooms for that very reason. At the very least, you should have access to a shower where you can sit on a stool and let warm water run over your breasts and abdomen, which not only feels good but can help stimulate contractions, explains Janke.
Whether you’re taking deep inhales or short, quick breaths, controlled breathing can prevent you from tensing up (which makes the pain worse) and help you make the most of each contraction. During the pushing phase, some women hold their breath, causing their face to turn purple (labor and delivery nurses actually call them “purple pushes”). This can lengthen labor by five to ten minutes, and cause both mom’s and baby’s blood pressure to spike, says Janke, who advises against purple pushes unless your doctor or nurse instructs you to do them. During your pregnancy, you should take the time to learn and practice various breathing techniques so you’re prepared when labor begins. (It’s one of the many important topics covered in birth class!) The key is to find breathing patterns that calm you down, keep you focused and give you a feeling of control.
To learn more about pregnancy and the birth experience, visit health4women.org, a Web site sponsored by the Association of Women’s Health, Obstetric and Neonatal Nurses. Or check out The Birth Book: Everything You Need to Know to Have a Safe and Satisfying Birth by William and Martha Sears. And remember that childbirth is a lot like climbing a mountain, as Janke explains. Both can be challenging. Both require preparation and hard work. Both involve some pain (but a normal pain that tells you that your body is doing what it should). Both benefit from companionship and encouragement. And for both, there are wonderful, overwhelming feelings at the end. So get ready for the climb and keep your eye on the prize-a beautiful baby you’ll love with all your heart.
Stacy Whitman is a Sun Valley, Idaho-based writer and mother of a 4_-year-old boy and 2-year-old twins.
Labor and delivery room pros share their best tips.