Congratulations on being pregnant!  During the course of your pregnancy, there are several steps that you can take to help ensure that you have a more satisfying birth:

Educate Yourself                                                              RETURN TO TOP

 First and foremost is educate yourself.  Read and learn all you can about pregnancy, birth, breastfeeding and parenting.  Ask questions at your prenatal visits and keep the lines of communication open with your healthcare provider(s).  It is also important to educate yourself about the birth attendant and facility you have chosen.  You may find it useful to inquire about their rate of cesareans, epidurals, episiotomies, and breastfed newborns.  Helpful Hint:  The more knowledge you have, the more prepared and confident you will feel.

Educate Others                                                                 RETURN TO TOP

Don’t be afraid (in fact, be prepared) to educate others regarding your birth choices.  Your partner, family, friends, and your healthcare provider can all benefit from knowing and understanding the reasons behind your preferences.

Get Prenatal Care                                                             RETURN TO TOP

Get prenatal care for the duration of your pregnancy (prenatal care can begin even prior to conception).  To reduce the chance of pregnancy and birth-related complications, it is very important that a qualified healthcare provider (i.e., midwife, doctor, nurse practitioner, physician's assistant, etc.) is monitoring your progress.

Practice Good Nutrition                                                  RETURN TO TOP

Practice good nutrition.  Make a special effort to eat a balanced diet and consume at least 80-100 grams of protein daily, which has been shown to help promote proper brain development (vitamin and mineral supplements do not provide any protein).   Also, take the prenatal vitamin that has been recommended by your healthcare provider.  Additionally, getting an adequate supply of folic acid is important because it has been shown to reduce the occurrence of neural tube defects such as spina bifida.  Eating well will keep you feeling at your best, will ensure that you gain an appropriate amount of weight, and will provide your baby with the nutrients he or she needs to thrive.  Try to avoid alcohol, nicotine, caffeine, environmental toxins, and all forms of recreational drugs.  Seek help if you feel you need assistance in avoiding any substances that would be harmful to your unborn child.  

Drink Enough Water                                                        RETURN TO TOP

Consume at least two quarts (eight to ten glasses) of water daily, as dehydration can, among other things, trigger the onset of preterm labor.  Helpful Hint:  Fill two pitchers with water first thing every morning, and try to have consumed it all by bedtime.

Get Exercise                                                                            RETURN TO TOP

Get plenty of mild to moderate exercise.  Walking, swimming, and prenatal yoga are great ways to stay fit during pregnancy.  Regular exercise will help keep you physically and mentally healthy, and will help ensure that you have the stamina needed for labor and birth.

Practice Pregnancy Exercises                                     RETURN TO TOP

Practice prenatal/pregnancy exercises that will help to prepare your body for labor and birth.  These include:  Kegel exercises (which strengthen the pelvic floor muscle and can prevent birth-related perineal trauma and prenatal/postpartum incontinence), tailor/Indian-style sitting (this posture moves the uterus forward into a better position and strengthens and stretches the inner thighs), squatting (this is a good position for pushing because it can increase the diameter of the pelvic outlet by 10-30%.  Practicing this position will strengthen your leg muscles as well as familiarize you with this position), and pelvic rocking while in the hands-and-knees position (this can help the baby come forward into a more favorable position, as well as relieving back and bladder pressure and improving circulation).  Helpful Hint:  These exercises prove so helpful that I would strongly recommend that you tape a reminder note to your bathroom mirror so that you will remember to practice them on a daily basis.

Attend Classes                                                                  RETURN TO TOP

Attend prenatal childbirth and breastfeeding classes (if you are particularly interested in having a natural birth, I recommend taking Bradley or Lamaze childbirth classes. For more information, visit www.BradleyBirth.com or www.Lamaze.com)  Helpful Hint:  You may get more objective information by taking a class that is not offered by the hospital (neither taught at the hospital nor by a hospital employee).  Such classes may have loyalties to the facility that hinder the exchange of uncensored information.

Attend La Leche League Meetings                              RETURN TO TOP

Attend local La Leche League meetings.   La Leche League International is a nonprofit organization that helps mothers to breastfeed through mother-to-mother support, encouragement, information, and education.  Attending while pregnant will give you exposure to mothers and breastfed babies, and will introduce you to knowledgeable LLL Leaders, whom you can later call with any breastfeeding questions or concerns.  Visit www.LaLecheLeague.org for more information or to find a group in your area.

Prepare a Birth Plan                                                        RETURN TO TOP

Prepare a birth plan that describes your preferences for labor, birth and immediately postpartum.  You will also want to include a birth plan for the baby as well as one to use in the event of an unplanned cesarean birth.  Develop this plan in consultation with your healthcare provider, as he or she may want to discuss some of your preferences with you.  Helpful Hint:  It would probably serve you well to word your birth plan in non-defensive terms (i.e., unless medically contraindicated, I/we would prefer . . . ), and keep it somewhat brief - two pages at most.  Discuss your plan with every midwife/doctor in the practice, and request that they sign it (as long as your requests are not unreasonable, most providers will not have a problem with this).  Have a copy of your plan put in your chart, and take a couple of copies to the facility you have chosen for your birth.  A final note on birth plans:  It never hurts to conclude your plan by thanking the medical staff, in advance, for participating in the birth of your child and for honoring your wishes, when possible. 

Prepare a Postpartum Plan                                           RETURN TO TOP

It can also be helpful to formulate a postpartum plan.  During the first few weeks postpartum, the new mom should be taking it easy and spending most of her time getting to know her baby.  In this plan, you can include a list of household chores that will need to be done, a list of any frozen meals you have prepared (and instructions on cooking them), and a list of things your husband/partner can do for YOU to help you feel relaxed and pampered during this often overwhelming time of adjustment.  When family and visitors inquire about what they can do to help, you can hand them a copy of your postpartum plan and have them pick a chore!  After all, holding the baby is seldom much help (unless it’s so that the new mom can get a much-needed shower!).

Practice Coping Techniques                                        RETURN TO TOP

Practice the various coping techniques that you plan to use during labor.  Whether you plan to use relaxation exercises, massage, visualization, breathing techniques, etc., it is essential that you practice, practice, practice!  Anything that your mind and body are not used to doing, will NOT feel natural during the intensity of labor.  You need to practice these coping techniques until they are “second nature”.  Make sure that your labor partner is practicing them with you, as you will most likely need his/her assistance to effectively cope with labor.  Finally, since labor is often unfamiliar territory and the exact course of your labor cannot be predicted, it helps to practice your coping exercises in various surroundings and circumstances (i.e., when you have a headache, when your are feeling stressed, when you are having a prenatal exam, etc.).

Consider Perineal Massage                                         RETURN TO TOP

To help prevent tearing, discuss perineal massage with your health care provider.  This can be performed by yourself (or your partner) prenatally, and by your birth attendant (with oils and warm compresses) before and during delivery (though recent studies suggest that vigorous massage during labor/birth may actually increase the risk of perineal trauma).  This technique, when gently practiced prenatally, helps to gradually stretch the tissues of the perineum and it also familiarizes you with the “burning” sensation you may feel as the baby’s head crowns.  If you are already used to, and expecting, this sensation, then you will be less likely to fight it by tensing up during the birth.  Practicing perineal massage prenatally also provides you with a great opportunity to practice your coping skills, as this unfamiliar stretching sensation can be uncomfortable.

Consider Hiring a Doula                                               RETURN TO TOP

Consider hiring a doula.  A doula is a professionally trained and experienced labor support person.  Her role is to provide continuous physical, emotional and informational support for the laboring woman.  Evidence indicates that the presence of a doula can increase your chances for a good outcome by decreasing your need for medication, decreasing your risk for a cesarean, increasing your chance of successful breastfeeding, decreasing your risk of postpartum depression, and possibly shortening the length of your labor.  A doula can be particularly useful if you want to have a natural birth in a hospital setting.  Additionally, when problems or birth defects are anticipated, a doula can be a comforting presence and can help guide you through the emotional aspects of such a birth.  To learn more about doulas or to locate one in your area, visit Doulas of North America at www.DONA.com. (link to books about doulas).  Helpful Hint:  A doula is a positive addition to any birth team, regardless of the type of facility, birth attendant, or number of other support persons present. Doulas are also invaluable to mothers who do not otherwise have much support.

Pack a Labor Bag                                                             RETURN TO TOP

Pack a labor bag.  Whether you will be giving birth at home, in a hospital, or at a birth center, prepare all of your “labor supplies” so that they will be readily available.  These items can include:  favorite music for laboring, your pillow, bath robe, tennis balls (for back massage), wooden massage tool, cornstarch or massage oil, lip balm, favorite drinking cup (bring a large, insulated one), lollipops or popsicles, favorite picture or another item to use for focusing, and a list of the coping techniques you think you might use.  You may never even open the bag, but it always helps to have your labor tools handy.  A word of caution:  Many women experience some degree of nausea during pregnancy, so be careful about including scented oils, candles, soaps, etc., as these can be quite offensive to the laboring women who is nauseous.

Choose a Birthing Facility and Attendant                 RETURN TO TOP

When deciding on a birth facility, labor partner, and birth attendant, try to ensure an atmosphere of comfort and privacy where you will feel free to labor in whatever way you need to.  You may want to consider choosing a midwife as your birth attendant, as they provide excellent personalized maternity care for the low risk woman.  Midwives believe in the normalcy of birth, and most remain with you throughout your entire labor.

Arrange for Postpartum Help                                         RETURN TO TOP

Try to arrange for help during the first few weeks after the birth.  This transition can be overwhelming, and you need to be able to get to know and care for your baby, as well as caring for yourself.  Having someone else take care of the meals and household chores will enable you to focus all of your energy on your baby and your own recovery.  If a close friend or relative is not available, you can look into hiring a postpartum doula. 

A note on preparing your home for the baby:  Try not to get overwhelmed by all of the baby gadgets and baby “superstores” out there.  All any baby really MUST have is his mother (and, of course, diapers and a car seat!).  If, however, putting together an attractive nursery filled with pretty clothes and toys makes you feel good, then GO FOR IT!  Just remember that Mommies are the “original” cribs, bottles, pacifiers, infant carriers, swings, teddy bears, and music boxes.  It’s really YOU your baby wants to be near, especially in those early months. 

Copyright 2002 A Better Childbirth, Inc.