Many women come to me seeking help promoting labor naturally. They’re looking for ways to prepare their body and mind to encourage the natural onset and progression of labor. Many want to avoid or at the very least, mi...
Many women come to me seeking help promoting labor naturally. They’re looking for ways to prepare their body and mind to encourage the natural onset and progression of labor. Many want to avoid or at the very least, minimize, the likelihood of medical interventions such as membrane sweeps, medical inductions, the need for Pitocin, and of course, Cesarean sections.
Today I’m providing you with a key set of tools to help you do that and much, much more!
These techniques are not meant to be guarantees, they are meant to set you up for the best possible opportunity for a natural onset and progression of birth. Our goal is always to remove any barriers to the natural onset. Keep reading to learn all of the different ways you can support your pregnancy, labor and birth.
As a Chinese Medicine Practitioner, I’m always concerned about stagnation or restriction of movement, but this issue is particularly important when preparing your body for birth. Muscle tension, inflammation and old injuries can impact the position and, more importantly, the mobility, of the bones and joints within the pelvis. They specifically affect the symphysis pubis joint, the Sacroiliac (or SI) joint, and the coccyx. This in turn can hinder the baby’s ability to move into optimal fetal position, engage in the pelvis before labor, and navigate the pelvis during birth.
What you can do to remove structural restrictions?
Luckily there are a whole array of techniques you can use to loosen tight muscles (especially pelvic floor muscles) and encourage joint mobility. Because I’m a Chinese Medicine Practitioner, I always utilize the amazing benefits of acupuncture, and often in conjunction with one or more of the below techniques. All are wonderfully supportive of your body.
Therapeutic Treatment: Acupuncture, Chiropractic and Pelvic Floor Physical Therapy are all focused on treating the underlying reason for a muscular or structural imbalance. Getting treatment in the weeks before birth can open up restrictions, some of which may were there even before pregnancy.
Exercise: Walking, yoga, pilates, and swimming are all excellent for lubricating joints and increasing blood flow to muscles and tendons. When circulation is adequate, blood, oxygen and nutrients can easily reach areas of the body that need extra attention and healing. I mention these particular types of exercise because they are low-impact, controlled movements (less likely to cause injury) and easy to do during any stage of pregnancy; however, many other types of exercise, including stretching, hip circles and resting in child’s pose each night before bed have similar benefits.
Diet: Chronic inflammation can cause and increase joint pain, as well as limit joint mobility. One of the fastest and most effective ways to reduce systemic inflammation as well as joint inflammation, is to eat a nutrient-rich diet, low in pro-inflammatory foods. The primary foods that contribute to inflammation are gluten, dairy and sugar. Eliminating, or at the very least significantly reducing, these foods will reduce overall aches and pains as well as increase the health of your joints, thereby improving joint mobility. Focus on eating foods that are naturally gluten/dairy/sugar free such as vegetables, organic meats, eggs, seafood and healthy fats such as avocado, organic raw nuts and healthy oils rather than “gluten-free” processed foods.
Generally speaking, labors start and progress with fewer problems when babies are head-down with chins tucked, facing the mother’s back. Some birth professionals would argue the ideal fetal position is what’s called the LOA (Left Occiput Anterior) position in which the back of the baby’s head, the occiput, is facing the mother’s left hip. These are important to take into consideration, but remember, babies can switch positions at any time including right before and during labor. Our goal is to give your baby the best possible opportunity to move through the pelvis and birth canal with ease by encouraging and/or removing any obstacles that could inhibit a head-down, chin-tucked position with the baby’s occiput facing the mother’s left hip.
What you can do to Encourage Optimal Fetal Position?
The most important factor when supporting the ideal fetal position is posture during pregnancy. While there are certainly factors we can’t control, such as shape of the uterus and shape of the pelvis, you can control your posture during pregnancy. Here’s what to focus on:
Avoid slouching: You always want to think about sitting up straight, on your sitz bones with your back well-supported. When sitting, knees should always be lower than your hips. Slouching and sitting back on your sacrum may encourage a posterior facing baby, looking out at the belly as opposed to back toward the spine. It can also be a factor in transverse or breech positions. Remember, we can’t always prevent non-optimal fetal positions but we can do everything we can to support the baby’s efforts in finding its way head-down and facing the back. Paying attention to posture is well worth the effort.
Hands and Knees: Spending time on your hands and knees uses gravity to help the baby into position. Keep in mind, the baby’s head is the heaviest part of its body. He/she wants to be head-down, comfortably nestled in the pelvis. If you know the baby is not in an ideal position, it’s worth spending time crawling each day to help shift and wriggle the baby into position.
Hanging Belly: Choose positions that allow your belly to hang in front of you, creating a sort of sling for the baby and encouraging that head-down, posterior positioning. For example, sit backwards in a kitchen chair with your back straight, hips open and wide, arms supported on the top of the chair and belly hanging forward. Or, lean against the kitchen counter on your forearms with knees bent, hips open and swaying. Another option is to kneel on the floor using an exercise ball as support, again with hips wide and possibly using this time to do hip circles to lubricate hip joints.
Throughout most of your pregnancy, your cervix is hard, closed and long but in the weeks, days and hours leading up to the onset of labor, the cervix begins to soften, dilate and efface or thin in order to allow the baby to pass into the birth canal. Our primary goal when thinking about the cervix in preparation for labor is to encourage a smooth, uninhibited transition to a soft, fully-dilated and fully-effaced cervix ready for birth.
What you can do to support the cervix?
From a Chinese Medicine perspective we want to focus on two things: 1) Removing any stagnation that would prevent the natural progression of cervical transition, and 2) providing the cervix with unrestricted blood, energy and nutrients during pregnancy, labor and birth. Acupuncture and/or acupressure are wonderful ways to accomplish this, but it is also important to stay well-hydrated and continue to move and exercise in the weeks before your estimated due date.
Acupuncture/Acupressure: I recommend women come in for weekly acupuncture treatments to help prepare their body and cervix for labor. Studies prove that acupuncture treatment can help soften and shorten the cervix, leading to natural onset of labor and/or easier induction processes. I find the following two acupoints to be most useful. When using acupressure at home, apply firm, steady pressure to the point for 2 to 3 minutes, several times a day in the weeks/days leading up to your estimated due date. These points can be used throughout labor, birth and/or an induction.
llustrations from A Manual of Acupuncture by kind permission of the publishers amanualofacupuncture.com
Stay Hydrated: Staying hydrated will help tissues stay supple and mobile. Other than water and coconut water, here are my two favorite electrolyte drinks: 1) ElectroMix by EmergenC and 2) E-lyte by BodyBio. Both can be found online and can be consumed regularly throughout pregnancy, in the weeks/days before your estimated due date and during labor and birth.
In the final weeks of pregnancy, many babies begin to wriggle further down in the pelvis. This is commonly known as the baby “dropping” or engaging in the pelvis. As the baby descends further into the birth canal, the top of the head begins applying pressure on the cervix. This pressure, in turn, encourages dilation and thinning of the cervix. If baby’s chin is tucked and he or she is optimally oriented within the pelvis, it will support natural onset of labor.
Avoiding stalls in labor is less important when laboring or giving birth at home, where homebirth midwives are not as concerned with time. For women who are giving birth in hospitals, which is the majority of women, time can be of the essence. If labor is not progressing in a way the doctor or hospital protocol deems appropriate, or the hospital has limited bed space, a delay or stall in labor could lead to a recommendation of Pitocin. There is some evidence that the administration of Pitocin leads to increased frequency of intervention.
What you can do to help the baby engage in the pelvis?
In my clinic, we use a combination of acupuncture, exercises and posture to create the best possible opportunity for the baby to further engage in the pelvis.
Acupuncture: Traditional Chinese Medicine theory is very concerned with the direction of the flow of energy. Acupuncturists are constantly thinking about which direction we want energy to move. For example, in early pregnancy, nausea is considered a result of “rebellious qi” or in other words, energy that’s flowing up, the opposite direction as it’s supposed to flow in relation to digestion. We use needles to stimulate acupuncture points to correct this by redirecting energy downward. When it comes to helping guide the baby further into the pelvis, we use acupuncture to send energy, or qi, downward. Women can support this effort at home by using acupressure (download my free acupressure cheat sheet below!).
Exercises: The primary exercise to support the baby engaging in the pelvis or dropping, is the squat. I recommend supported squats. You can ask another person to hold a scarf or towel as you grasp the other end, then simply lean back into a deep squat with legs and hips wide. Stay for as little or as long as feels good to you. Alternatively, you can use the wall as support. With legs wide, sink down until your bum is resting on a yoga block or a firm rolled up blanket. Again, stay for as little or as long as you like. Doing this several times a day in the final weeks/days of pregnancy should allow the baby to descend further into the birth canal, if he or she is so inclined. Prenatal yoga is also wonderful for releasing tension in the hips and providing the best possible chance of the baby engaging.
Posture: Throughout pregnancy, but especially in the final weeks of pregnancy, maintaining proper posture is of utmost importance. Posture that supports optimal fetal position and therefore a higher likelihood of engagement has several elements. You’ll want to focus on stilling up straight on your sitz bones. Think of the old dance instructor adage of a string at the top of your head pulling you straight up to the sky. This can be taxing during pregnancy, so be sure to use blankets, pillows or other means of support to help maintain proper posture. Avoid slouching and/or leaning back on your sacrum. Instead, sit tall on your sitz bones, with hips relaxed, feet on the floor and legs wide. Sitting (and bouncing) on an exercise ball is fantastic.
Women are very action-oriented and when it comes to getting labor started, we are no different. Women often come into my office looking for a to-do list that will get their labors started and in part, that’s what I’ve tried to provide today. But perhaps the most important thing women need “to-do” is nothing.
What you can do to calm your mind?
It’s important you take time to rest, connect with your body, connect with your baby and partner, spend time in quiet, low-lit settings maybe reading or taking a bath, go for leisurely walks and appreciate nature, practice relaxation breathing techniques or listen to guided meditations.
Guided Meditation: Many women do not have the luxury or the opportunity to “relax” or slow down in the weeks before birth. Limited maternity leave can drive women to work right up until they go into labor. If this is the case for you, try to carve out even 30 minutes a day to listen to a guided meditation in a warm, comfortable, low-lit setting. One of my favorite meditations is Hypnobabies, Come Out Baby. The goal here is to leave the worries and stress of life behind you and spend a small amount of time connecting to your body and your baby.
Quiet Time: The body and brain need to know you are in a safe place for labor to begin and progress smoothly. In other words, cortisol levels need to be low and the body needs to be relaxed. But, cortisol isn’t the only important hormone to take into consideration. We also want to encourage, or maybe more importantly, avoid discouraging, the presence of melatonin. Cortisol and melatonin are inversely related, so the higher your stress levels (and therefore the higher your cortisol levels), the lower your melatonin levels will be and vice versa. Melatonin has two important roles when it comes to labor: 1) it ensures efficient uterine contraction, and 2) it supports oxytocin in the strength of contractions. So keeping stress levels low to support low cortisol levels and spending time in quiet, low-lit rooms to keep melatonin levels high will support the natural onset and smooth progression of labor.
You may have noticed that I didn’t talk about inducing contractions in this post. It is my opinion that inducing contractions via acupuncture is as much an intervention as any other. I much prefer to prepare mother and baby in the time leading up to labor and birth, so that the two can work together and labor/birth progresses naturally, in a timely manner, in the best possible way.
If, however, your water breaks but contractions have not begun or your doctor is recommending an induction for medical reasons and you are considered full-term, we can use acupuncture to encourage contractions. I use specific acupuncture points along with many of the ideas mentioned above to encourage the onset of contractions and move labor along.
After 10 years in practice and helping prepare many women leading up to birth, I have seen the best outcomes when patients begin weekly acupuncture treatments in the 36th or 37th week of pregnancy.
“After I left the appointment yesterday, I went for a walk and I kept having mild contractions every 20 minutes that started to get closer and more intense as the afternoon went on. I got in the bathtub around 6:30pm and labored there until we left to go to the hospital at 7:45pm, we got there at 8pm and I was 10cm dilated and ready to push! Lilia Sophie was in my arms at 8:26pm. We were there for only 26 minutes. She was in posterior position, otherwise she would have probably been born in the car! Needless to say, it was completely intervention free. It was a wonderful, quick labor and we are doing great. Thank you so very much for your support, your treatments and your kind words of advice! I truly believe that you helped me so much in achieving this amazing labor, despite the baby not being in ideal position!”
Vivian – Medford, MA
“I think the needles must have done the trick because I started labor about 12 hours after leaving your office! Currently holding a beautiful, 6-day-old little boy.”
Alison – Sommerville, MA
“All of your suggestions of exercises paired with some acupuncture truly paid off! Although our baby moved to the transverse position at week 38, at week 39 she successfully moved back in to place! We were beyond surprised and excited that we didn’t have to go for the version when I went into my 39 week apt. Thank you for everything! You helped give the natural labor and delivery that I thoroughly enjoyed back! Without your support, we would have gone for the version with the suggested induction or c-section to follow. Instead our baby, naturally joined us on her due date – December 14, 2017. I still can’t believe we were able to move such a big baby (9lbs 3ozs) back in place so late in the pregnancy! Thank you again for everything! ”
Katelyn – Raynham, MA
“I can’t thank you enough for all your expertise and care in the past few weeks. I think this labor went so well because of all the work you did!”
Erin — South Boston, MA
“It was one of the very few times during my pregnancy when I had a chance to relax and actually consider what was happening. It helped me find a good emotional space to prepare for childbirth. On a very practical level in addition to helping with induction, acupuncture reduced the pain and swelling in my ankle from a previous injury.”
Dia — Somerville, MA
“Angie is very thoughtful and takes the time to listen to clients individual and unique concerns. I went to her several days overdue as my care provider was discussing a medical induction. Two days after two treatments I went into labor. ”
Maria — Somerville, MA
“My water broke on its own less than 24 hours after my appointment and my son was born another 24 hours later. It was a VBAC. ”
Julie — Arlington, MA
“I highly recommend Angela as she is an expert in women’s health and acupuncture. I believe her treatment and suggested acupressure points helped me go into labor naturally and avoid interventions. ”
Jess — Charlestown, MA