Episode #43: 5 tips to prepare for birth

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In this episode, Dayna shares her top 5 tips to prepare for birth. There’s a lot that is out of our control during birth. But there are also a lot of things we can do to mentally and physically to prepare for this challenging event! If you are pregnant, or hoping to become pregnant one day, this episode is for you!

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LINKS & RESOURCES MENTIONED IN EPISODE:

🔹 Frida Mom Pregnancy Lotion
🔹 The Fourth Trimester Book
🔹 Dayna’s Birth Prep Class at Rebirth Wellness


SHOW NOTES:
(0:49) - Episode intro
(01:56) - Tip #1 - It’s never too early or to late to begin preparing for birth
(04:21) - Tip #2 - Perineal massage
(09:40) - Tip #3 - It might be helpful to attend a birthing class
(13:47) - Tip # 4 - Prepare for the mental/ emotional aspects of birth
(18:59) - Tip #5 - Prepare for the first 12-weeks postpartum during pregnancy

  • Episode #43: 5 tips to prepare for birth

    We're excited to have you join us for this episode of Pelvic Health and Fitness. I'm Dayna Morellato, Mom, Orthopedic and Pelvic Health Physiotherapist. And I'm Rhonda Chamberlain, Mom, Orthopedic Physiotherapist and Pre Postnatal Fitness Coach. On this show, we have open and honest conversations about all phases of motherhood, including fertility, pregnancy, birth, postpartum, menopause, and everything in between.

    We also provide helpful education and information on fitness, the pelvic floor, and many aspects of women's health, including physical, mental, and emotional wellness. Please remember as you listen to this podcast that this is not meant to treat or diagnose any medical conditions. Please contact your medical provider if you have specific questions or concerns.

    Thanks so much for joining us. Grab a cup of coffee. Or wine. And enjoy!

    Welcome to the pelvic health and fitness podcast. This is Dayna and I am going to do a solo episode here for everybody today. And I thought I would talk a little bit about my top birth prep tips. Um, I get, it's a question I get asked a lot.

    It's definitely a topic that people come to clinic quite often for. They come specifically for, um, Push prep classes, we call them, where I work here in London, or they'll just sort of start seeing me throughout their pregnancy, and inevitably we always start talking about what can I do to prepare for my birth.

    Um, and in those sessions, I also will, I chat to them about preparing for postpartum, so maybe that's an episode I'll do later on, and what can we do to prepare. For postpartum, because there's definitely not enough information out there about that, nor are you provided, in my opinion, nearly enough, um, in the postpartum period, uh, especially those first six weeks.

    But anyways, for tonight, we are going to talk about my top birth tips, so I have five of them. My first. tip is that it's never really too early or too late to begin preparing for birth. I often have people that come in their first trimester and are concerned that they're too early and then I have people who come at 36, 37 weeks and they're worried that they're too late and everywhere in between.

    I don't think that you're ever too early or too late to start preparing and connecting with your pelvic floor, particularly if you've never really been taught how to do a Kegel. Um, you know, in prior previous episodes, we've talked about how Kegels, especially towards the final stages of pregnancy, maybe are not the main goal.

    We want to make sure that that pelvic floor is able to relax and let go for a vaginal delivery. Um, But connecting, being able to know what a contraction feels like, being able to recognize what a relaxation feels like, being able to sort of check in with other areas of your body, for example, your jaws directly related to your pelvic floor, um, that can't come to you.

    early or too late. Certainly any amount of practice or knowledge about that is power in the birth experience. If you come a little bit earlier, you've obviously got a little bit more time under your belt to practice these things, but um, yeah, I don't, I don't really think that there's any time that is the wrong time to start preparing.

    Um, and preparing for your birth is so much more than, um, coming to a pelvic physio or any sort of birth prep class. It, it can give you some other exercises, some yoga poses, hip openers. Um, if you are having any pain during your pregnancy, then sort of Finding ways to alleviate that in the, in the, with the goal of alleviating tension throughout your body can be really helpful at any stage of your pregnancy.

    Um, these are not really in any particular order either. I should say that as well. I was just sort of writing down my thoughts. In a random order, as has been my way previously at the time of this recording, it is December of 2022. Um, everybody's kids are constantly sick and Christmas is on Sunday. So it feels like a wild time.

    So pardon me if it's a little bit all over the place. Um, the stuff. Second tip I have is perineal massage. So perineal massage is the um application of some pressure at the bottom part of the opening of the vagina into the area between the opening of the vagina and the anus which is considered the perineum This is the area where we most often see tearing And, or episiotomies can happen during the birthing experience, so, um, if you sort of picture the opening of the vagina as being a clock, we're down in the 6 o'clock region, I usually have people work anywhere from like 3pm to 9pm, if you can sort of visualize that, um, and then most of the work being done down at 6, 5, and, um, 7 p.

    m. Um, so you would apply a little bit of downward pressure and or downward pressure and sort of tracing up the walls, um, to those time points on the clock and holding for about 10 seconds. The idea being that when we apply that stretch to the tissue, we're getting a little bit of pliability in those tissues, training an area that doesn't generally experience any stress, a stretch part of me.

    And for a first birth probably hasn't experienced stretch ever, and training that tissue to let go and respond in that sort of softening type way. This is something that isn't done until after 35 weeks of pregnancy, so we don't want to start it too early. You can use any sort of lubricant, um, that you're comfortable using.

    I've had people use coconut oil. I know Frida Baby has, um, a product that I've had several clients who like. I have no association with them specifically, I just know they have a great line. Um, And so we're applying that downward stretch with or with a sort of a U shaped trace up to 7, um, or 5 p. m. on the other side.

    Yes, it can reduce the risk of perineal tears because as baby crowns and comes through, we've practiced having that tissue stretch and so theoretically it has a little bit more give. My understanding of the research, I haven't read anything that's super current. So pardon me if this has been updated, is that there is research support for it.

    It's not a massive reduction in risk of tearing, but it's not nothing. And so I think any benefit of, um, Any benefit is benefit. What I always sort of add to this with all my clients is if they choose to do it and you can do it to yourself, you can have your partner do it. It doesn't matter. Um, what I always add is when that uncomfortable stretch sensation is applied to the perineum.

    Because it isn't comfortable, it, you know, it's an area particularly at 35 weeks that has been holding a lot of tension for the marathon up to that point, um, and it's tissue that isn't necessarily being stretched on the day to day basis. So it's not a comfortable experience. So I think what the biggest or one of the biggest pieces that people benefit from when they practice that is they apply that stretch.

    I have them apply that stretch and then practice their reverse Kegel. If you're new here, or reverse Kegel being that nice big belly inhale, thinking about relaxing your jaw and yielding to that uncomfortable stretch sensation. That is super important during birth and that's part of my first tip is learning to relax that pelvic floor and then the perineal massage combined with that helps you relax and keep relaxed.

    Um, as an uncomfortable stretch sensation is happening, happening in your perineal, um, body in that perineum. Now. The stretch in intensity is obviously going to be quite a bit higher on the day of the birth, but there's no better way to practice it. So I think that that relaxation of the jaw is very important.

    It's an important aspect to practice. Spoiler alert, I don't know how many episodes you've listened to. So again, if you're new here, jaw tension is directly related to pelvic floor tension. So I will often have people practice that reverse Kegel. Letting go of their belly and letting go of their jaw throughout their pregnancy.

    Doing, you know, a number of repetitions, 15 to 20 repetitions of those a day, as they, especially in the second half of their pregnancy. Um, during labour, your abdominal wall is contracting, so it gets harder to check in with that abdominal wall. Um, to have that feedback for relaxation in the pelvic floor, but your jaw, you can always check in with.

    And I love to give this tip to partners, something that they can remind you of throughout your labor is to relax your jaw, drop your shoulders so that we're keeping that pelvic floor relaxed as relaxed as possible throughout the process. Um, so you can practice it all through the pregnancy, you can practice it with perineal massage.

    Um, and again, then it will be directly applicable to you in birth, during birth, in birth, anyways. Um, I think attending a birthing class is, can be very beneficial as well. And so it can be a specific. Um, push prep class like, um, I've been chatting about where we really sort of zero in on what can you do during labor?

    What can your partner do? Uh, what does a push feel like? Where should you feel that pressure? But even further to that, I think a birthing class, um, where you sort of learn about what's happening, you know, with baby and, and lots of, uh, different tips and tricks for, for, um, for the actual birth. Um, Some people will come to like a birth, uh, what do they call them?

    Child birth ed classes, usually they're called, and then like I said, the push prep that I do is sort of a zeroed in version of that, so some courses are going to have really detailed, um, descriptions of sort of all of these things in one. I, I always like people to have the aspect of, you know, Um, the breathing, how can we connect with the pelvic floor, what are some strategies during labor that can help with the movement of baby down through the birth canal, whether that's movement, and you want to make sure that the class is giving you options for medicated and unmedicated.

    Even if you have strong, very strong opinions either way, I really truly believe it's about just knowing what your options are in either of the situations, because as I always say, birth has a plan. Um, and so sometimes people are really adamant that they're not having an epidural and end up with one or somebody who's adamant they're having one and there's no time.

    Um, I think it's really important that we just know what all of our options are for either type of birth. Um, we want to make sure that the part your partner knows How to get involved. We, you know, whether that's some counter pressures, hip squeezes, sacral pressures, things that they can remind you of, as I was saying earlier, things like remembering to relax your jaw and drop your shoulders are really great cues.

    Um, I like to have partners keep an eye on the time. and have mom move every 45 to 60 minutes, change positions, um, maybe encourage a bathroom break to go pee because the bladder, uh, can impede baby's movement down the vaginal canal. So definitely making sure that the, that the partner is involved. And I also truly believe it's very important that at some point during the session, cesarean birth should be done.

    discussed. Cesarean birth is birth. And I really believe that it's important that we prepare women for birth, which is both of those situations. I think the current stack in Canada is that, um, and it might be Ontario, but in Canada, it's, uh, one in five births is a cesarean birth. One in five. So we do a disservice.

    To our clients and you know even perhaps to yourself if you're preparing for birth if we don't even let that enter our mind Just knowing that it's on the table and sort of understanding and asking questions I always tell people to you know, have that conversation with your midwives have that conversation with your OB What are situations that would lead to a cesarean?

    What could you expect from a cesarean birth so that it's in your mind? the When we're preparing for birth, it's important to know that birth can happen in two ways. It can be a belly birth, it can be a vaginal birth, and knowing that option beforehand, I really truly believe sets you up for success regardless of the path that that goes.

    And therefore, pardon me, sets you up for, um, success postpartum. And by success, I mean a more comfortable recovery. So bonus marks if they're talking about, um, cesarean births. I My fourth tip is preparing sort of for the emotional and mental aspect of your birth. And what I mean by that is I always encourage my clients to think about the environment that they're going to be in.

    So for home births, this is maybe a little bit easier, obviously, that Um, has played a huge role. You've chosen to have a home birth for obviously a number of reasons, one of them being you want to be at home. It's a comfortable place. So if you are having a hospital birth, I always encourage people to think about what can you take into that room that is going to make the room a little bit more familiar, a little bit more comfortable for you on a day when not a lot is familiar or comfortable.

    Um, things like, um, Pictures or, um, having a playlist of music or, uh, shows or movies on an iPad that you think you'd like to have playing in the background, right? Like, I had friends going sort of in the background of my entire second lab Labor. I love friends. So does Rhonda. I know the jokes. And that kind of stuff is important for your central nervous system.

    On a day where not a lot is familiar, making sure that there's something that you find soothing or familiar in your environment can be very helpful for your central nervous system to decrease some of the tension or the, the stress that is produced from that alone. Uh, I always encourage people to think about lighting.

    Right, if you're, if, and you know, you can tell your partners if you're having a few contractions that are maybe a little bit more, um, challenging or you're tired, you just got an epidural and you're going to have a nap. Now, labor and delivery nurses are usually really on that one. They'll often dim the lights in hopes that you'll have a little bit of a sleep.

    Um, But I had a client just today, actually, she said to me, you know, I'm really light sensitive. So part of her birth plan is to have her partner suggest when they go in that they can keep the lights a little bit more dim right from the get go just to sort of settle her central nervous system. So think about the environment that way.

    I often get asked about water births, not water births, pardon me, but laboring in water. And I think it can be a great tool. One of the things I always ask people first and foremost is Do you like water? Do you like being in water? And that doesn't mean that if you don't like water, that being in the water is a terrible idea for you.

    It's not necessarily, but when you're sort of setting up an idea of how you would like things to go and having your options of where you would maybe go first, if you're not really somebody who likes the idea of baths. Maybe that's not at the top of your list. However, birth has a plan. So if you're sort of really trying to avoid a medicated birth and you've tried all the other things, then maybe you do get into the water.

    Um, but I think it's important to sort of have a game plan of what things that you would try first and things that you find supportive for you when you're not in labor. Um, and. all sort of with the idea that you are trying to calm the central nervous system. The other thing that I heard a number of months ago, and I thought was a really great thing, and I've started this with some of my clients is, um, if you can think of like a mantra or, um, You know, just a word that you want to think about, or even just sort of like a, a noise that you find soothing, so like a low hum or something like that.

    Starting to use that earlier in your pregnancy, um, doesn't matter how early, really, again, never too early, too late, but starting to practice your focus on that. With the reverse Kegel, letting go of your jaw, doing that breathing, and really practicing focusing on that mantra, that hum, that mental image, that one word, whatever it is, that in the moment can help you stay sort of focused and distracted on something.

    That those are opposite descriptors, but it can help you stay sort of focused on something other than the intensity of the contraction. Um, and the longer you've sort of practiced that, the easier it is for you, the more familiar it feels, the more is to your central nervous system. So, I think it s very important, yes, your body, you know, the physicality of birth, at the end of the day there is a level of, um, instinct there and there is lots that we can do to sort of help support that physicality.

    But the mental aspect of it, especially if it's your first birth, you just. Oftentimes, and I was the same way, you just don't know what to expect or how you're going to handle it. But if you have just sort of a mental strategy, um, an emotional strategy in terms of your environment and things like that, and calming that central nervous system from different, um, inputs like those I've discussed can be really, really helpful.

    And then my last tip, and I sort of alluded to this at the beginning, You want to learn about the first six weeks, or even the fourth trimester, which is really the first twelve weeks, postpartum, as you're preparing for birth. Every, almost every patient who comes to see me will say, I had no idea. That this is what it was going to be like.

    Um, and one of the things I often will chat about with clients in often, the thing that I chat about clients, with clients often is the first six weeks and what we're sort of watching for from a pelvic health perspective, from what they should be watching for to let them know if they're doing too much.

    But, uh, a book I often recommend to people is called The Fourth Trimester. The first six weeks especially is a wild time and I don't you know You leave the hospital with a lack of information about baby, but especially if it's your first baby It still feels like not even close to enough and and that is where I think people will spend the majority of thinking When somebody tells them to prepare for postpartum and to learn about what that means I think most people think that That's what they mean.

    We want to learn as much as we can about babies. And what do we do if the newborn does this? And what do we do for purple crying and all that sort of thing? And while that's great information, what I mean is learn about postpartum for mom. What does that look like? What does that look like physically?

    What can it look like mentally and emotionally? I think having conversations with partners beforehand and maybe even family members and friends if that is something that you need to about setting some boundaries. about visiting times and how long that people can be there and when they're allowed to come.

    Should they be allowed? Are they going to be allowed to hold your baby? So it's not stuff that you're dealing with when you're healing physically, when you are healing emotionally and mentally, depending, you know, how you feel about your birth, trying to figure out which way is up, you're sleep deprived, you're wearing a diaper, um, these are things that we want to have sorted out.

    Beforehand and have for sure you and your partner on the same page about so you're not feeling like you're sort of being left unheard We want to know that there is a dinner plate size wound left by the placenta in the uterus following birth which means You need to be resting. Yes, sleep when the baby sleeps, but pelvic and abdominal rest, we need most of our time in the first two weeks to be in bed on a couch, relaxing, reclined.

    The next two weeks should be in and around, right? We shouldn't, we're not going out for five kilometer walks in the first six weeks. And signs and symptoms that we've sort of discussed in previous sessions, you know, watching for postpartum bleeding levels and, um, any changes to bowel and bladder and pressure and heaviness in the pelvic floor and pain.

    Those are all things that we are signs and little flags that you should build more rest in. Um, good things to know, for sure, for postpartum. The cueing that we sort of give women by calling, you know, you go and see your midwife or your, or your OB for your six week clearance or your six week check, um, that's sort of when people will get the okay to return to intercourse, return to exercise.

    And so the messaging there is. You should feel better. Go ahead. Go back to your activities. Go back to intercourse. And most people will come to me at six weeks. Most people. And feel like their body is failing them because they do not feel ready. to be intimate with their partner. They do not feel ready to add in exercise.

    They haven't slept. Maybe they've not even showered in days. Um, and so I think that we need to really change that expectation. It's why like the fourth trimester, it lays it out from the beginning that this is really a 12 week healing, um, allowing that placental wound to heal. To heal, allowing your pelvic floor, your abdominal wall, if you had a cesarean birth, that scar to heal, and we don't heal by running errands and vacuuming the house while trying to feed a baby and getting broken two hours and three hours stretches of sleep at night.

    We need to prepare for this time and mentally accept that we're not going to be able to be the busy bodies that we generally are, and that's okay. That is okay. Okay. Hopefully that is helpful for somebody, um, out there. Let us know what you think. Um, and I think probably I will do my top tips for preparing postpartum.

    Things that I tell people from a pelvic perspective as well as just sort of an energy conservation. Um, but I hope you enjoyed. Thanks for listening to today's podcast. We hope you enjoyed the conversation. If you liked what you heard, we would love if you could share this with a friend, leave us a review or subscribe to anywhere that you listen to your podcasts.

    Thanks for being here.

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Episode #42: 6 Tips to stay consistent with exercise over the holidays