Preparing to welcome a new babe into your family can be overwhelming. Here are some tips and local resources to help you prepare to rock your birth (including getting ready for what comes after).
Written By: Alex Courts, DPT, PCES
There are so many options for preparing for birth these days, so what really matters? As I write this, I am expecting my second daughter in September and preparation is in full swing, so I get it. While birth usually doesn’t go exactly according to our best made plans, one thing we can do is prepare to make decisions that align with our own preferences no matter the circumstances. As a doctor of physical therapy with training in obstetrics and a childbirth prep instructor, I’ve gathered my favorite resources to simplify your prep and help you feel confident heading into birth.*
Here are my 5 steps to preparing for birth (and beyond):
- Decide Your Birth Preferences
- Get Support
- Discuss Your Preferences with Your Provider
- Prepare Your Body (and Mind) for Birth
- Prepare for Postpartum
Below you will find a free birth preferences worksheet, my favorite resources, exercises, and more.
While you can do these steps in any order, this order will allow your values and preferences to guide your preparation, so let’s get started with step 1:
Step 1. Decide Your Birth PreferencES
Did you know that your birth preferences actually matter? ACOG, the American College of Gynecologists and Obstetricians, supports a mother’s ability to move, position and push freely during uncomplicated labors.1 So, even with all of the amazing training your obstetric provider has, you may still be the best person to determine exactly how your baby is born!
“How will I know my birth preferences if I have never given birth?” – this is a legitimate question in a day and age when most women give birth in the hospital, so family members do not have as much opportunity to witness the miracle of birth. Cue the endless googling! An alternative to scrolling through endless blogs, instagram, and youtube videos, would be talking with trusted friends and family to hear real birth stories. Documentaries and podcasts can also be great options for learning about birth and hearing real birth stories.
Here are 2 of my favorite resources for researching options for birth:
- Evidence Based Birth
- check out their signature articles, pain management series, and podcast
- Childbirth Connection
- a great resource to learn the pros and cons of various interventions that may be offered to you during birth
If this is your first baby, give yourself plenty of time to research. I am biased, but I highly recommend a childbirth class to learn how to turn your birth preferences into an action plan on your big day. While it’s never too late to change your mind, deciding what birth class you would like to take at around 20 weeks is a good idea. Some classes are up to 12 weeks long, so you want to have time to sign up for these classes (and complete them) before baby makes their debut! I often recommend that first time families take a class before 30 weeks in the rare event that they decide they would like to change providers based on the preferences they discover after class. Some providers require you to establish care by 32 weeks.
And if you are an experienced mom wanting to have a different birth experience this time around, I still encourage you to do your research and sign up for a birth class. If you are fairly confident in your birth preferences, I have worked with some families as late as 36 weeks. These families are ready to rock their birth with class so fresh on their minds.
STEP 2. GET SUPPORT
Once you have narrowed down your preferences for birth, start lining up support for pregnancy, birth, and postpartum. Here are a few options to consider when it comes to support:
- What setting do you plan to give birth in?
- Hospital, Birth Center, Home?
- What type of provider would you like to attend your birth?
- OB or a midwife?
- Who would you like to be present for non-medical support?
- Continuous labor support has been shown to improve birth outcomes.2 Contrary to belief, nurses do not attend to your needs constantly during birth, so planning for support during birth may be beneficial
- Would you like a doula?
- Check out this post to see how doulas improve birth outcomes
- Did you know there are doulas for pregnancy, birth and postpartum?
- Your partner, friend or family member can even act as a doula if you do not want a formal doula at your birth
- Would you like any other support during pregnancy?
- Here are a few other professionals that can help during pregnancy: dietitian, mental health professionals, physical therapists, fitness professionals, prenatal yoga instructors, health coaches to name a few
- click here for a list of local resources in pregnancy and postpartum
- Who do you plan to support you after birth?
- You are not only going to be caring for a newborn but also caring for yourself as you recover from birth. Based on personal experience and feedback from past clients, I recommend lining up support for AFTER birth. For ideas on postpartum support, see Step 5.
There are lots of options for support available, so figure out which ones would serve you best and start discussing your birth preferences with your birth partner and doula (if you choose to have one) to prepare for the next step.
STEP 3. DISCUSS YOUR BIRTH PREFERENCES WITH YOUR PROVIDER
Now that you have a better idea of your own preferences and are feeling supported, it is time to formally write them down and start to discuss them with your trusted provider. Here is an example of a Birth Preferences Worksheet that you can fill out and review with your provider.
When should you do this step?
I personally don’t think it is ever too early to start having discussions about the type of birth you would like. As I mentioned earlier, some providers require care to be established by 32 weeks, so I recommend starting to talk with your provider about your non-negotiable birth preferences by early third trimester. You may want to start this process even earlier if your provider is part of a large practice in which there are multiple providers who could be present the day you give birth. You will want to set up appointments with different providers each visit, starting as early as you feel comfortable to get a feel for each different provider – their views are not always the same. This gives you time to make a change if you find that your provider is not supportive of what is important to you.
You should plan to have your hard copy of your birth preferences worksheet signed by your provider by 36 weeks. This is a great opportunity to review any hospital/center/provider policies, so don’t be alarmed if your provider wants to have a respectful discussion about certain parts of your plan. Typically, your provider will keep a copy and you will want to keep a signed copy for your records. This document should be available in your medical record for anyone attending your birth, but it is a good idea to keep hard copies in your hospital/birth bag to share with anyone present at your birth. Delegating this responsibility to your partner is a great idea. They can help advocate for your birth plan while you are focusing on your labor.
Hopefully getting the sign off on your birth preferences is a weight off of your shoulders! Now that all the big things are lined up, you can solely focus on preparing your body for birth with our next step!
STEP 4. PREPARE YOUR BODY (AND MIND) FOR BIRTH
I am a big advocate for exercise during pregnancy. If you want to learn more about the general benefits of exercise during pregnancy, check out this video on the topic later. Today, we will talk a little more specifically about preparing your body (specifically your pelvic floor) and your mind for birth!
One area that can be key for preparing for birth is your pelvic floor. Have you heard of it? The pelvic floor includes the muscles and supporting tissues at the bottom of your pelvis where the baby will come out in a vaginal birth. Pelvic floor muscle exercises (also referred to as kegels) during pregnancy are gaining popularity; if you want to learn more about this, see this post later. Pelvic floor muscle coordination and the ability to relax your pelvic floor during the pushing phase has the potential to reduce pushing time3 and chances of tearing4. See the video below to learn how to start preparing your pelvic floor to stretch as needed for birth.
If that video didn’t scare you off and you are ready to take it one step further, another important option for preparing for an unmedicated birth is perineal massage. Just as we might stretch a tight muscle or massage a scar, perineal massage can be a way to prepare your pelvic floor to stretch for a vaginal birth. I personally think this also helps you mentally prepare for some of the sensations you may experience during an unmedicated birth. This allows you to experience these natural processes of birth with familiarity and the knowledge that baby is almost here, rather than fear. This technique is something that should be cleared with your provider if you would like to perform it after 35 weeks of pregnancy. You can find more detailed information on this topic here.
If perineal massage is not for you, don’t fret, you can still practice relaxing your pelvic floor during your daily activities. ACOG does support your preferred method of pushing in uncomplicated births,1 so if you would like to try breathing the baby down, you can practice relaxation and breathing during a bowel movement! We cover this in more detail in the Active Labor class, but a great start is to avoid bearing down and to breathe as you focus on opening and relaxing your pelvic floor. Talking with your provider before practicing pushing around 35 weeks is recommended. To learn more about the pros and cons of different methods of pushing, check out this post.
Now that we have started physically preparing for birth, let’s talk about how equally important it is to prepare mentally. The benefits of psychological prep for birth are not all in your head! According to Dr. Jade Wu, using mindfulness in childbirth has been associated with feeling:
- “Less fearful“5
- “More connected“5
- “More satisfied”5
- “More Bonded”5
- And having a “better postpartum recovery”5
Here are a few ways to incorporate mental preparation for birth:
- Birth Affirmations (see free examples on spotify here)5
- Body Scans5
- Mindfulness with Movement (one example is prenatal yoga)
You can learn more about using mindfulness to ease childbirth pain here.
STEP 5. POSTPARTUM SUPPORT
One thing most first time moms feel unprepared for is postpartum recovery and the demands of caring for a newborn. I will keep this section short and sweet but packed with key things to consider lining up to make the next step in your motherhood journey just a little easier.
Postpartum Support ideas:
- postpartum doula/friend/family support
- childcare for older siblings
- meal train or freezer meal prepping at the end of pregnancy
- list of local postpartum support professionals to contact if you need them
- lactation, physical therapy, mental health, nutrition specialists to name a few
- here is a list of postpartum providers in Cincinnati, Ohio
If you want to avoid sending your partner out to the store for feminine products, here is a post on some of the key things I like to have on-hand for postpartum recovery. And if you want a deeper look into postpartum recovery, here is a blog post and instagram live that gives you a more realistic idea of what postpartum recovery looks like. All too often, moms feel unsupported after their 6 week clearance visit with their obstetric provider. I want you to know ahead of time that recovery takes time and that there are people out there to support you as you continue on your journey in motherhood. Feel free to contact me for additional support.
HOW ABOUT YOU?
What steps are most important to you to prepare for the birth of your babe?
About the Author:
Alex Courts, DPT, PCES is the author of this blog post and owner of Vibrant Physical Therapy & Wellness. After the birth of her daughter, Dr. Alex noticed gaps in maternal health care that were echoed by fellow moms. She began focusing her career on filling these gaps and helping moms navigate the physical journey of motherhood starting with education, prevention and exercise support in pregnancy and continuing with postpartum physical therapy and exercise services. To learn more about Vibrant Physical Therapy & Wellness, including our childbirth prep classes, see our home page or schedule a discovery visit to discuss your goals with Dr. Alex.
- ACOG Committee Opinion No. 766 Summary: Approaches to Limit Intervention During Labor and Birth. Obstetrics & Gynecology. 2019;133(2):406-408. doi:10.1097/aog.0000000000003081
- Campbell DA, Lake MF, Falk M, Backstrand JR. A randomized control trial of continuous support in labor by a lay doula. J Obstet Gynecol Neonatal Nurs. 2006;35(4):456-464. doi:10.1111/j.1552-6909.2006.00067.x
- Kamel R, Montaguti E, Nicolaides KH, Soliman M, Dodaro MG, Negm S, Pilu G, Momtaz M, Youssef A. Contraction of the levator ani muscle during Valsalva maneuver (coactivation) is associated with a longer active second stage of labor in nulliparous women undergoing induction of labor. Am J Obstet Gynecol. 2019 Feb;220(2):189.e1-189.e8. doi: 10.1016/j.ajog.2018.10.013. Epub 2018 Oct 12. PMID: 30321525.
- Abdelhakim, A.M., Eldesouky, E., Elmagd, I.A. et al. Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials. Int Urogynecol J 31, 1735–1745 (2020). https://doi.org/10.1007/s00192-020-04302-8
- Savvy Psychologist, Wu J. Can Mindfulness Ease Childbirth Pain? A Neuroscientist Says Yes. Quick and Dirty Tips. https://www.quickanddirtytips.com/health-fitness/mental-health/mindfulness-childbirth-emiliana-simon-thomas. Published March 6, 2020. Accessed July 22, 2021.