Tag: Pregnancy Article

Whether you give birth in a hospital, at a birthing center, or at home, there are things you can do to support your body through labor. Each stage of labor brings different challenges, and the techniques discussed below will hopefully aid in a smooth labor and delivery. The information in this article will apply to women who choose an epidural as well as no epidural. It is important to remember that every woman’s labor experience is different, and the length of each stage will vary. 

Early Labor

During early labor, surges will feel more mild and irregularly spaced out. Contractions may feel like menstrual cramps at this point. Since this stage can last the longest, rest will be your best friend during this time! It is best to ignore the contractions until you simply cannot any longer. Try to go about your day as you normally would, and get as much sleep as you can during the night. Labor is often described as a marathon, but some would argue that it is nothing of the sort! Indeed, you truly cannot know how long of a “marathon” you will have to run until it is over and your baby is born. This is why conserving energy in the beginning is crucial, especially for first time moms, as early labor tends to be the longest phase. 

Active Labor

You will know you are in active labor when those contractions start to become more intense, last longer, and occur more frequently. If you are already at the hospital, a cervical check would show that you have surpassed five centimeters of dilation, another telltale sign that active labor has begun. The best thing you can do for your body during this time is to change positions frequently! Studies have shown that changing positions as often as every thirty minutes can actually progress labor faster. 

Even if you have an epidural, you can still move despite the numbness in your lower half. Some women like to lay on their side with a peanut ball between their legs to help open up the hips. You can lean on a birth ball or your support partner and gently sway your hips, as well. Any upright position will help allow gravity to do its job as well as facilitate pelvic opening. If upright positions become too difficult with the epidural, try getting on all fours to relieve some pressure you may be experiencing in your back. 

If you do not have an epidural, any of the positions listed above will still be beneficial! However, you will have feeling in your lower half and will therefore be able to incorporate slightly more movement. Walking around at a comfortable pace will help your baby move into the most ideal position for that pushing phase! Try moving into a deep seated squat, or a rocking side lunge, to open up your hips. If you have a birth ball, pelvic circles and figure 8’s will help to relax and lengthen your pelvic floor. A relaxed pelvic floor is what you need in order to push your baby out! That sucker needs to move out of the way in order for your baby to move through the birth canal. As you rock on the birth ball, submit to each surge by relaxing any tension you may have in your jaw, face, and shoulders. This is one of the most important things you can do during the active stage of labor; open jaw, open fanny! The connection between your jaw and your pelvic floor is astounding. There is significant research to suggest that tensed-up jaws lead to tight pelvic floor muscles. If you focus on breathing and relaxing your jaw, your pelvic floor will follow! 

Next time, we will dive into stage two of labor, often called the pushing stage. Now that you know how to move during early and active labor, we can discuss different pushing positions for women with and without epidurals! 

The important takeaway is to listen to your body’s cues. Your body is intuitive and knows what it needs during labor. If rocking side to side on all fours stops feeling good, you will know it is time to shift into a different position! Just listen to those cues and stay positive. You are so close to meeting your baby!

Sara French, ACSM CPT, NASM CNC

Sources

https://evidencebasedbirth.com/evidence-birthing-positions

https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/labor/art-20546804

https://www.tmh.org/blogs/a-midwifes-guide-to-labor-positions-and-support-tools#:~:text=Upright%20Positions,%E2%80%A2

You’re nearing that time when it might be hard to tell if the sensations you are experiencing are false labor, often referred to as prodromal labor, or early labor. If you have been having braxton hicks contractions for a while, it might be even tougher to distinguish whether or not it’s go time! Let’s get into the nitty gritty on the different stages of labor, and what to expect for each one. My hope is that you will go into your birth feeling educated and empowered knowing what your body is doing in each stage. 

Stage One

If you don’t know for sure whether you are in labor, you are probably in the very early stages! Ignore it until you can’t anymore! Stage One of labor lasts the longest, and early labor can last up to 12 hours for some women. The hardest part about preparing your mind for labor is not knowing what cards you will be dealt. Labor is like a marathon, except it could be shorter or longer than 26.2 miles. You won’t know until you go through it! That is why it is so important to conserve energy and hydrate well in early labor. 

The first stage of labor is defined by the period of time it takes to go from zero centimeters dilated to fully dilated. Contractions, or surges, may start slow and infrequent, occurring between five and 30 minutes apart and lasting around 30-45 seconds each time. The surges in early labor are mild to moderate, and get gradually stronger and closer together. This is how you will know it is the real deal! If it were prodromal labor, contractions would start and stop in an unpredictable manner; this could sometimes last for days! 

You might experience some cramping, diarrhea, and the loss of your mucus plug. Fun fact: only about 10% of women have their water break before labor begins, and most women experience a slow leak of fluid rather than the sudden gushing you see in the movies! 

Stage Two

Stage two of labor is often described as the “pushing stage,” as your cervix has reached full dilation and effacement. It is marked by the time you reach 10 centimeters until your baby is born. By this point, contractions have reached peak intensity. Each surge is longer and stronger, and you will experience less of a break in between the surges. 

Your perineum has stretched quite a bit at this point, so you might be feeling some burning sensations as the baby crowns. Research shows that performing perineal massage starting around week 34-36 in first time mothers reduces the risk of tearing in labor. Bonus: it also gets you used to that burning sensation you will feel during the pushing stage! Additionally, studies show that laboring in a birth pool reduces the likelihood of tearing. You can achieve the same effect by having a member of your birth team apply a warm, wet rag on your perineum!

It is important to note that just because your cervix is dilated to 10 cm does not necessarily mean your body is ready to push. Women who labor down without an epidural often wait until they feel the urge to push. It is harder to feel that urge when you have an epidural, which is why coached pushing is sometimes necessary! Next week, we will explore how to labor down, how to breathe during contractions, and how to push without straining your pelvic floor.

Stage Three

Congratulations! Your baby is here, and now you need to birth your placenta. This is the marker of the third and final stage of labor. It sometimes can take up to 30 minutes for your body to expel the placenta, during which you will feel more contractions. If you are in the hospital, a nurse might perform a fundal massage by pressing on your uterus to help your body along. Once the placenta is birthed, the baby’s cord will be clamped. How long you want to wait to clamp the cord is up to you and your birth plan! 

Sara French, ACSM CPT, NASM CNC

Sources

https://www.hopkinsmedicine.org/health/wellness-and-prevention/labor

https://www.thewomens.org.au/health-information/pregnancy-and-birth/labour-birth/stages-of-labour#:~:text=There%20are%20three%20stages%20of,is%20happening%20during%20your%20labour.

Whether you call it a birth ball or a yoga ball, you might be surprised to learn just how much this tool can help to prepare your body for labor. Some people recommend incorporating it into your daily routine in the third trimester. I would advocate for using it all throughout pregnancy! Purchasing a birth ball is only a minor investment and can be found right on Amazon! Let’s dive right into how birth balls prepare your body, how to use one, and some exercises to try at home.

How Does a Birth Ball Prepare Your Body for Labor?

Using a birth ball in lieu of a chair during pregnancy can help to align the pelvis better. This may encourage your baby to move into a more comfortable position, which can provide relief from any aches and pains. Sitting on a birth ball helps to open the pelvis as well, similar to how it opens during squats. Additionally, sitting upright on the birth ball helps to strengthen your abdominals and lower back. You may even feel less pressure on your pelvic floor as opposed to sitting upright on a solid chair. Some studies have shown that using a birth ball in the latter half of pregnancy significantly reduces pain and fatigue in the hips. These are all great things that can happen just from sitting on a birth ball! Later on, we will discuss how using a birth ball during exercise can help prepare your body and baby for labor.

How and When to Use a Birth Ball

As stated earlier, you can simply sit on your birth ball and notice a positive impact on your posture, hips, and pelvic floor. Be sure to sit with both feet flat on the ground. The birth ball should be firm, not deflated. Ideally, your hips should either be level with or above your knees.

To prepare your hips and pelvic floor for labor, you may sit on the birth ball and add some gentle movement. Try making circles with your hips in both the clockwise and counterclockwise direction. Keep your posture upright, limiting the movement to your hips. Imagine there is a string at the top of your head keeping your neck stacked directly on top of your spine. Once you have mastered the hip circles, add in some sways. Try rocking forward and backward to help practice pelvic tilts. Then, try rocking your hips to the left and right. These movements are simple and can be done for however long you feel comfortable doing them!

Additional Exercises to Try

Aside from doing pelvic circles and pelvic rocking, it is worth leaning on the birth ball. Simply get on your knees and lean forward onto the ball. Your partner can even practice applying counter pressure or rubbing your back and hips. This is a great position to labor in, especially if your husband can apply counter pressure. You may even hug the birth ball and add a rocking motion with your hips. Fold your arms over the ball and rest your head on them. Keep your hips in the air, and gently sway back and forth. This will relieve low back pain, round ligament pain, and even pelvic floor pain. I like to do the rocking child’s pose with my birth ball at the end of the day, especially when my back and hips ache. I lean on the birth ball and sit back on my heels, then I rock forward and lift my butt into the air. This is a dynamic exercise, and I like to rock back and forth like this for about a minute. If being on the ground hurts your knees, you can also try leaning and swaying on the birth ball from a standing position! Simply place the ball on your bed and sway from a standing position. 

As you can see, there are many ways to incorporate a birth ball into your daily routine. Your body and baby will thank you at the end of the day!

Sara French, ACSM CPT, NASM CNC

Sources

https://health.clevelandclinic.org/birthing-ball

https://www.nhs.uk/start-for-life/pregnancy/preparing-for-labour-and-birth/how-to-use-a-birthing-ball/#:~:text=Birthing%20balls%20

Birth Balls

Routine cervical checks are often started toward the end of pregnancy, around week 36 or 37 of gestation. Your healthcare provider will perform a physical exam of your cervix in order to assess how “ready” your body is for labor. There are some pros and cons to these routine exams, which is what will be discussed in this article. 

The Pros of Cervical Checks

Cervical checks, both before and during labor, can provide answers to a number of questions. As you approach the final weeks of pregnancy, your body should be preparing itself for labor. Having a cervical check will tell you how dilated and effaced your cervix is at that moment. Your doctor may even use this as a tool to determine whether or not she believes you are in active labor. Dilation refers to how open the cervix is and is measured in centimeters. Effacement refers to the thinness of the cervix and is measured as a percentage. If you are 10 cm dilated and 100% effaced, your body is completely ready for your baby to move through that birth canal! If you have been induced, your doctor will perform cervical checks to monitor the progression and effectiveness of the induction method. Healthcare providers may even use these exams to assess the general health of your cervix toward the end of pregnancy. You can also request to have a cervical check out of pure curiosity! Some women like to have as much information as they can going into labor. Although there are several benefits to cervical checks, there are also some drawbacks that need to be discussed. 

The Cons of Cervical Checks

If no one prepared you already, let me be the first to share that cervical checks can be quite uncomfortable! Women who experienced pelvic floor pain during their pregnancy have even described them as downright painful. They can even increase the risk of infection in the pregnant mom. We discussed dilation and effacement earlier, and how your doctor uses cervical checks to assess how progressed you are in labor. However, it gets tricky because every woman is different! For example, one woman might be four centimeters dilated for several weeks before progressing any further. A different woman might go from four centimeters dilated to ten centimeters dilated in a matter of hours! Because of this, using cervical checks as a prediction for when a woman will go into labor is extremely inaccurate. If your healthcare provider solely uses cervical checks as a marker of labor, this could lead to unnecessary interventions. Luckily, there are some other ways to tell how progressed your labor is, such as how vocal you are, how focused you are, and how intense your contractions are. 

Please remember that you have the right to refuse any medical procedure, and that includes cervical checks. If you would feel more comfortable allowing labor to progress on its own time, you have permission to decline the cervical checks. Know that you have options and can make informed decisions about your body. It’s up to you, momma! You know what is best for you and your baby. 

Sara French, ACSM CPT, NASM CNC

Sources

https://pmc.ncbi.nlm.nih.gov/articles/PMC5503468/#:~:text=Careful%20read%20of%20the%20original,178)

https://pubmed.ncbi.nlm.nih.gov/34768023/#:~:text=The%20number%20of%20cervical%20exams,during%20labor%20management%20at%20term.

If you are in your second trimester of pregnancy, you are likely experiencing something called round ligament pain. While this may seem worrisome, it just means your body is making more room for that growing baby of yours! Throughout this article, we will discuss: what round ligament pain is from a physiological standpoint, how to alleviate it, and when to call a doctor.

What is Round Ligament Pain?

Every woman has two round ligaments on either end of her uterus. These ligaments hold the uterus in place and attach in the groin. They are designed to stretch and thicken during pregnancy to accommodate your growing baby. While this may happen at any point during pregnancy, it is most common during the second trimester. Round ligament pain might feel like occasional sharp or stabbing pain, particularly if you change positions too quickly. This sharp pain is typically brief, and does not last for more than a few seconds at a time. It also may feel like a dull ache in the lower abdomen or groin area. Both sensations are harmless, albeit uncomfortable. You might notice that round ligament pain happens more often if you stand up too quickly, roll over in bed, or cough and laugh too hard. 

How Can I Combat Round Ligament Pain?

There are some ways to relieve round ligament pain when it becomes especially bothersome. The first thing I recommend is slowly changing positions and see if that helps. We want to avoid any positions that worsen the pain. Personally, I find that laying on my side with my knees tucked up is the best position to relieve my pain. Applying some gentle pressure or massaging the aching area may help as well. Try doing some gentle stretches or relaxing prenatal yoga if resting does not take care of it! Remember to breathe and move in a slow and controlled manner. Any quick or sudden movements might cause the pain to return or worsen. As pregnancy progresses, some expectant mothers find it helpful to wear a belly support band; only a small investment to help lift up your belly and take some pressure off of your round ligaments! If all else fails, I find that taking a warm – not hot – shower helps to relax the muscles and ligaments in my pelvis. It is important to go easy on your body during this time. Oftentimes, round ligament pain presents itself when your baby is going through a growth spurt. Just remember that your body is doing miraculous things in order to support your precious baby.

When Should I Call My Doctor?

It is difficult to distinguish which pains are normal during pregnancy and which pains require a chat with your birth team. Here are some symptoms that might tell you it is time to reach out to your doctor or midwife:

• Severe pain or cramping that persists
• Fever or chills
• Bleeding or spotting
• Nausea or vomiting
• Pain with urination
• Sudden and extreme low back pain
• Sudden onset of contractions or other labor symptoms

It is always better to be safe than sorry. If you feel something is wrong, there is no harm in contacting your birth team. They are there to help!

Sara French, ACSM CPT, NASM CNC

Sources

https://www.marshfieldclinic.org/specialties/obgyn/pregnancy/care-tips/pregnancy-info-round-ligament-pain#:~:text=You%20may%20feel%20the%20pain,your%20baby%20is%20pushing%20down)

https://my.clevelandclinic.org/health/symptoms/21642-round-ligament-pain

https://www.babycenter.com/pregnancy/health-and-safety/round-ligament-pain_205

If you are pregnant, you have likely heard of abdominal coning, or “doming.” This is a natural occurrence that happens when the middle of the abdomen bulges outward in a cone-like shape due to increased intra-abdominal pressure. Coning is quite common during pregnancy and is nothing to be afraid of! It is simply a sign that you are putting too much of a strain on the midline of your abdomen. If you experience coning intermittently throughout your pregnancy, you likely will not cause any significant damage to your abdomen. However, repeated coning is a major contributor to diastasis and should be addressed immediately.

In order for your baby to grow, it is normal for your abdominal muscles to stretch and separate a little bit. Putting excess stress along tissue that is already being stretched may delay your body’s ability to heal that abdominal separation postpartum. Follow these guidelines to reduce abdominal coning during pregnancy:

Train Your Core

Training your core is one of the most beneficial things you can do during pregnancy, as it connects to your pelvic floor and prepares your body for labor and delivery. If you notice coning or doming during any of your core exercises, it is in your best interest to modify the movement and scale back for now. You are either lifting too heavy or have lost the ability to engage your deep core properly. 

It is a misconception that you need to train your core every single day during pregnancy. Like any other muscle group, the core needs the appropriate amount of recovery time in order to become stronger. If you add too many core-specific exercises to your daily workouts, your abdominal muscles will never have time to repair and grow. Studies show that it is better to sprinkle in core stability movements just a few times per week in order to train your brain to connect with your core. Additionally, dedicating one day per week to working your entire core system, low back, pelvic floor, and abdominals, has also been shown to have more beneficial outcomes than training core every day. 

Practice Diaphragmatic Breathing

Diaphragmatic breathing, or 360 breathing, is an excellent tool to help connect your abdominal muscles to your pelvic floor muscles. This is especially important for those who are used to holding their breath during exercises; pregnancy is not the time to hold your breath! To practice diaphragmatic breathing, it is best to start sitting upright. Place your hands along your ribcage. Inhale through your nose and feel your ribs expand beneath your hands. Exhale as you draw your belly button back toward your spine. Do not hold your breath at any point. Inhale slowly for four seconds, then exhale slowly and intentionally for eight seconds. Practice this breathing drill for a few minutes every day. This translates directly to lifting weights. When you are lifting something heavy, forcefully exhale during the toughest part of the exercise. For instance, you would inhale during the descending portion of a deadlift, and forcefully exhale as you ascend back into an upright position. 

Remember, coning is a natural occurrence and should not be feared if you know what to look out for and how to prevent it! Training your core and practicing diaphragmatic breathing are two essential steps to preventing coning and decreasing your chances of developing diastasis postpartum. 

Sara French, ACSM CPT, NASM CNC

Sources

https://www.pelvichealthnj.com/pelvic-floor-blog/how-can-i-get-rid-of-abdominal-coning

Avoiding “Coning” During Pregnancy Can Help Prevent Diastasis Recti

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9999308

What is Lightning Crotch?

Lightning crotch is a very common sensation during pregnancy, especially toward the end. It is often confused with round ligament pain, though there are some distinct differences of which to make note. Women who experience lightning crotch describe the feeling as a sudden sharp or burning pain in the pelvic or vaginal area. Not fun! Round ligament pain is a more dull, aching pain that typically lasts longer than a second. While lightning crotch may happen at any point during pregnancy, it is most likely to occur during the third trimester. Unfortunately, the severity and frequency of lightning crotch varies among women. So if you were hoping to gauge when it would happen for you and how long it would last, I can’t help you there, my friend! Personally, I started experiencing it infrequently around the second trimester. It has definitely ramped up now that I am in my third trimester, and I have noticed that it happens more frequently when my baby goes through growth spurts. It helps to identify patterns like this, so that I can know what to expect and remind myself that it is temporary; it won’t last forever. A moment of pain for a lifetime of glory!

What is Diastasis?

Diastasis Recti, or abdominal separation, is one of the many changes that may happen in your body if you are pregnant. Indeed, diastasis is actually unavoidable during pregnancy. Research has confirmed that nearly 100% of women experience abdominal separation by the end of their third trimester. The degree to which this separation occurs varies among women; but it is, in fact, an unavoidable phenomenon. 

In order to understand diastasis, we first need to examine how the abdominal muscles connect with each other. Every person’s abdominal muscles are separated down the middle and connected by a band of tissue called the linea alba. The linea alba allows for abdominal expansion during normal daily activities, such as breathing. Without it, your body would not be able to adapt to your needs. Your abdomen needs to expand in order to function properly. 

Is Diastasis Preventable?

Pregnancy requires abdominal expansion over a significant amount of time. Diastasis must occur in order for your baby to grow. Hormones also surge and increase during pregnancy. Relaxin is one such hormone that increases the laxity in your joints and tissue. Without these hormones, your abdomen would not be allowed to expand as your baby grows. Women are often frightened by diastasis happening to them during pregnancy, but it is truly unavoidable. Once we understand how the abdomen is designed, we can then understand why diastasis occurs. It is nothing to be feared! There are some techniques you can employ in order to manage the degree of separation that may occur. 

How Can I Manage Diastasis During Pregnancy?

While we cannot avoid diastasis from happening during pregnancy, we can attempt to minimize the severity and help quicken the healing process postpartum. This can all be achieved by training your core throughout your pregnancy! Focus on these simple tips:

• Inhale during the easier part of the exercise and exhale during the hard part
• Modify exercises throughout each trimester as your body changes
• Stack your ribs over your pelvis during exercises for proper alignment
• Decrease reps, sets, or weight as needed throughout each trimester

Training safely during pregnancy will set you up for a more positive postpartum healing journey. Diastasis typically resolves on its own after labor and delivery, but it is important not to jump back into too much activity while you are still healing. Lastly, give yourself grace. You’re growing life, and that is something to be celebrated and cherished!

Sara French, ACSM CPT, NASM CNC

Sources

https://my.clevelandclinic.org/health/diseases/22346-diastasis-recti

Diastasis Recti and Pregnancy: ‘Closing the gap’ between current treatment practices and clinical evidence

As you near the third trimester, you might be feeling the added pressure of your growing belly! Whether it’s simply uncomfortable or downright painful, we can all agree that it’s no fun. You might be experiencing round ligament pain, pelvic heaviness, or back pain. Thankfully, there are a plethora of belly support tools available for you to try! In this article, I hope to shed some light on belly bands and kinesio tape.

Belly Bands

Belly support bands provide just enough compression to support your hips and back during pregnancy. Their material is flexible, not rigid, and wraps around the entire abdomen. Belly bands come in all different shapes, sizes, and patterns. Some women like to wear them to close the gap in their unzipped jeans too! 

Women who use belly bands during pregnancy report having less back pain, less pressure on their bladder, and more stable hip joints. The band is designed to distribute weight more evenly, which is why pressure is taken off the back and ligaments in the hips, causing less pain! Additionally, some women have stated that their balance improved when they wore a belly band due to the more even weight distribution. According to the ACOG, wearing a belly band during exercise may help to avoid injury as well as make walking and jogging easier. It can also provide more stability during weight lifting. 

Because the belly band provides gentle compression, it should not be worn all the time. Try to wear it when you are feeling more uncomfortable and are needing some relief. Your baby needs proper blood flow and constant use may prohibit this! Your belly band should be snug without being too tight. You will know if it’s too tight as it will become extremely uncomfortable really fast! 

Kinesio Tape

You may have heard of kinesio tape, or k-tape, as a tool to support your growing belly during pregnancy! Just like belly bands, k-tape is a safe and easy way to reduce the aches and pains that come along with the third trimester. Not only can k-tape relieve back and hip pain as well as lighten the load put on your bladder, it can also help reduce swelling in your feet and ankles! Strategically placed tape lifts the growing belly and decreases pressure put on the lymphatic vessels, causing them to drain more efficiently. Additionally, taping around the torso can make it easier for you to breathe comfortably.

It is important to note that kinesio tape causes skin irritation in some people. Pregnancy causes the skin to change and become more sensitive as it is, so be aware that taping might make the skin more irritated! Always talk to your birth team before adding something new into your regimen. It might help you feel more confident taping on your own if you have learned a few techniques from your provider first! 

Sara French, ACSM CPT, NASM CNC

Sources

https://pelvicare.uk/blog/kinesio-taping-in-pregnancy#:~:text=In%20addition%20to%20helping%20athletes%2C%20kinesio%20taping,provide%20support%2C%20reduce%20pain%20and%20improve%20circulation.

https://www.premierhealth.com/your-health/articles/women-wisdom-wellness-/how-belly-bands-and-belts-help-relieve-pregnancy-s-discomfort#:~:text=Belly%20bands%2C%20which%20are%20flexible%2C%20tube%2Dlike%20garments%2C,that%20gets%20exposed%20as%20the%20belly%20expands.

https://www.ladybirdpt.com/post/taping-a-pregnant-belly#:~:text=Kinesio%20tape%20is%20an%20easy,the%20need%20for%20pain%20relief