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Natural Birth Compass Blog

Strength in the birth room and beyond

03/23/2020

Prefer to listen? Find the accompanying podcast episode on the Unschooled Homebirth podcast, Episode 11, wherever you get your podcasts!

 

There is no question that pregnancy & birth will test your strength in many, many ways, so today we are exploring the ways that women and their partners experience and exhibit strength in pregnancy, birth and beyond, we will also explore whether it's possible to be too strong, and share some tips you can use to improve your strength for your own pregnancy, birth or postpartum recovery.

 

What are the ways strength shows up in the birth room? For the person giving birth, you are going through one of the biggest transformations of your life, no one comes through birth unchanged, and when it goes well and you stay present with your birth and in your control, even if it doesn't go exactly as planned, this transformation should make you stronger, should make you feel powerful, when you meet your baby face-to-face for the first time, you should have the feeling that you can do anything, you can climb mountains.

 

If you don't feel that way, then something went wrong in the birth room, you lost control of the birth, medications interacted with your natural hormone flow, or you labored into exhaustion without the guidance of how to rest during labor.

 

What About Your Birth Partner's Strength?

 

For the birth partner, strength comes out as the confidence that they can support their laboring partner, that they understand their needs so well, they can identify them before anyone else in the room. When a birth partner can connect with the laboring mother in this way and directly see the impact of their support, they feel strong and protective of the birth space and experience.

 

This level of confidence is not something we see in many birth partners because many of them come to the birth with little to no preparation of how to actually support their laboring mom. They might know the basics from their classes, like support techniques and ice chips, but when it comes time to act in the moment or to be her voice, or to anticipate her needs, they can feel at a loss to help. This position of feeling ill-equipped to support birth can leave the birth partner feeling disempowered, weak and even scared in some cases.

 

The Two Keys...

 

Here are the two keys to mental strength in birth - one is communication & the second is being prepared for the birth process, being prepared for how different it can look from what you learn in classes or what you see in videos. We covered communication in a previous article, so I am not going to cover it today, you can go here to read that article for a deep dive into communication, because it is one of the most important aspects needed to feel strong in birth.

 

Being prepared for birth is what childbirth education is all about, but the thing about childbirth education is, it's a bit like college, remember how they encourage you to get a well rounded education by requiring you to take a handful of credits from specific types of classes outside your major? Taking your standard childbirth class and reading the standard books is probably not going to give you the well rounded perspective of birth that you think it might, it will teach you what "normal" birth looks like, but it won't prepare you for what your birth looks like. For that it requires learning about yourself and your specific style of communication, support needs and an understanding of how you relate to your exterior world on a day-to-day basis.

 

That is one of the purposes of all the work we do at the Natural Birth Compass, so you find helpful and empowering new perspectives and learn techniques to gain insights about yourself and the nature of birth.

 

Physical Strength & Pregnancy - What's Safe & What's Risky

 

Today we are seeing a broad spectrum of recommendations in regard to prenatal fitness. On one end, it seems more and more pregnant women concentrate on physical fitness and strength during their pregnancy, they are doing this for their prenatal health, as a means to prepare for their birth, and to improve their postpartum recovery.

 

At the other end of the spectrum, there are a large number of women who are told they should not workout at all or very little, that it can be dangerous to the health of their pregnancy. Why is there this disjoint in the advice out there? Our understanding of prenatal health and what women can and should do in pregnancy is going through a transition phase, and like any transition, the messages about what is right and wrong are going to be confusing. The other reason is that the level and types of exercise appropriate for pregnancy will vary from person to person depending on their constitution, their previous exercise experience, their health status, and the health of their pregnancy.

 

In most cases, for healthy people experiencing a healthy pregnancy, a moderate amount of exercise is going to benefit you. If your care provider recommends you cut back on your exercise once you are pregnant, but you want to continue, you can and should consult with a prenatal fitness expert who can help guide you on the correct exercise routine for you. And then listen to your body, if it feels too uncomfortable or causes pain that is worrying you, then stop immediately, but if you are feeling good, exercise will benefit your pregnancy, your baby and your labor preparation.

 

That being said, there is a boundary of being overfit and I can't help but notice the correlation between higher c-section rates and those who are doing more extreme workouts during pregnancy. In many cases, these are fitness instructors and professional athletes whereas most pregnant women won't be working out at these levels.

 

As these pregnant fitness professionals or extreme fitness women become more prominent in the headlines, it's important to point out that over-exercising can be just as impactful as far as increasing the risk of birth interventions and c-section risk as being too sedentary, because of nutrient imbalances, injuries from not understanding how to workout with their changing body, overtightening their core and their pelvic floor, and being in a state of physical stress, that fight or flight state, too much of the time. 

 

Are You Too Tight?

 

Being overtight and overstressed can interfere with the softening and ripening of the cervix in the weeks leading to birth and an overtightened pelvic floor can make the pushing stage of labor more difficult, it can lengthen the time of the pushing stage and put you at more risk of interventions like forceps, vacuum extraction or episiotomy.

 

Oh boy, now I told you some exercise is good, but too much is too much, and now you might be thinking, but how much is good and how much is too much!? It depends on you! I know, not helpful, right? Don't worry, I am going to try to help you assess yourself, so you can get a better idea of how to approach your exercise routine.

 

First, you have to be comfortable with the exercise you are choosing. Comfortable mentally and comfortable physically. Now I'm not saying you can't continue to push yourself just outside of your normal boundaries in order to improve your physical fitness, in a healthy pregnancy, you can increase your fitness level, you can push those boundaries, but you don't want to push yourself to pain and certainly not to injury.

 

If you were not previously exercising regularly, you can start in pregnancy, but work it in slowly, walking, yoga, swimming are all great places to start and will allow you to gently get used to moving your body during the changes that are happening during your pregnancy.  If you were already exercising before pregnancy, unless there is a medical reason, most people will be able to continue doing what they were doing before, especially in the first half of pregnancy. As the pregnancy progresses, you will want to pay particular attention to a few areas to prevent injury.

 

Of particular importance during pregnancy is the fact that your joints are going to be more mobile, both during and even in the early postpartum months, and this can make your joints more susceptible to injury. So you do want to have special awareness of not overstretching, especially your hips, your low back and your pelvis.

 

Your TVA & Breathing - One of the Most Important Things in Pregnancy!

 

A second area is your core, and being mindful of supporting your core properly to reduce your susceptibility to diastasis recti, which is the separation of the abdominal muscles where they meet at the midline. This comes by being aware of the different layers of your abdominal muscles, especially the inner most layer, the traverse abdominis or TVA for short. You can think of this muscle group as the corset that holds your stomach in place, when it is strong, it keeps your abdominal region firm and will hold everything together. Accessing the TVA is one of the key's to supporting a strong core all the time, but especially during pregnancy.

 

How do you do that? You can do it simply by breathing correctly. To get started, try placing your middle finger of either hand on your belly button, then place your first finger just above your belly button and your third finger just below it. Now take a breath, do you feel your fingers being pushed out? If not, then chances are you are not using your diaphragm or your core to breath, and this is a missed opportunity to improve core strength, improving your breathing and actually de-stress your body a bit.

 

If you are having trouble bringing your breath, try it laying down on your back or on your side, whichever is more comfortable, and focus on bringing your breath all the way down to your belly button, to your baby, the more you practice, the more you will be able to use your core to control your breathing and this will be a tremendous boost to your strength in later pregnancy and in birth.

 

And while we are on the topic of breath and exercise, the third thing to be aware of is feeling comfortable with your respiration during your workouts. Your oxygen needs are going to increase in pregnancy to support your growing baby and that means your blood volume will change throughout your pregnancy too. You may notice that there are times in your pregnancy where your respiration may feel more restricted or more difficult and this might affect your normal ability to workout. Usually this only last a few days as your body adjusts to the increasing needs of your baby, so if you feel that you are short of breath or your muscles are burning more than usual, it might a sign that you need a few days of rest or at least lower intensity until your body stabilizes to another one of the many changes that happen during pregnancy.

 

Key Points About Strength

 

So that brings me to our key points about strength for today. First, strength in the birth room comes from being prepared and having communication tools. You can go back to this articlefor my deep dive into communication and keep learning about birth from a variety of perspectives, because there is not one way that birth happens. 

 

Then we have physical strength, pregnancy is a great time to be increasing your physical strength to help you prepare for a healthy late pregnancy, a strong birth, an efficient postpartum recovery and the upcoming years of keeping up with a toddler - which is a workout routine all in itself, those of you who already have toddlers know what I mean! Just be conscientious of your ever flexible joints, your core and pelvic stability and changes in your oxygenation and blood volume. If you need help coordinating an exercise routine for yourself, find an expert in prenatal fitness to make sure you stay healthy, fit and safe.

Listen to the Unschooled Homebirth Podcast for more about preparing for your Homebirth! 
Listen Now!
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