Preparing for labor and birth

You can make your labor and birth experience more relaxed and help yourself have a good recovery by preparing now.

Attend childbirth classes

Childbirth classes teach you relaxation and breathing techniques and offer education about what will happen during labor and birth. A variety of classes is available, most offered by either clinics or hospitals.

Many couples find that attending these classes together gives them a special time each week to prepare for their new baby and focus on the upcoming labor and birth.

Practice for labor

On your own, you can work in short practice sessions of relaxing and breathing during the day. But you also need to practice with your labor companion. You two need to learn each other's signals and work out ways of communicating to each other now, before labor begins. Learning to relax and breathe together will ease your worries about labor and birth and help you meet that experience with confidence.

Pregnancy is busy and demanding, and finding time for just the two of you, much less time to practice for labor, can seem nearly impossible. Still, preparing now will pay off with big dividends: a more relaxed, more comfortable labor and birth. Set aside 15 to 30 minutes every day for the two of you to relax together and prepare in this way for your baby.

Here are some guidelines for productive practice sessions:

Begin with relaxation. Have your labor companion talk you through one or more relaxation techniques. This is very important. During labor, your labor companion can use these tools to help you relax during contractions.
Create a mock labor. Begin by timing brief, easy contractions and let them get longer and more intense.
Have your labor companion call contractions. You should respond as though these are the real thing -- ignore distractions, concentrate on relaxing and breathing, and stay with it until the contraction is over.

How to call a contraction: "Contraction begins, take a relaxing breath...it's getting stronger, keep breathing . . .relax, good, you look relaxed . . . it's getting stronger . . .breathe . . . relax . . . it's getting easier now . . . it's going away, keep breathing . . . it's gone. Cleansing breath. Good!"
Just like in real labor, if you lose track of your breathing, don't quit. Regain control and find your rhythm again.
Have your labor companion check your relaxation during each contraction while you concentrate on breathing and relaxing.

Learn breathing techniques

Your uterus can work harder if you keep it supplied with oxygen and the rest of your body relaxed. That means relaxing and breathing through each contraction. You can endure more hours of labor if you distract yourself with specific breathing techniques, which also keep your uterus supplied with oxygen. You'll learn these techniques in your prepared childbirth classes: relaxing breathing, focused breathing, patterned focused breathing and breathing for pushing.

During your third trimester, set aside time at home to practice each technique with your labor companion. The more you practice, the more natural it will be for you to use these techniques during your labor and birth.

During your contractions, choose any breathing technique or invent one of your own. As contractions intensify, you may find it helpful to use the techniques that require more concentration. At any time in your labor, you can go back and try a simpler technique. There are no rules. Consider these techniques to be tools you can use in any way you like.

Relaxing breathing

One of the most effective ways to get relaxed and stay relaxed through labor is to breathe slowly and deeply.
Graph showing waves of relaxing breathing through a contraction.
You have your own level of breathing that feels most relaxing to you. You may need to experiment to find this level. Try this:

First, put your hands underneath your baby. Fill your hands with your breath. Think about breathing down to the level of your hands. You should feel your hands move. Take your time. Let the air flow in. Don't force your breath. Breathe at this level for a minute or two. How does it feel?
Second, move your hands above your baby so they rest on top of your stomach. Bring your breathing up to this level. Your hands should move a little with each breath. Breathe at this level for a minute or two. How does it feel? Your most relaxing breath may lie between these two levels.
Third, move your hands to the level where your breath seems the most relaxing. Breathe at that level for a minute or so.

If you want, your partner can help you "mark" the level where you are breathing by placing his or her hands on your lower back for deep breathing and at your waist for higher breathing. When you find the relaxing breath that is best for you, have your partner mark that spot in a way that you can use during labor.

You can use your relaxing breath several ways:

Take this breath when you feel a contraction begin. It can help you focus your attention on your coping techniques for that contraction and signal to your partner that a contraction has begun and that you need attention and support.
Continue breathing at this level during the contraction. You can stay relaxed by focusing on this breathing.
End each contraction with a relaxing breath. Use it as a signal to relax and rest until the next contraction.
Continue breathing at this level to stay relaxed until the next contraction begins.

Focused breathing

As your contractions become more intense, you may find it easier to breathe more lightly and to move your breathing up to your chest level. This is the kind of light breathing you do when you talk.

Find the balance of rate and depth that is comfortable for you.
Place your hands lightly on your chest, above your breasts.
Breathe lightly and evenly.
You will feel a slight movement with each breath.
If you wish, your partner can mark your level of breathing by placing his or her hands on your back at about the level of your shoulder blades.
Your partner may not be able to feel any movement as you breathe.
Set a steady, regular rhythm for yourself, like trying to inhale for three counts and exhale for three counts: "In-2-3, out-2-3."
When you exhale, whisper "huh."
You can count or repeat words to help you keep your breathing even, like "in-out, in-out."
Use this technique when slow, deep breathing no longer distracts you.

Patterned focused breathing

For even more distraction, you might want to add a pattern to the sound of your exhales, like "ha, ha, ha, who" or "come, out, ba, by."

Breathing for pushing

Often, your body will rest after your cervix is fully dilated. This resting phase at the beginning of the second stage of labor may last several minutes to an hour. It is usually all right to wait.

When you squat, kneel, or sit on the toilet to push, your baby's head presses evenly all around the opening of the vagina. This may reduce the need for an episiotomy (an incision made to enlarge the vaginal opening as your baby's head is beginning to be born) or allow a smaller incision to be used. Squatting can strain your knees and labor companion to support your weight. Squat only during contractions. Between contractions, stand, sit, or rest on your hands and knees.

You may also push in a side-lying, semi-sitting, or all-fours position. Feel free to change positions. The change and movement may help your baby move lower and improve your own comfort.

To breathe for pushing:

As your contraction builds into an urge to push, take deep, relaxing breaths.
Tune into your body and push only when you must.
Release and relax your perineum (the area of your body covered with pubic hair). Let your bottom open up. Let your baby come out. Your ability to relax and release your bottom is more important that your ability to push. Tip: relax your mouth. This often helps your pelvic floor relax.
Ask your health care provider to apply warm compresses or gentle massage to your perineum to help you focus your pushes and relax below.
Your uterus can push your baby out. Don't strain.
If you're in a semi-sitting position, let your legs fall open or pull them back as you push.
Use your abdominal muscles to push down, out, and away. Visualize your baby moving down and out your birth canal. Visualize opening up your body to let this happen naturally.
Make noise! Grunts and low, deep sounds are fine and show you are pushing effectively.
Don't hold your breath for more than 5 to 6 seconds when you push. You and your baby need oxygen.
Touch your baby's head -- it helps you connect with what your pushes are accomplishing.
When the urge to push passes, take a deep, relaxing breath, exhale, and return to a resting position until the next contraction.

Learn about birthing your baby's head

As your baby's head is being born, your health care provider may ask you to stop pushing. This allows your perineum to stretch more gradually, and may help avoid an episiotomy. If you are told not to push, relax, put your head back, and breathe lightly and quickly, saying "we-we-we." This will not take away the urge to push, but it will reduce your pushing efforts while your uterus births your baby gradually, reducing the chance of a tear in your tissues.

Choose who attends your baby's birth

You can choose whom you want present at your baby's birth. Besides your baby's father or your partner and your labor companion or doula, you may want others to help you and witness the birth. Consider your own comfort and make these choices.

You have many options. Family members or friends can stay with you throughout labor, or may come for the last hour or so to be there for your baby's birth. They may stay in the room with you during procedures and exams or leave when you require privacy.

If you wish to have children and siblings at the birth of your baby, talk to your health care provider. With good preparation, this can be a very positive experience. Attend a "Children at Birth" class so your children and their support person will know what to expect. You will probably be most relaxed and able to focus on contractions and pushing your baby out if another adult is present to care for the other children. You'll want to know that someone your children trust is there to reassure them and see to their needs.

Remember to prepare your children and any other people you wish to have present at your baby's birth for the fact that labor and birth rooms have limited space. There may only be room for two or three additional people. If an emergency arises, children and others may be asked to leave the room.