Your Doula's Guide to Optimizing your Body for Birth and Encouraging Baby's Arrival
When you are approaching or are within your "Due Window" (37-42 weeks of pregnancy), there are multiple ways to actively prepare your body for your upcoming labor and birth and, if desired, set the stage for nudging baby earthside. Let's explore what these are and help you streamline this process by way of an easy checklist that can help keep you on track!
Start with Daily Body Preparedness
Stay hydrated. Drink 2-3 quarts of water every day. Every morning, measure and fill your water container(s) with that day's goal so that you can easily keep track of your intake.
Nourish & tone your uterus by consuming Red Raspberry Leaf Tea. At a minimum, use 1-2 tea bags to make 1-2 cups per day, but for maximum benefit, slowly build up to using 1-2 handfuls of loose-leaf tea in a quart of water. Avoid using too much sweetener, but a little honey to make it palatable is generally fine unless you have diet restrictions.
Reduce sugar and simple carbs intake. Give your baby optimal nutrition and avoid blood sugar spikes by opting for a healthy, well-balanced diet so that your baby grows well without the empty calories that can cause you and your baby to gain excessive weight. If you want something sweet & are not diabetic, try eating/incorporating dates and/or pineapple, as there is some anecdotal evidence that they may help promote a soft cervix.
Get adequate rest. Try to get a full night's sleep every night. You may benefit from applying magnesium lotion to your legs to help you relax. It is imperative that you go into labor fully rested, so make this a priority and plan to get mid-day naps, if possible, as your pregnancy progresses or if you sense that labor is imminent or near. Even a 20-minute power nap before you go into labor can make a world of difference to ward off extreme exhaustion.
Don't be too sedentary. Keep your body moving by incorporating some kind of physical exercise every day. The easiest way to do this is by walking a minimum of 20-30 minutes, but you could also do a gentle yoga or stretching routine or something similar. If you need to break it up into smaller sessions throughout the day, that's okay! Feel free to increase the frequency, amount of time, or intensity of walking if you are more actively trying to induce labor. But balance a lot of walking with rest, if you are fairly close to going into labor.
Keep your pelvis optimized for baby positioning by doing the Spinning Babies Exercises called the 3 Balances once per day. These are: The Forward Leaning Inversion (30 seconds), The Side-lying Release (up to 3 min each side), and The Jiggle (as long as your partner can help you, typically 1-5 minutes on each side). If you don't know how to do these exercises, there are videos online, or ask your doula to teach you!
Use your birth ball instead of a chair. A birth ball helps your pelvis to stay at the proper angle so that your baby can get into an optimal position, so whatever your sit-down tasks are, do them from your birth ball. This includes everything from when you are working at your computer to folding laundry, relaxing, or whatever you do sitting down. Also, don't just sit there, bounce, make figure 8s or circles, or do other movements that keep your hips in motion. Don't sit cross-legged or recline back in an easy chair too long during your 9th month, as that is counterintuitive to the best pelvis position.
Address pelvic or round ligament pain, including lighting crotch, pressure, cramps, etc. by using hydrotherapy (warm soaks in a tub or hanging out in a swimming pool), and relaxing or using gentle stretching exercises. Consider investing in an SI (Sacral-Illiac) Belt which is worn low across the hips & pelvis to help reduce pain & fatigue while supporting your pelvis structure. KT Tape is another way to stabilize your growing belly and your pelvis. There are YouTube videos that can show you various ways to apply it. Don't use a belly band instead, as it does not provide the proper support for optimal pelvis health.
Talk to your midwife or care provider about additional herbs/supplements that may help your body prepare for birth. Some may recommend the use of evening primrose oil (either orally or vaginally or both).
Incorporate Weekly (or on an As-Needed Basis) Appointments
Pre-Natal Massage. If you can afford this luxury, (or if your partner is talented and so inclined), give your body this gift of ultimate relaxation.
Webster-Technique Chiropractic Adjustments. Find a certified practitioner who understands how to align, adjust, and balance your pelvis (and the rest of your body!) so that your baby can get into the best position possible. Get on a regular schedule for your last few weeks of pregnancy, as these work best when repeated every few days.
Acupressure/Acupuncture/Moxibustion. These alternative techniques are an option for those who want to encourage a natural induction by promoting cervical softening and production of oxytocin, by way of stimulating your body's own rhythms. Multiple sessions may be necessary to maximize the effects.
Periodically add in Potentially Useful and Non-Invasive Natural Methods (on whatever schedule feels right to you)
Have sexual intercourse regularly! When you orgasm, it stimulates contractions in your uterus and while they may not be labor-inducing contractions, every little bit can help. Plus, semen is known to be a source of natural prostaglandins (the hormone responsible for softening your cervix), so let it pool on your cervix for a while. And of course, as they say, "What gets the baby in, can help get the baby out!" And that is especially true because lovemaking promotes naturally high levels of oxytocin (which is the love hormone and is absolutely necessary for labor progression).
Eat spicy foods. Maybe. Depends if you are prone to horrible heartburn or not. If not, then spice it up. This sometimes may kick start labor because spicy foods can irritate your bowels and cause a laxative effect. When that happens, it can simultaneously stimulate your uterus to contract. I only recommend this if you love really spicy foods anyway and will enjoy the experience even if it doesn't start labor.
Do the Miles Circuit. This is a series of exercises and positions that you move through over the course of about 90 minutes. It includes some similarities to the Spinning Babies exercises, but also incorporates, lunges and curb walking, etc. It is designed to help the baby get into and stay in an optimal position, which can in and of itself stimulate labor or restart a stalled labor. It is easy to find all the movements online on their website. (You can actually start the Miles Circuit early in your due window in shorter stints and work up to the full amount of time as you approach and pass your due date. So, it can be used as a daily maintenance technique or saved for promoting a natural induction.)
Get Serious! When (or if) you feel an urgency to progress from these maintenance levels of optimization to a more aggressive 'natural' induction, here are some additional ideas to add to your routine:
Membrane Sweep (also called Stripping Membranes). This is something you can ask your midwife or care provider to do for you. It is similar to having a cervical check, but with the added movement of their fingers entering your cervix to separate where the bag of water is attached to the cervix. This allows your cervix to move more freely and may stimulate it to dilate more readily. It can be painful, especially if your cervix is in a posterior position and it does come with the risk of breaking your water. Some people feel this procedure is very invasive (and it especially is if done without consent!) and others view it as a minimal and somewhat natural intervention. If it doesn't work, sometimes you can get it done again a few days later.
Nipple Stimulation. Technically, this is something you can incorporate even before you are feeling desperate for your baby to arrive, whether as a part of your lovemaking/partner times or otherwise. The easiest and most effective way to do nipple stim is to use a breast pump (or actually nurse a real baby/toddler). If you really need to naturally induce, it is my #1 recommendation. This is because first of all, it is safe (it won't put you into labor unless your body and baby are ready) and also, it is very effective (if your body and baby are ready). It can be combined with other induction methods and is non-invasive. I typically recommend 20 minutes on one side, 20 minutes rest, 20 minutes on the other side. Repeat as needed, perhaps every 3 hours or so. There is no one right answer to frequency or duration, so it is customizable! Not only can it be done multiple times per day, but you can increase/decrease the number of minutes or stimulate both nipples at the same time if you choose. (If your nipples are too sore, then pause or discontinue.) Nipple stimulation works because it promotes the production of oxytocin and can create effective contractions.
Castor Oil. This is a laxative that can stimulate your bowels. (Remember we talked about that earlier with spicy food…but this is much more powerful!) It is the primary ingredient in "Midwives Brew" but there is no agreed-upon recipe for said brew, which commonly calls for orange juice. I actually recommend that it is taken mixed with a protein such as peanut butter or eggs, to make it easier to swallow. Be aware that it can make you very nauseated and occasionally induces vomiting. The big question is how much do you consume? Well, that also isn't agreed upon and can be highly personal. You might only need a teaspoon for the effects or you might need a tablespoon or more (or multiple doses). There really is no one right answer! Start slow and take extra after about an hour, if necessary. Don't consume if you don't have easy access to a bathroom, because it can create uncomfortable cramping and diarrhea. Disclaimer: It is highly recommended that you only attempt a castor oil induction under the direction of your midwife or care provider.
Lift and Tucks. If you aren't in labor but are getting a few contractions (either because you are having prodromal labor or because you've used any of the above techniques), but active labor hasn't set in, you can try lift and tucks. This is a Spinning Babies technique that your partner can help you with (a rebozo may also help). If you notice that your belly is falling forward away from your body too heavily, this may indicate that the baby's head is not engaged. By lifting and tucking your baby into the proper position during contractions, you may eliminate the problem. What this technique does is to help apply your baby's head more firmly to your cervix, thus stimulating labor to begin. Be aware that this technique is uncomfortable to perform. Sometimes it helps to use a belly band to secure the baby so that they don't fall out of position between contractions. You may be able to learn how it is done by watching a video online or you may want in-person instruction.
Ask for a Mechanical or a Minimal Intervention Induction. What if none of the natural methods work and, if possible, you want to avoid a traditional pitocin induction? Here are some choices, but PLEASE NOTE FIRST: If your cervix is not dilated at least a little bit or is not ripe and ready (soft and stretchy enough), you may need cervical dilation medications such as Cervidil or Cytotec, which are synthetic prostaglandins, before the following ideas may be considered:
Foley Bulb. This is a catheter that can be placed in your cervix with enough tension to force your cervix to dilate to approximately 3.5-4 cm. It is somewhat invasive and may hurt to have it placed, but it also may not hurt at all. It simulates a baby's head pushing on the cervix, so the action is entirely mechanical and any resulting contractions are equivalent to what would be produced if your baby's head was providing the pressure instead. It will fall out on its own once your cervix has dilated to about 3-4 centimeters and may be enough to trigger labor for you. If not, you can continue with added nipple stim or move to the next step.
Breaking Your Water. Also called AROM (Artificial Rupture of Membranes) or popping your bag of water. Normally, it is recommended to let your bag of water break naturally or at least not to do it artificially in early labor (for several reasons), but at times, it is preferable to induce labor with this simple technique. As a broken water bag is a variation of normal childbirth, the contractions this is likely to induce are the same intensity whether it breaks on its own or with help. This may be sufficient to trigger active labor, especially if combined with nipple stim.
Low Dose Pitocin. If those mechanical induction methods do not work, even when blended with nipple stimulation and lift & tucks, you may have no other option than to have at least a minimal dosage of Pitocin given through an IV. Sometimes a low dosage of "pit" is all that is necessary to trigger labor and can be turned off or down if your body takes over with sufficient oxytocin production. In some cases, pitocin may be needed throughout labor in order to produce contractions that are strong enough to produce adequate cervical change.
NOTE: Natural induction methods will only work if your body/baby is ready for labor and are typically more effective if you are at least between 40-42 weeks of pregnancy. And even then, they are not guaranteed to work at all. All inductions, natural or otherwise, should only be done if you are sufficiently informed and have consented. You have autonomy and can refuse any induction methods if you choose. Please weigh all benefits and risks carefully before deciding what you want to do. Some medical conditions or concerns may weigh heavily into your decision.
ALSO NOTE: If your baby is breech, there is additional information that may be useful for you to know as you prepare for your birth that is not covered fully in this article. Please ask for extra guidance from your doula and midwife/care provider.