Sunday, December 6, 2009

Birth preparation

The Blessingway ceremony is just one form of birth preparation. There are many other ways in which a woman (and her partner) can prepare for birth and all families registered with the NHS (in the UK) are given the option of antenatal classes as they near the end of pregnancy. These classes can be beneficial for some, and certainly provide information concerning hospital policy, pain relief methods and possible interventions, but they don’t focus so much on actual ‘preparation’. Again, knowledge breeds confidence and for a woman to feel confident, she must feel prepared for all that can / may / will happen to her during labour. Birth preparation focuses on both physical and emotional preparation.

Labour has been likened to running a marathon, an extreme physical endurance for which the body must be prepared. Yoga and swimming can help to strengthen core muscles, encourage good posture and promote breathing techniques, whilst walking allows the woman to remain active and encourages the baby to get into a good birthing position. Optimal foetal positioning (OFP) can be used to help turn a baby who isn’t lying in the best position, and can also maintain the position of the baby up until labour (figure 1).

Figure 1 - taken from

Many babies who are found to be in the breech position (feet down, head up) can be gently encouraged to turn using OFP techniques, as well as other (less-researched, unvalidated!) methods. These include: shining a torch on the belly (the baby will move its head away from the light); doing somersaults in the swimming pool; and even talking to the baby and asking it to move. Consultants may try to move a baby using a method known as external cephalic version (ECV) which can be uncomfortable for the mother and only has an average success rate (~65%). It is therefore important to encourage good foetal positioning via good posture and other OFP techniques.

As well as preparing the body for labour, it is equally important to prepare the mind. Ina May Gaskin often talks about stalled labours being restarted once the woman has released an emotional stress.

“... I then learned that the woman in labour had been adopted and had confided to her friend that she had grown up afraid that her biological mother had died in childbirth. She was apparently too embarrassed or too far beyond speech to admit she was afraid of dying if she surrendered to the power of her labor. Once this profound fear was mentioned aloud, her cervix relaxed and displayed abilities it didn’t seem to possess earlier. It wasn’t long before it was completely open. A healthy baby was born within two hours of the mention of the secret fear.”

Many birth preparation methods involve discussing thoughts and fears surrounding labour and birth. This becomes increasingly important for mothers having a second baby where the first labour has not gone as hoped. Much of the work of doulas in the UK involves helping women who are planning a vaginal birth after a first Caesarean section (VBAC). In these cases it is important for a mother to understand what happened during the first birth, what interventions were given, when and why, in order for her to move on and believe that she is capable of giving birth naturally. Equally important is to help her understand that if a second Caesarean section becomes likely, then this is in no way a ‘failure’ to birth her baby. A traumatic birth experience (use of interventions such as instrumental delivery or surgical birth) may increase the likelihood of post-natal depression, increases the chance of the mother developing post-traumatic stress disorder (PTSD), and decrease the success of extended breastfeeding. There are many resources available to women who have suffered a birth trauma; and for those wishing to gain knowledge in VBACs, and alternative birthing methods (doulas, independent midwives, home births).


Wolf, N., Misconceptions. 2001, London: Vintage. 282.

Gaskin, I.M., Ina May's Guide to Childbirth. 2003, London: Vermilion.

Mongan, M., Hypnobirthing: The Breakthrough to Safer, Easier, More Comfortable Childbirth. 2007: Souvenir Press Ltd.

England, P. and R. Horowitz, Birthing From Within. 1998, London: Souvenir Press. 406.

Bailham, D. and S. Joseph, Post-traumatic stress following childbirth: a review of the emerging literature and directions for research and practice. Psychology, Health & Medicine, 2003. 8(2): p. 159-168.

Beck, C.T. and S. Watson, Impact of birth trauma on breast-feeding: a tale of two pathways. Nurs Res, 2008. 57(4): p. 228-236.

Lawrence-Beech, B.A., Am I Allowed? 2003: AIMS. 112.

Lowdon, G. and D. Chippington Derrick, VBAC - On Whose terms? AIMS, 2002. 14(1).


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