While my pregnancy landed after COVID-19 restrictions started to ease, I still found there to be barriers to the traditional delivery experience. This became clear when my mom encouraged me to participate in a labor and delivery course. Our hospital was only offering a virtual (and expensive!) L+D course. When I brought this up to my OB, she directed me to this YouTube link.
I found the video to be extremely insightful and have since recommended it to close friends in pregnancy. This video has information that is even meaningful for mamas who have already had a previous delivery. I hope you find it helpful, too!
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Video Basics
This is Part 1 of a Prenatal Class given by Holliday Tyson, a midwife from Canada with over 30 years of experience. This first video is 40 minutes long and is a recording of an in-person prenatal class. Watching this virtual class was a great way to learn at home in a calm environment. I also enjoyed having a recording that could be paused (for snack or pee breaks!) and later re-watched.
I have included a summary of the topics covered, as well as a few pertinent time stamps. I highly encourage any pregnant mama to watch the video with your birthing partner to prepare together for labor and delivery.
“You’re Not Just Delivering a Baby, You’re Developing Becoming Parents.”
Holliday discusses the importance of partner/team support during labor and how it plays a huge role in delivery satisfaction and long-term happiness in your relationship.
She also addresses that by joking about dad’s inability to go through labor or his struggle to support the mama, “we forget that it’s their baby too, and they’ve never been to a birth before.” Yet we expect them to be excellent coaches. This is an important reminder to try to extend kindness and understanding to your support person during this time, as it can have long-lasting impacts on your relationship.
Holliday recommends discussing how you would like your partner to support you prior to labor. It is difficult to try to discuss this if you wait until mom is in pain; especially for the first time. This can be a scary and intimidating time for dad.
Anatomy & Physiology: The Pelvis
“The last couple months of pregnancy are a gradual transition into labor.”
Pelvises come in different shapes and orientations. The shape of the pelvis can affect the specific way baby moves during delivery. It can also affect the rate of delivery, such as in stories of women who give birth very quickly (like in the bathroom) — although this specific shape of pelvis is actually quite uncommon.
Pelvic ligaments become less stable during pregnancy due to hormonal changes: progesterone & estrogen help in the last month of pregnancy to get ready for birth. This can sometimes cause discomfort if trying sudden movements, twisting, lunges, or taking stairs late in pregnancy.
Some positions open the pelvis more, such as squatting, but this is not a movement regularly practiced in daily life for most mamas in western cultures. If it is not something done regularly, it can be uncomfortable to start during pregnancy.
Holliday recommends trying gentle movements to open the pelvis:
1) Spend time leaning on counter and rock side to side (14:16). Do this daily to help open the pelvis to allow baby to move down naturally.
2) Mimic hula hoop movements (15:29). Both movements can be helpful in the last trimester of pregnancy, as well as during active labor.
Anatomy & Physiology: The Uterus
The uterus is a big set of muscles that starts out the size of a pear pre-pregnancy. This is one area over which you have some control during labor and delivery.
The muscle develops “polarity” where it will thin towards the cervix where baby’s head will rest and thickens towards the top in order to be able to contract and expel baby through the birth canal.
Sufficient development of polarity is hindered by distraction, talking, high light environments (18:26). There has been a historic increase in “augmented labor” (requiring medical intervention, pitocin, etc.) which may be due in part to societal increases in timing different aspects of labor, exposure to bright light, and increased talking, such as trying to continuously update family during labor (20:17).
Quiet, darker environments are proven to improve polarity by facilitating production of the hormone oxytocin, which helps the uterus operate correctly. Optimize polarity towards the end of pregnancy and during labor by spending time in quiet, dark environment without phone use or other distractions.
How Does Baby’s Head Fit Through?
The vagina is lined by pre-existing folds that allow tissues to expand during childbirth and return to pre-baby size afterwards (26:32).
The cervix transitions from the texture of the firm tip of your nose to that of a softer tissue, like the lips of the face. A softer cervix is favorable to labor at the end of pregnancy.
Some activities that soften labor include walking and squatting. In modern society, sitting in a chair removes the weight on the cervix and does not encourage the cervix to soften normally. You can combat this with the leaning and hula hoop maneuvers discussed above, increase in exercise (walking one hour/day for healthy pregnancies), or increasing sex in the last trimester.
Regular sex causes mechanical movement of the cervix in addition to releasing prostaglandins in semen; both help to soften the cervix and create contractions. Nipple stimulation can also encourage these changes. Sex-positive cultures where daily sex is common have much lower incidences of pregnancies past 40 weeks. However, if sex causes hours of contractions, contact your OBGYN.
The Mucus Plug
The purpose of the mucus plug is to provide a barrier within the cervix to prevent infections entering the uterus.
Some people lose the mucus plug all at once: approximately the size of tampon, may have mucus +/- blood component.
It is more common to lose the mucus plug gradually: feels like increased discharge, also may be more noticeable after sex.
There is no danger or risk with the how or when of losing the mucus plug at the end of pregnancy.
The Pain Question
As many mamas have never experienced labor before, Holliday uses the familiar comparison of how people tolerate pain at the dentist differently (20:57).
She explains that some people have thin nerves, some have thicker nerves. Thicker nerves are found in people who feel pain more strongly. You don’t have any control over the makeup of your nerves and “it is important to know that needing an epidural is fine and doesn’t mean that you didn’t perform.” Some people do not experience labor as painful as others and there is no sure way to know which group you belong to until you are in active labor.
The nerves involved in labor are in concentrated in a “plexus” or web along the lower abdomen and low back.
Partners/Men Can Provide Support Maneuvers to Target Nerve Areas And Ease Labor Pain
Holliday encourages mamas to practice movements with partner in late pregnancy prior to labor.
“The penguin walk” (23:48): Partner stands behind mama and uses both hands to help lift the bottom of mama’s belly upwards. This can improve pain in labor. This should feel good/supported. Give partner pointers and encouragement. Once adequately supported, partner and mama can waddle forward to walk likes penguins while nestled close together.
The second support maneuver is to help with back labor (38:00): Partner stands behind mama and presses both palms or a single fist firmly along mama’s low back/pelvis area. Partner needs to press hard in order to compress nerves and improve pain. Compressing nerves in this area improves pain associated with back labor.
Importance of Fetal Movement
This is perhaps the single most important marker of an ongoing healthy pregnancy. Consistent fetal movement may be even more valuable that most other hospital tests. It is important to feel fetal movement every day. If no movement felt, call your OBGYN immediately no matter what.
My Birth Experience
After watching this video, my partner and I both felt more confident in our labor and delivery experience. I practiced the recommended pelvic rocking movements in the last months of pregnancy, and also in the hospital. The partner-assisted back labor maneuver helped immensely with my pain. I believe these factors were significant in allowing me to be able to have an unmedicated birth.
I was also fortunate to actually end up working with a midwife and had a fantastic experience!
Do you have any labor & delivery resources that you found helpful? Comment down below!
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