Cory Simon-Nobes, APRN, CNM, is a certified nurse midwife at the University of Vermont Medical Center.

Cory Simon-Nobes, APRN, CNM, is a certified nurse midwife at the University of Vermont Medical Center.

People often track a woman’s labor progress by how much her cervix is dilating (opening), but much more is happening during labor.

With each contraction, a woman’s uterus pushes her baby down into her pelvis, and the baby tucks and turns to find its way through. A woman feels intense pressure and stretching as her baby moves down. Ligaments – loosened during pregnancy –allow the pelvic bones to move and make more room for the baby.

Most women worry about labor being long or difficult. Small minorities of babies become stuck in a tough position during labor, or have heads bigger than their mother’s pelvis, and are eventually born by cesarean. A majority of babies can and will fit through the pelvis, given enough time and support. If we look at labor from the baby’s perspective – as a challenging journey through a woman’s curvy, tunnel-like pelvis – there are several things women can do to enhance comfort and encourage their baby’s progress toward birth.

How To Make Labor Easier

Tips During pregnancy

Be active

Aim for at least thirty minutes of moderate activity daily – it doesn’t have to be all at once.  Walk, jog, or swim. Try yoga, which combines stretching and strengthening with breath awareness, a great a mind-body preparation for labor. Staying fit will give you the strength and flexibility to move around during labor to help your baby move through your pelvis.

Eat well

Healthy eating will help you grow a healthy-sized baby. Choose plenty of vegetables and whole grains, and beans, nuts, lean meat, dairy, eggs for protein. Try to eat smaller meals at meal times and snacks with protein in between. Ask your provider about recommended weight gain for the full pregnancy, and try to stick to your goal. If money is tight you may qualify for the Women, Infants and Children (WIC), a government program offering financial assistance for buying food.

Sit smart

Watch posture during long hours at your desk or in the car. When a woman sits lying back or hunched over with her pelvis tilted back, her lower back forms a comfy hammock for her baby and the baby is more likely to lie with its back against her back, looking up toward the ceiling. A baby who stays in this “posterior” position during labor has a harder time squeezing through the pelvis. You can encourage your baby to settle in an “anterior” position, facing down toward your tailbone, by sitting upright with hips above knee level and your pelvis and belly tilted forward. Tuck one pillow behind your lower back, and if necessary, another pillow under your buttocks.

Take a birthing class

Childbirth classes teach pain-coping practices, labor positions, and helpful comfort measures. This knowledge may help minimize stress and fear and provide you with tools for coping with pain and unexpected events during labor.

Tips During labor

Walk, move around, and change positions

If you listen to your body, you will often choose the best position for your baby’s labor progress.  Sway back and forth leaning on a partner “slow dancing,” try hands and knees position, or bounce, or do figure eight circles on a birthing ball. Change positions every few contractions to create more space for the baby to navigate through the pelvis.

Rest, reenergize and hydrate between contractions

After each contraction take a deep breath, and on the exhale release tension and let the body soften. Sip a drink or some ice chips to stay hydrated. If you’re hungry ask your provider if you may have light snacks. When fatigued, try positions that allow for maximum rest during breaks. Relaxation allows the baby to settle lower into the pelvis as labor progresses.

Ask your provider about your baby’s position

A baby who is face down in the “anterior” position usually has an easier time fitting through the pelvis than a baby who faces “sunny side up” in the “posterior” position. Contractions push the back of a posterior baby’s head against the back of its mother’s pelvis (sacrum), rather than straight down through the pelvis and into her cervix. The baby takes longer to engage in the pelvis, the cervix takes longer to dilate, and the mother experiences more back pain. If a baby is “posterior,” nurses, midwives, and doctors can suggest positions that will help encourage rotation. Sometimes a provider can turn the baby by gently rotating its head during an internal exam.

Tips As you are pushing

Keep changing positions and resting between contractions

Just like earlier in labor, try to change positions every fifteen minutes during pushing. Sitting on the toilet, squatting, hands and knees, lying on each side, or lying on your back with knees pulled wide and back can all be helpful positions to push your baby down and out.  Use your breaks between pushes to rest – some women even fall asleep for a moment!

A baby makes its final twists and turns with the final pushes, and at last emerges into the world.  Labor is hard work, it hurts, but women and babies are strong, and we know that with time, support and encouragement they can do it.

Request an appointment online with a nurse midwife at the UVM Medical Center, or call 802-847-1400.

Cory Simon-Nobes, APRN, CNM, is a certified nurse midwife at the University of Vermont Medical Center. Learn more about Obstetrics & Midwifery at the University of Vermont Medical Center. 

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