How to prepare yourself for a physiological birth
By Lindsay McCoyThe Body Ready Method® secret sauce for how to achieve the natural/physiological birth you desire.
So you like giving birth ‘naturally’…Now what?
Let me start with a little story. When I was pregnant with my first, I decided that I wanted to have a physiological birth. I did not really know much about it, except that I wanted to avoid the epidural. My thought was, “People have been doing this for thousands and thousands of years, right? I am sure if they could do it, I can too.” And with that, I did very little preparing beyond reading all the natural childbirth books I could get my hands on.
I am here to tell you what REALLY helps when planning a natural birth.
Why I dedicated my life to childbirth
I will have you know that I googled “doulas near me” and did find that there was one an hour away. This was 2007 and doulas were not quite as well-known as they are now. I thought to myself, “Meh…I don’t want to spend the money and that is too far away.” So on I went with my pregnancy—blissfully unaware of what was to come. Without making this entire article about my first birth story, we will say that I ended up with what felt like every intervention in the book while still having the baby come through my vagina. After that birth, I vowed to learn everything I could, and now I have dedicated my life to childbirth! I went on to have three natural water births and support hundreds of families as a childbirth educator and doula. I spent 12 years in the field and have now trained over 1,200 birth professionals to use the method I developed to prepare the body intentionally for birth. I am here to tell you what REALLY helps when planning a physiological (natural) birth.
What are the benefits of physiological birth?
First of all, what is a “physiological birth,” and why do we care? Physiological birth means that the birth is powered by the innate human capacity, by the physiology. It is a bit more specific and defined than to say one wants a “natural birth.” So, what is the point of physiological births? First of all, there are no medals in birth and this is not about bragging rights. Every birth is valid and every birthing person is amazing. Physiological birth does have some amazing benefits to a birthing person and baby, and here are a few:
Decrease chance of cesarean
Freedom of movement
Avoid the cascade of interventions
May make labor and birth shorter and easier
Helps baby’s gut flora
Enhanced parent–baby attachment and early breastfeeding success
A shorter physical and psychological recovery period after the birth
Better regulated body systems for the baby, including blood sugar, temperature, breathing, and blood circulation
Physiological Birth Tips:
Body Ready Method® recipe for smart physiological birth preparation
Consider birth location
This and choice of provider are the most important decisions that you will make for your birth. Dr. Neel Shah, OB/GYN, says that your number 1 predictor of cesarean birth is your place of birth. Do not enter into this decision lightly.
Physiological birth in a hospital:
If you are planning a hospital birth, it is important that you research your hospital choice, including their cesarean rate. Here is an analogy: If you are wanting sushi, don’t go to an Italian restaurant. Even if they are nice and want to help you have some sushi, it will not taste the same as sushi from a restaurant that specializes in making it. So too, if you want a physiological birth, you want to go somewhere that sees it regularly and knows how to support it well. If the hospital has a 50% cesarean rate and an 85% epidural rate, they do not see normal physiological birth very often. It is true that good births can happen anywhere, but you don’t want to have to fight for what you want and you want staff who knows how to support it well. Even well-meaning providers and staff may have a difficult time supporting normal physiological birth if they do not see it very often.
Freestanding birth center birth:
Freestanding birth centers are on the rise! While they are not yet in every community, they are a great option for low-risk pregnancies. Do not confuse a hospital maternity ward with the words “birth center” in their name with an actual freestanding birth center. Some L&D wards have inaccurately started to market themselves as birth centers due to their growing popularity. While there is nothing wrong with choosing the birth in the hospital, it is very different than birthing in a birth center and should not be marketed as such.
Freestanding birth centers do not offer labor induction or augmentation with pitocin, epidural or other pain medications (though many offer nitrous oxide!), or cesarean sections. They are also not a good choice for someone who is considered higher risk. The provider (typically a midwife) will monitor the birthing person and the baby similarly to monitoring and if needed, will transfer to the hospital in case of needed interventions or distress. If an epidural is desired, transfer will happen for that as well. The statistics show that 84% of those who begin labor in a birth center will birth there and 93% will have a spontaneous vaginal birth, regardless of if they transfer in labor or not. That means that birth centers have a 6.1% cesarean rate, which is amazing!
Freestanding birth centers are a good option for those with a low risk pregnancy who want a natural birth.
Home birth:
Home birth is similar to a freestanding birth center birth, just in your own home. Despite much misunderstanding among the general public, the same emergency equipment is typically brought to the birth, including anti-hemorrhage medication and oxygen. Home birth providers, typically midwives, are trained to monitor pregnancy and birth well, transfer if the individual risks out during pregnancy or birth, and intervene when needed. Also similar to a birth center birth, home birth is a good option for low-risk pregnancies.
Stats show a 7.2% cesarean rate and primary reasons for transfer were non-emergent “failure to progress.”
When considering home birth, it is important to interview midwives and ask important questions about how they handle different situations and about their training and experience. Home birth midwives are trained and experienced in physiological birth and know how to support it well. If you want sushi, they are the sushi chef!
Birth location is a personal decision. There is not one right way to have a physiological birth. Consider where you would be able to let go and relax into the process with the greatest ease.
Birth location is a personal decision. There is not one right way to have a physiological birth. Consider where you would be able to let go and relax into the process with the greatest ease. Interview and tour different providers and facilities. And also listen to your intuition.
Choose provider wisely
After considering your birth location, you will want to consider your provider. There are generally three types of providers who attend birth: OB/GYNs, family practice doctors, and midwives. Each tends to approach birth differently and it is important to research the differences. It is important also to consider the provider’s general policies and beliefs around the birthing process. Ask lots of questions. What is their cesarean rate? Why do they tend to induce (including if they induce at 39 weeks, 41 weeks)? What is their episiotomy rate? There are many important questions to ask your provider during the interview. I think we sometimes forget that we are in charge and we are the one hiring them, not the other way around. It is also helpful to ask the local birth community, if you have one, which providers tend to be most supportive of physiological birth. Doula groups, for example, tend to know which OB/GYNS are natural birth supportive (rather than just paying lip service to it) and which family practice doctors and midwives are especially awesome.
Depending on where you live, your options may be more limited. Even if there are not many options, it is still important to ask questions and make your preferences known far ahead of time.
Hire a doula
Doulas are statistically proven to decrease cesarean rate by 39%, decrease dissatisfaction with the birth experience by 31%, decrease the use of pain medication by 10%, and decrease labor augmentation medication like Pitocin. They offer a continuity of care, physical, emotional, and informational support that is absolutely essential to those planning a physiological birth. While not all those who hire a doula will have a natural birth, having one by your side can significantly stack the cards in your favor. Additionally, a doula is an essential part of a medicated and cesarean birth team. They have a special role that is different and complementary to the role of the partner, nurse, and medical provider.
I highly recommend birth professionals certified in the Body Ready Method®. We can guarantee they know the most cutting-edge techniques to help you prepare your body and mind intentionally for your best possible pregnancy, birth, and recovery. We have a directory of certified pros worldwide. Simply go tobodyreadymethod.com/birth-pro/, filter for your location, and see if there is one near you.
Take a solid childbirth education program
Some childbirth classes are mostly, “Here is how to be a good patient at our hospital.” These are not the best childbirth classes for those planning a physiological birth. The best childbirth classes will cover things such as:
Pros and cons of different interventions
Physiology of labor
Comfort measures and techniques
How to write out your birth preferences
Childbirth education is not just for the pregnant one, it is extremely helpful for the partner as well! This is something that they have maybe never done, or only done a few times, and learning about the process and the choices that can be made is important for the birth partner because during the labor process they will be needed to speak to the staff and help the birthing person consider their options when the birthing person is in “labor land” and not as much in their “thinking brain.” We also all know how much a stressed out and anxious vibe can be contagious and this is especially true in the birthing space, so having knowledge of what to expect in this process can help the partner to maintain a more cool and collected state for the benefit of everyone in that room. Our favorite birth classes are Hypnobabies® and Lamaze-based classes.
Prepare your body
Pregnancy and birth is a unique and amazing physiological event and preparing well for it includes specific body preparation to optimize the process. Just like you would not train for a marathon the same way that you would train for a weightlifting competition, so also we must use what Exercise Science calls the law of specificity to train intentionally for a more easeful and efficient birthing process. And YES this can be done and I have devoted my life to learning how and now am teaching it to others!
Our prenatal exercise program, Body Ready Pregnancy, teaches how to specifically prepare the body for birth through our innovative Body Ready Method®. It focuses on exercises that help create mobility and balance of the pelvis, yield of the pelvic floor, support with the core, and more. Preparing the body is an important, yet often overlooked part of preparing for physiological birth, and we do not recommend the old school recommendation of 100 kegels a day, which can actually create a lot of issues.
Prepare your mind
You would (hopefully!) not go into an athletic event thinking, “I can’t do this” and during the event you would not think “I can’t, I can’t, I can’t.” This is a recipe for a really difficult experience. High-level athletes know that they need to prepare their brains just as much as their bodies. They also know how deeply connected the brain and the body are. The same is true for birth. We need to do the work ahead of time to prepare our minds to be able to let go and flow through the strong sensations of birth. There are many ways to do this.
Hypnosis, pregnancy affirmations, and practicing having a calm mind during more challenging yoga poses are all excellent options.
But the big piece is learning how to regulate the nervous system! How we manage the stress in our life is quite closely tied to how regulated (or not!) the nervous system is. Becoming aware of how one handles distress in one’s life can be a helpful indicator to tune into what might be needed to be able to be calm and collected during the strong sensations and twists and turns that birth can bring. If milk spills on the floor, we cannot control that it happened, but we can control our reaction to it. We can choose to freak out or we can choose to sigh and calmly clean it up. Of course there is a range between these two reactions. Having tools to be able to manage stress and regulate is hugely important before entering the birthing process and also for being a parent and happy, healthy human! Life skills!
We cannot control everything about the birthing process. Even among those planning a physiological childbirth who do “everything right,” sometimes unanticipated interventions will need to occur. Maybe even a cesarean. Yes, many interventions are used too frequently and that is why it is so important to educate yourself about them, but truly they are not evil and they are very necessary sometimes. The best we can do is prepare well ahead of time, set the stage and have an amazing team during the process of childbirth, and then let go. The only predictable thing about childbirth is that it is unpredictable. However, when you prepare yourself ahead of time, you stack the cards greatly in your favor for a natural childbirth! Check out our different targeted programs for each stage of your journey into parenthood—with tips and movements to help prepare you for your birth at bodyreadymethod.com/offerings/.
References and resources:
Stapleton, S. R., Osborne, C., & Illuzzi, J. (2013). Outcomes of care in birth centers: demonstration of a durable model. Journal of midwifery & women’s health, 58(1), 3–14
Janssen, P. A., Saxell, L., Page, L. A., Klein, M. C., Liston, R. M., & Lee, S. K. (2009). Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 181(6-7), 377–383.
McGrath, S. K., & Kennell, J. H. (2008). A randomized controlled trial of continuous labor support for middle-class couples: effect on cesarean delivery rates. Birth (Berkeley, Calif.), 35(2), 92–97.
This article originally appeared in Pathways to Family Wellness magazine, Issue 80