Body Work

4 Birth Prep Tools Every Woman Should be Using from Julie at Strong Body, Strong Mama

Daily Activities for Pregnancy for an Easier Birth from Spinning Babies

The Miles Circuit  This position series can help to rotate a baby. As a natural method of induction, it helps get things going if baby just needed a gentle nudge into position to set things off. Start practicing the circuit at about 37 weeks, starting with 10 minutes per position per day, adding a few minutes each day until they get to the full 90 minutes.

Connecting the Breath & Pelvic Floor 

Step 1. The Diaphragmatic Breath

Step 2. Combine the diaphragmatic breath with “Reverse Kegels” (aka pelvic floor lengthening or the pelvic floor drop).

  • Lie on your back with a pillow/wedge placed under your right hip.
  • Keep your spine in a neutral position and do not tilt your pelvis as you practise this visualization exercise. The focus is to move the pelvic floor muscles only.
  • To feel the difference between tension and relaxation, start by gently contracting your pelvic floor. Then relax and release the pelvic floor muscles.
  • As you inhale, focus on gently wrapping your muscles around baby and lengthening your pelvic floor. Imagine moving the pubic bone towards the ceiling and tailbone towards the floor as the muscles between lengthen to create space in your pelvic floor.
  • It is helpful to take a mirror to look at your contraction and relaxation. You should see the anus release and your perineal body (tissue between the vagina and anus) move downwards towards the mirror.
  • The perfect time to practice is while you’re having bowel movements in the weeks leading up to the birth. In this position, visualize gently wrapping your pelvic floor muscles around baby, your tailbone moving towards the toilet tank and your pubic bone moving away from the toilet as you inhale.

Check out other labouring/birthing positions to try the reverse kegel in:

Practice Comfort Measures and Labour Positions Prenatally 

Comfort in Labour (Penny Simkin)

Using a Rebozo from Spinning Babies

The Abdominal Lift and Tuck from Spinning Babies

Perineal Massage

Most birthing parents hope to deliver without perineal tears, grazes and stitches. Perineal massage during the last month of pregnancy encourages the perineal tissue to stretch/expand more easily during birth to prevent tearing.

Prenatal digital perineal massage done 1-2x a week starting at 35 weeks pregnant:

  • Decreases the risk of perineal trauma (15% less likely to need an episiotomy and 10% less likely to have a tear that needs stitches) for folks who have never had a vaginal birth, and
  • Decreases the incidence of perineal pain at three months postpartum for folks who have birthed vaginally before.

Perineal massage should not cause pain if done correctly. You should feel pressure or discomfort (pinching, stinging, burning) that lessens as treatment continues. If you experience pain, STOP and talk to your midwife (or primary care provider for the pregnancy). You can also consider a visit to a pelvic floor physiotherapist to demonstrate the technique.

Check out the Belly Whisperer for a FREE step-by-step perineal massage video guide using a watermelon wedge and anatomical pelvis! Click here.

How to Perform Perineal Massage

Preparation

  • Wash your hands or use latex free medical gloves.
  • Trim your fingernails
  • Find a mirror (handheld or floor mirror)
  • Get lubricant or inert, unscented oil (ie., olive oil, coconut oil).
  • Find a comfortable and private area.
  • Take a warmth bath or shower before to increase blood flow, circulation, and soften the tissues before stretching

Position

  • Recline slightly backwards in reclining chair, prop up your back with pillows on a bed/sofa or rest back against a pillow on a wall with legs open wide and knees bent. Avoid lying flat on back during 3rd trimester. If you are most comfortable on your back, place a wedge (e.g., pillow) under your right hip.

Lubrication

  • Place oil or lubricant on thumbs as well as on the lower part of the vaginal opening and perineum.

Diaphragmatic Breathing

  • Inhale and exhale a few times with your eyes closed to help soften your tissues.

Massage

  • Slowly and gently rub along the OUTSIDE of the vaginal opening along the labia major or minor to prepare for massage INSIDE the vaginal opening.
  • Place your thumbs about 2-4cm or to the 1st knuckle just on the inside the lower portion of the vagina opening at 6 o’clock above the perineum. Use a mirror to find landmarks.
  • Gently press downwards toward your anus for about 10-15 seconds until you are used to the pressure without pain and then aim for at least 30 seconds to up to 2 min stretching holds
  • Massage using your thumbs upwards and outwards then back again in a U-shaped movement starting at 6 o’clock and moving to 3 and 9 o’clock. (Remember to use slow, deep breathing during the massage)

Partner Involvement

  • Massage can be difficult during the later stages of pregnancy so involve your partner if you can. Follow the same method as before. Your partner may want to use index fingers rather than thumbs.

 

References

Beckmann MM, Stock OM. Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD005123. DOI: 10.1002/14651858.CD005123.pub3