Pointers from the pros

Five top tips from five top experts.
By Tracy Brown

childbirthObstetricians, midwives, doulas … these men and women devote their careers to helping mothers welcome healthy babies into the world. And between professional training and ample hands-on experience, it’s safe to say they know a thing or two about labor and delivery. So we asked them to share their best advice—a handful’s worth of practical suggestions expectant mamas can heed as they prepare for the big day. Find their words of wisdom below.

Elizabeth Layliev, MD, FACOG, attending physician in obstetrics and gynecology at Beth Israel Medical Center in New York City

1. Prep for it. Familiarize yourself with what to expect either through reading Your Pregnancy and Childbirth Month to Month by the American College of Obstetricians & Gynecologists or by taking childbirth classes such as Lamaze or hypnobirthing. Be sure to write down any lingering questions to ask your doctor during your prenatal visits.

2. Know thyself. Be aware of your medical and surgical history and how they play a role in the outcome of your labor and delivery. Ask your doctor about any possible concerns and risks regarding your particular pregnancy so you are well informed and prepared for any potential complications or setbacks.

3. Make a plan. Come up with a birth plan, which doesn’t necessarily need to be written down, but should include your plan for pain management, who you want in the delivery room with you, your thoughts about having a caesarean section if labor doesn’t lead to a vaginal birth, and your plans to breastfeed versus formula feed. Most importantly, keep your birth plan flexible to adjust to the unexpected changes that may arise in your labor and delivery and discuss the birth plan with your doctor to clarify things prior to going to the hospital.

4. Feed your soul. There is a very strong push toward breastfeeding and with good intent. Bonding, nutrition and passage of immunity to your newborn are all important advantages of breastfeeding. If for any reason a woman decides not to breastfeed, she shouldn’t feel inadequate or self-deprecating. A happy mother who feeds with formula is just as amazing a mother and creates just as strong a bond with her newborn as a happy mother who breastfeeds.

5. Soak it in. Amongst all the anxiety and pain during labor and delivery, don’t forget to actually enjoy the birth of your newborn. Beautify yourself prior to coming to the hospital, bring some relaxing music or scented soothing oil diffusers, and manage your pain with either hypnobirthing or an epidural to relieve the sensation of pain and to help you enjoy this incredibly joyous experience.

relaxing-bathKaren Zelman, CNM, MS, midwife at Parkland Memorial Hospital in Dallas
1. Take a warm bath and drink water. Do this when you feel the first contractions at home to avoid unnecessary trips to the hospital. You’ll know you’re in labor if your contractions persist and get stronger. If you can calm down your body, then you just experienced a false alarm.

2. Get moving. During labor, it’s helpful to stay mobile and switch positions. As you shift your body, the baby is able to move down deeper into the pelvis and get into birthing position faster.

3. Keep your bladder empty. Contractions press on the bladder, so when it’s full, this increases discomfort. An easy way to reduce pain is to simply use the ladies’ room as necessary.

4. Relax and breathe. It’s important to be as “noodle-like” as possible during labor. Tension in your body causes more pain, so try practicing relaxation techniques (like breathing exercises) during your pregnancy so you are prepared and able to relax yourself on the big day.

5. Confuse your pain receptors. Therapeutic touch is a miracle in labor. While experiencing painful contractions, you can actually trick your pain receptors by having a loved one gently massage your back. You can also relieve the pain by applying counterpressure to your lower back by pushing against it during contractions.

laborballShannon Pratten, RN, IBCLC, CD, (DONA) birth doula in Berkeley, California
1. Interview and choose your care provider carefully. Make sure your chosen obstetrician or midwife upholds the same ideals you do. Some important things to think about are caesarean rates, emphasis on breastfeeding, and comfort with normal physiological birth. You may also want to take this time to interview a pediatrician.

2. Consider hiring a doula. Having a baby is an intimate experience and the right doula can help you feel loved, supported and safe. Interview at least three candidates and hire the one with whom you feel an emotional and spiritual connection.

3. Register for and complete a birthing class. Birthing From Within, The Bradley Method and Lamaze are just a few courses that will prepare you and your partner for the physical and emotional demands of labor. This is also a good time to take a breastfeeding class since nursing can be difficult and having a good foundation of knowledge is beneficial.

4. Maintain a healthy diet and exercise program. Being healthy in mind and body throughout pregnancy will give you the strength and endurance to complete the marathon of labor. Yoga is a great tool for flexibility and breathing techniques.

5. Make a point to reconnect with your partner. Plan a babymoon, go to dinner, and spend time together listening to each other’s concerns and fears regarding childbirth and parenting. Having a partner who is there to support you will make all the difference.

Lisa Leffert, MD, chief of the Obstetric Anesthesia Division at Massachusetts General Hospital in Boston
1. Be flexible. The happiest women in labor are those who “go with the flow.” Why make final decisions about labor pain management before you know how you will feel?

2. Ditch the guilt. You are in no way taking the easy road if you choose an epidural. (After all, there is no easy road when you have to raise a child!)

3. Feel confident. Don’t worry that you will be too numb or not numb enough to push with a labor epidural. Women can successfully deliver babies under all kinds of different circumstances.

4. Play nice. If your anesthesiologist wants to meet you when you first arrive on the labor floor, welcome her, even if you think you neither want nor need anesthesia care. She can be a valuable member of your care team regardless of whether you use an anesthetic.

5. Know the facts. Remember, getting an epidural for labor does not increase your chances of needing a caesarean delivery.

Laura Elledge, RN, BSN, L&D clinician with the MothersFirst Program at Northside Hospital in Atlanta
1. Schedule a tour of the hospital. Do this at least six to eight weeks before your delivery.

2. Learn everything you can. Seek out a credible source to educate you about labor, birth, feeding, and how your baby communicates and what it means. Attending classes and sharing thoughts and concerns with other couples will help you make informed decisions with your healthcare provider throughout pregnancy, birth and beyond. Select programs taught by nationally certified educators with creative and interactive teaching strategies that allow for questions, participation, state-of-the-art technology, and flexible class schedules to meet your needs.

3. Know your labor preferences. Your nurse is interested in knowing your most important concerns and desires. Do you want dim lighting, music or pillows? Do you want to move during labor and use a ball, rocking chair or pillows in the bed? Your healthcare team wants to partner with you on decisions regarding medical interventions. We want to know what your preferred pain tolerance level is and provide you with encouragement and support all along the way.

4. Choose your company. Your time in the labor and delivery unit is a very special, personal and intimate time. Decide who you want in the room with you when you’re in labor, preferably someone who helps you to feel calm and relaxed and who can help you make decisions; someone who went to classes with you would be helpful.

5. Bond through skin-to-skin contact. After the birth of your baby, have your unwrapped baby placed tummy-down, directly on your chest, right after she is born. Skin-to-skin care stabilizes her blood sugar and temperature and promotes an early and sustained milk supply for breastfeeding. Consider making this a priority before welcoming other visitors and family. This is an important transition time for your new baby.

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