Through any challenging time, using affirmations is an effective strategy to control our mindset, reduce anxiety, and improve our overall ability to believe in ourselves. Mothers could use affirmations to help get them through the hardest days, as this job is the toughest one in the world. And it starts at the beginning — the very beginning. Birth affirmations are a way women can coach themselves and find the inner strength to endure labor and delivery.

What are Birth Affirmations?

Birth affirmations are personal statements you choose to help you endure the intense and painful labor and delivery experience. They are a mindfulness technique — you are training your brain to focus on your strength.¹ And how capable you are. And how you are, in fact, ready for this and that you will get through it.

Positive birth affirmations might include statements like “My body is strong” and “Every contraction brings me closer to my baby.” But it’s truly up to the mother to decide what types of messaging will resonate with her and effectively reduce negative and sabotaging thoughts.

Birth can be grueling, and mothers often feel defeated when things don’t go as planned. (Because babies don’t always follow birth plans as they make their way into this world. They are already letting us know that they run the show!) That’s why having a few positive words of encouragement for labor and delivery in your proverbial “back pocket” (likely just written down somewhere where you can see them easily or even saved in your phone) might be just the trick you need to get through that final push.

7 Benefits of Birth Affirmations

The true benefits of birth affirmations will vary from mother to mother, but in general, they serve to calm the mind and recenter your focus so you can find the inner strength you need to keep going.¹ Here are some potential advantages of using birth affirmations:

1. They Can Foster a Connection With Your Body and Your Baby

By training your mind via birth affirmations, the mother will continuously center herself around what her body is doing and how two lives are coming together to achieve something that is heroic and miraculous.

2. They Can Help You Feel Empowered and Believe That, Yes, You Can Do This

Sometimes, especially when we’re really far into the labor and delivery process, moms need a boost of confidence, as we can feel defeated by exhaustion and pain. Positive birth mantras empower us to believe that we are stronger than we realize and still have the energy to continue. The emotional support provided by affirmations helps solidify a feeling of competence in the mother.²

3. Birth Affirmations Can Help with Pain Management

Pain management, in general, can often be managed via mindfulness techniques like repeating birth affirmations to oneself.^1,3 Labor and delivery is definitely a painful experience in which such mindfulness training can be very effective because the pain during childbirth serves a function — it lets us know what our body is doing — and we must be in tune with the pain. However, taking slow, deep breaths, picturing certain images in the mind, and repeating positive birth affirmations over and over can help us cope and work through the pain.^3,5

Affirmations “are not intended to ‘fix’ or solve your pain,” Psychology Today explains. “The practice keeps your attention in a powerful place and your brain can create new circuits in response. However, it is also important to allow yourself to feel the mental or physical pain before you redirect.”⁴

4. They Can Help You Feel More in Control

One of the hardest parts of labor and delivery for me was the lack of control and not knowing how it would all go. And while, yes, it’s true that there are some things we have to leave up to the powers that be (and let baby run the show!), positive birth affirmations can help us remember that we can control our mindset.

5. Birth Mantras Help in Reducing Stress

Stress tenses the body, prolonging labor and releasing stress hormones called catecholamines. Stress hormones suppress oxytocin, the hormone that gets your uterus contracting. Less oxytocin means a slower, longer labor that might need to be augmented with Pitocin, a synthetic oxytocin.⁶ It is hard to relax when the body is in pain, but training the mind to be calm is one way to help fight those stress responses as painful contractions hit.

But mindfulness techniques (like telling yourself positive affirmations over and over or seeing them written on the wall where you can read them throughout the labor and delivery process) can help reduce stress and increase the likelihood that birth will go according to plan.

6. They Lead to Reducing and Releasing the Fear of Labor and Delivery

With my first child, I was scared of what would happen to my body through labor and delivery and if my baby would be okay. Like stress, fear can cause the body to tighten and tense, making for longer labor, and anxiety or nervousness in pregnant women increases the risk of dystocia (difficult or obstructed birth).⁷

Birth affirmations remind the fearful mother, especially if this is her first experience through labor and delivery, that she is strong, capable, and can handle whatever is coming her way.

7. They Reduce the Likelihood of Unwanted Medical Interventions

Many pregnant mothers desire a birth with limited or no medical interventions, and positive birth affirmations can help achieve that by keeping the mind and body more calm and the mother more focused on what she needs to do. Having delivered three babies, I know first-hand that the longer labor takes, the more likelihood of medical interventions. Doctors want to get that baby out to minimize the stress labor can put on both the mother and baby. Relaxing your body and mind might help your labor move along more quickly and reduce the chances of medical interventions.²

How To Use Positive Birth Affirmations During Your Labor

One way to use positive birth affirmations during labor is to memorize key phrases you believe will help you endure the process best. Repeat them and consider asking your support person(s) in the room with you to say them as well.

You also might consider writing them down onto affirmation cards or hanging them on the wall where you can see them easily through all phases of your labor. Another option is to have your birth affirmations on a recording of some kind where you can hear them through a speaker in the room or even headphones if you prefer a softer, more personal connection.

But most importantly, as the mother, you need to be all-in. In my experience, birth mantras will only work if you’ve chosen statements that resonate with you, that you’ve practiced through your pregnancy, and that you embrace with your whole being. Jotting down a few motivational sentences on your way to the hospital isn’t going to cut it — utilizing birth affirmations means figuring out what works for you, knowing what you need to hear when things are really, really hard, and practicing saying them to yourself over and over until you believe them.

25 Labor Affirmations To Consider Using

Labor affirmations come in all forms, and finding a list that truly resonates with you is important. I need to hear that I am strong and can do hard things. What do you need to hear when things are challenging for you? Here are some examples of labor affirmations and birth mantras:

1. My body knows how to give birth.

2. I trust my body.

3. My body is strong.

4. I can do this.

5. I am ready for this.

6. I trust that my baby’s birth will happen when needed.

7. I accept that my baby’s path to being born is right.

8. I relax my body so that my baby can relax.

9. I breathe deeply and calm my mind and body.

10. My body is doing its job.

11. I find more strength with each inhale and release pain with each exhale.

12. I will meet my baby soon.

13. Each contraction brings me closer to my baby.

14. This pain is temporary.

15. I am stronger than the pain.

16. I have the power and strength to birth this baby.

17. I am proud of how strong I am.

18. I am brave.

19. I am safe. My baby is safe.

20. I can do hard things.

21. I can let my body take over and do what it needs to do.

22. I am doing my best and doing an amazing job.

23. I know I can do this because I’m already doing it.

24. This is our journey together — mine and my baby’s. And we’re doing it.

25. Women all over the world are doing this right now too. We’re all in this together.

There are endless options for birth affirmations that might resonate with you. Learn what works for you through other stressful moments in your life and start compiling mantras to consider as you near labor and delivery. Soon, you’ll have your list ready, packed neatly in your hospital bag, or taped to the wall in your delivery room. You got this, Mama. You are strong and brave.

“When is your due date?” Most women will hear this question multiple times during their pregnancy. Once you found out you were expecting, circling this monumental date on a calendar was probably one of the first tasks you completed. However, what happens when things don’t go quite as planned? Enter preterm birth.

A preterm birth can occur spontaneously or may be anticipated because of certain medical conditions.¹ Delivering a preterm baby comes with its own language and potential complications. This article will dive into the often unexpected experience of premature labor, preterm birth, and premature babies.

What Is Preterm Birth?

A normal pregnancy lasts 40 weeks or about nine months. Health professionals calculate a baby’s due date from the first day of your last menstrual cycle.² Babies need time to grow and develop inside your womb before birth. When a woman goes into labor before 37 weeks, it is called preterm labor. If labor continues and the baby is born, the birth is called a preterm birth, and the baby is called a preterm infant.^3,4,5

Preterm vs. Premature: Is There a Difference?

“Preterm” and “premature” mean the same thing and can be used interchangeably. A woman may experience preterm labor, but doctors may be able to stop her from delivering prematurely. So, premature labor does not always result in a preterm birth or preterm baby.³

What Causes Preterm Birth?

Experts feel several factors may contribute to preterm births, including psychological, biological, genetic, and medical components.^1,6 These births are often spontaneous, meaning a woman suddenly and unexpectedly goes into labor and delivers a preterm baby before 37 weeks. Most times, the cause is unknown. However, infections or other inflammatory processes can precipitate premature labor. Women who have one premature baby are at higher risk of having another preterm baby.^1,3,4

If the woman or fetus has medical complications and continuing the pregnancy may do more harm than good, tough choices need to be made. Although healthcare providers typically make every effort to prolong a pregnancy, sometimes it is necessary to deliver early. Doctors may induce labor, resulting in a vaginal delivery, or perform a Cesarean section. It is possible to have a preterm birth without preterm labor with a Cesarean section. Preeclampsia and cholestasis of pregnancy are two examples that may lead to a medically necessary preterm birth.^1,4

Preterm Birth Symptoms

Preterm labor usually precedes a spontaneous preterm birth. Labor occurring anywhere between weeks 20 and 36 of pregnancy is considered premature. Although women may feel irregular contractions or Braxton Hicks during pregnancy, premature labor includes changes in the cervix. The cervix begins to prepare for birth by softening, thinning, and dilating, but it is too early.^3,7

Regular and frequent contractions or tightenings around your abdomen are cause for concern, and you should seek medical help immediately.⁴ Other signs and symptoms of preterm labor include:^3,4,7

• Vaginal discharge like bleeding or leaking fluid
• Rupture of membranes known as “water breaking“
• Constant, dull, and aching lower back pain
• Abdominal cramping that may be similar to menstrual cramps
• Pressure in the pelvic or lower abdominal areas (it may feel like your baby is pushing down)

Seek medical care immediately if experiencing any of these signs or symptoms.

Risk Factors for Preterm Labor

A woman’s family and health histories can affect her risk for preterm labor, but they may be out of her control. Lifestyle choices also play a role, and you can reduce some risks by making healthier choices. However, even if you do everything right, sometimes preterm labor happens without warning.^3,4,8

Women who already had preterm labor in one pregnancy are more likely to experience it with future pregnancies. Carrying more than one baby, like twins or triplets, also increases a woman’s risk, as does a family history of preterm labor in close female relatives.^3,4,8

More risk factors for preterm labor and birth include:^3,4,8

• Pregnancy complications such as preeclampsia, gestational diabetes, and intrahepatic cholestasis of pregnancy
• Getting pregnant within six months of giving birth
• Conception through in vitro fertilization
• A shortened or incompetent cervix
• Certain disorders or conditions affecting the fetus
• Placenta previa, where the placenta implants over part or all of the cervical opening
• Existing pre-pregnancy medical conditions like diabetes, genetic diseases, or blood clotting disorders
• Women older than 35 years and teenagers
• Sexually transmitted infections
• Being obese or underweight
• Smoking, alcohol, or drug use
• Domestic violence

How Common Is Preterm Labor?

In 2022, preterm births accounted for about 10% of all births in the United States. African American women had a higher rate at about 14%, white women were at 9.4%, while Hispanic women had a 10.4% rate. Almost 60% of women carrying multiples like twins or triplets result in preterm births.^5,9

Preventing Preterm Labor: Can It Be Done?

You may prevent preterm labor by adjusting for controllable risk factors. Lifestyle choices are a good place to start and include:^3,4

• Starting prenatal care by scheduling a visit with your provider as soon as you think you may be pregnant
• Maintaining a healthy pre-pregnancy and pregnancy weight
• Seeking medical assistance immediately if you have any signs and symptoms of preterm labor
• If you have a history of preterm labor or birth, talk to your provider about possible additional interventions or monitoring.
• Taking care of any ongoing pre-pregnancy medical conditions
• Spacing pregnancies at least 18 months apart
• Not using alcohol or drugs or smoking while pregnant

However, other risk factors, like a shortened or incompetent cervix, may be out of your control. The cervix should remain tightly closed until it dilates in labor, but with these conditions, the cervix is weakened and may result in a premature birth or loss of a fetus. Healthcare providers may attempt to prolong a pregnancy using a surgical procedure known as a cervical cerclage. The process involves closing the cervix with stitches. Your physician will remove the cerclage before you give birth.^3,10

Doctors gave progesterone shots to women in the past, but they are no longer considered effective in the prevention of premature labor. Additionally, contrary to popular belief, bed rest is not generally recommended.^3,10

What Are the Short-Term Effects of Preterm Birth?

Babies born early have immature bodies and brains. They are not simply tiny versions of full-term infants. Full-term babies have more time for their systems and organs to develop within their mother’s womb. A premature baby is born before it can fully mature, and most children will require hospitalization in a neonatal intensive care unit (NICU). Health providers use medical technology to continue ” growing” the baby outside the womb. Prematurity is a leading cause of death and disability for infants, especially for those born before 32 weeks.^5,11

Depending on when a baby is born, they could spend days, weeks, or months in the hospital before going home with their parents. The closer a baby gets to 40 weeks, the better their brains, lungs, skin, digestive system, eyes, and other processes develop. A preterm baby may require breathing support with ventilators, tube feedings, and multiple other life-saving interventions.^9,11

What Are the Long-Term Effects of Preterm Birth?

A preterm baby may suffer long-term effects from an early birth. Besides the potential complications from being born early, premature babies may have experienced other prenatal situations, like being deprived of oxygen to vital organs. Preemies typically need specialized care in the short term after birth and specific follow-up once they go home.^5,11,12

Long-term effects of preterm birth may include:^5,11,12

• Learning disabilities and developmental delays
• Cerebral palsy
• Vision problems, including blindness
• Hearing problems
• Respiratory problems like asthma
• Mental health conditions
• Behavior problems

Preterm births can carry significant consequences for premature babies and their families.

Starting prenatal care early is important because it improves health outcomes for women and infants. If you experience any signs and symptoms of preterm labor, seek medical attention immediately.

We’ve all heard stories about birth. Maybe you’ve heard your own birth story from your parents. And if you are pregnant or have children of your own, you have definitely heard several birth stories, even from strangers! Some of those stories are good, and some are not so good. Unfortunately, it seems like the not-so-great and even scary birth stories are the ones that are told the most. As a doula who helps families have better birth experiences, this breaks my heart. What we hear can form a belief about how birth is and what it can be. Imagine if you only heard stories about birth being beautiful, empowering, even pleasurable, and orgasmic. What an impact that would make! My guest today knows all about this and is chatting with us about orgasmic birth and what expecting families need to know.

Who is Debra Pascali-Bonaro?

Debra Pascali-Bonaro is a world-renowned inspirational speaker, podcaster, filmmaker, doula trainer, childbirth educator, and author. She brings together her passion for pleasure in every aspect of life with her Jersey-Girl attitude of talking about what no one is talking about!

Debra is a mother, grandmother, and featured expert in parenting journals and media worldwide. She is also Co-Chair of the International Childbirth Initiative, which promotes safe, respectful childbirth maternity care. She is a Lamaze International childbirth educator, birth and postpartum doula trainer with DONA International, Director of the award-winning documentary Orgasmic Birth: The Best-Kept Secret, co-writer of “Orgasmic Birth: Your Guide to a Safe, Satisfying and Pleasurable Birth,” Author of “The Ultimate Guide To Sex After Baby: Secrets to Love and Intimacy,” and the Founder & President of the revolutionary online childbirth class Pleasurable Birth Essentials which prepares expectant mothers, fathers, and partners to be positively prepared for birth and focuses on the intimate and sacred nature of birth. It’s evident that Debra is highly passionate about changing childbirth so that every woman/partner has a safe, respectful, and pleasurable birth.

What Did We Discuss?

In this episode, we chat with Debra about orgasmic birth and tips and secrets to create more love and intimacy in birth and parenting. Here are several of the questions that we covered:

• How did you become passionate about the birthing experience?
• Childbirth and sex can both be taboo subjects. Why do you think this is, and how can we change this narrative?
• Can you elaborate more on the connection between childbirth and sex?
• What is orgasmic birth? And is it real?
• Why should pregnant people include intimacy and sexuality in preparing for birth?
• What can women do during pregnancy to help prepare for a positive birth experience?
• What role does a partner play in this experience?
• How can a doula help facilitate a pleasurable birth experience?
• What are your top tips for ensuring an enjoyable and pleasurable birth?
• What are the benefits of an orgasmic birth?
• The narrative around birth is often that it is painful and scary, but I have heard you say it is powerful and can be pleasurable. How can we empower more women to approach birth with this mindset?
• How do you recommend women continue to connect to their intimacy during the postpartum period?

Debra’s Resources

• Website: OrgasmicBirth.com
• Instagram: @orgasmicbirth
• Facebook: Orgasmic Birth
• YouTube: Orgasmic Birth
• TikTok: @orgasmicbirth
• Podcast: Orgasmic Birth Podcast
• Documentary: Orgasmic Birth
• Books:
  • Orgasmic Birth: Your Guide to a Safe, Satisfying, and Pleasurable Birth Experience
  • The Ultimate Guide To Sex After Baby: Secrets to Love and Intimacy

If you haven’t already, please subscribe to Chick Chat: The Baby Chick podcast wherever you listen to podcasts and leave us an honest review. Cheers to a positive and pleasurable birth!

Your labor experience isn’t always the way you expect it to be. I’ve given birth to five babies, including twins, and had an emergency Cesarean section. I have also delivered thousands of babies as a nurse midwife. Each delivery was different. I’ve made a list of things I wish I had known when I gave birth to my two oldest before I was a nurse. I’ve also included things my patients have said they wish they had known to prepare better.

Things I Wish I Knew Before My Labor Experience

Here are 14 things I wish I knew before my labor experience and things other women said they wish they knew before theirs.

1. Hospital Bag

It’s called a hospital bag because it’s not a suitcase! You don’t need to bring half your wardrobe, entertainment center, or kitchen appliances. Many expectant mothers haul way too much stuff to the hospital. Remember, you must move your belongings from triage to your labor room and again to postpartum.

A checklist can help you determine what to pack for your labor experience. Only bring your bag to the hospital once you know they have admitted you. Your support person can grab it for you.

2. False Labor

You may go to the hospital for labor and be sent home. It happens a lot! False labor contractions called Braxton Hicks can be confused for labor.² Some women may visit the hospital several times before they’re admitted. You may also be sent home if your contractions are labor, but it is still very early.

Real labor contractions have the following characteristics:^1,2

• Come at regular intervals
• Getting closer together
• Last 60-90 seconds
• Continue even when you rest or change positions
• Become stronger with each one
• The pain usually starts in the back and moves to the front
• There is often a bloody mucus discharge called bloody show

3. Birth Plans

Birth plans need to be renamed to birth preferences. It’s impossible to plan your birth. So many things can happen. You only know what you will want in labor once you are experiencing it.

It’s great to have ideas about how you would like to labor in a perfect situation. Writing out your thoughts helps you organize and communicate your wishes to your partner and healthcare team. Studies have found that women have more positive labor experiences when having a birth plan.^3,4

However, keep in mind that you cannot plan for things such as:

• How your baby tolerates labor
• If you are exhausted or sick when you go into labor
• Back labor
• Prodromal labor
• Induction of labor
• Complications

The most important thing to plan for is that unexpected things will happen. The main goal of any plan should be the safety of you and your baby.

4. Get Out of Bed

Labor is easier if you can get up and move. Getting out of bed can help you have:⁵

• Faster labor
• Increased comfort
• Increased likelihood of giving birth vaginally
• Better sense of control
• Decreased need for pain medications

5. Get in the Water

One of the best places out of bed to labor is in the shower or tub. Being in the water has many advantages, including:⁶

• Decreased need for pain medications
• Promotes relaxation
• Increased energy
• More efficient contractions
• Improved blood circulation
• Decreased anxiety
• Reduced stress-related hormones

Many women don’t want to move once they are in bed. But they are much more comfortable once they are up, especially in water. I’ve repeatedly seen stalled labor pick up pace with movement and time in the water.

6. Support

You will need support, but possibly not how you thought. Maybe you have gone to birthing classes with your partner and read about coping with labor pains. You may imagine that you want massages and foot rubs. Then contractions hit, and you don’t want anyone to touch you.

Discuss how your partner can support you through labor and be prepared for various support techniques. If you have many options, you will find what works for you when the time comes.

7. Your Body is in Charge

During the labor experience, your body is in charge. You cannot stop or pause contractions. The different sensations you feel may be new and overwhelming. At times, you may feel out of control.

When I had my first baby, I imagined being calm and focused. I ended up screaming my baby out. The labor was very fast. I felt I didn’t even have time to come up with an idea of coping before the next wave started. After my daughter was born, I remember thinking, “Wait! I didn’t even get a chance to do my breathing techniques.”

8. Pushing

Pushing is usually hard work. At some point during their labor experience, most women will say, “I can’t do this! But somehow, you will. You will dig deep and find the strength and courage to push your baby out.

The pushing stage can be long. It is normal to push for up to three hours with your first baby and up to two hours when you have had a baby before.¹⁴ However, it usually takes much less time.

Even with an epidural, the urge to push is often intense. But some women don’t feel that urge and must learn how to bear down. I have heard many women say it was a relief to be able to push after going through labor. They could finally do something with the contractions.

9. Birthing Positions

The traditional position for pushing is on your back with your legs pulled back. While this position works for many women, there may be better options for your labor experience. Talk with your healthcare team and try different positions.

Any position where you are upright will allow gravity to help. When you are vertical, your pelvis has more room to open. When squatting, the bottom part of your pelvis has about 20% more space. Contractions are stronger and more effective, and women often find being upright more comfortable.⁷

Other positions that are beneficial are side lying and hands and knees. Side-lying can decrease your risk of tearing and make you more comfortable. Hands and knees allow your pelvis to open in all directions and may reduce tearing.⁷

10. Labor and Birth are Not Like TV

Birth does not fit neatly into 30 minutes like it does on TV. There are often hours of just waiting or working through contractions. The average first labor lasts 12 to 24 hours, from the first mild contractions to having your baby in your arms.⁹

Birth is often messy. Losing up to 500 ml of blood with a vaginal birth is normal.⁸ That is equal to about 2 cups of blood. Amniotic fluid, pee, poop, sweat, and vomit may also be present.

Birth is often noisy. Women make various noises during the labor experience, from moaning to grunting to screaming.

11. Delivering the Placenta

Your baby is finally in your arms. You cry happy tears that you are through with labor. But wait! You aren’t done yet. You still must deliver your placenta. It is normal to take up to 30-60 minutes after a vaginal birth.¹⁰ It often comes out within a few minutes.

Fortunately, your placenta is soft, not like your baby’s head. You may push a time or two to deliver it, but it’s nothing like pushing out your baby.

12. Stitches and Ice Packs

Okay, so now you are finally done. Not so fast! Between 53% and 79% of vaginal deliveries will result in some tearing.¹¹ Those tears, or lacerations, usually need to be repaired. In my experience with labor, repairs can take three to four minutes to over an hour.

The good news is you have a new baby to hold and distract you. Your doctor or midwife will make you as comfortable as possible with the epidural you already have or by injecting local anesthetic.

Ice packs for your perineum after delivery will become your best friend. Using ice packs decreases your pain and swelling.¹³

13. Uterine Massage

Heads up. Nothing is comforting or relaxing about uterine or fundal massage.

As part of your labor experience, your nurse will check frequently to ensure your uterus is firm after birth. These checks are done by massaging your uterus through your abdomen. Massaging your uterus helps it to contract and decrease bleeding.¹² This all sounds great, but it is not comfortable. It can be pretty miserable.

The best approach is to do your best to relax and take slow, deep breaths. If you fight the process, it will take longer and be more uncomfortable.

14. Your Nurses

Your labor and delivery nurses will be your biggest cheerleaders, educators, supporters, and comforters. Most parents are surprised at how much their labor nurses do for them.

If you appreciate your nurses, give them a thank-you note, treats, or another token of appreciation. Nurses cherish thank-you cards. I know many nurses who keep every one of them forever.

Every labor experience is different. No matter what, there will be surprises. There will likely be even more than a list can count, but be flexible and know that you can tackle whatever may come your way.

None of my five babies ever liked to be shushed to sleep. Instead, deep humming was their preferred noise. They would lay their heads on my chest, finding comfort in the vibrating guttural sounds and the beat of my heart. Turns out, there is something to be said for this type of noise-making or vocal toning.

Vocal toning and breathing techniques can help induce calm, ease anxiety, and distract from pain and prove beneficial in labor.¹ If you’re looking for how to ease contraction pain, using vocalization in labor is helpful. Read on to discover how the pelvic floor, diaphragm, and vocal cords perform.

Your Pelvic Floor, Respiration, and Vocal Toning

There is minimal research specifically linking the muscles of the pelvic floor, the motion of breathing, and the impact of vocal toning. But let’s explore some body mechanics to find the link.

The Motion of Breathing and the Pelvic Floor

The diaphragm, located below your lungs, is the primary muscle used for breathing. During inspiration, the diaphragm contracts. During expiration, the diaphragm relaxes.² The contraction of the abdominal muscles and changes in intra-abdominal pressure (IAP) — the state of pressure within the abdominal cavity — affects the diaphragm’s motion.

Studies confirm the link between IAP changes and the contraction and relaxation of the pelvic floor muscles (PFM). The PFM, the abdominal muscles, and the diaphragm are responsible for reacting to and controlling changes in the IAP. The strength and stability of your PFM correlate to adequate control and the efficacy of your breath.²

The Pelvic Floor During Labor

The pelvic floor is a collection of muscles and tendons that form a sling to support the organs of your reproductive and urinary systems. Your PFM generally relaxes during inspiration and contracts during exhalation.² PFM relaxation is necessary during labor to make way for a baby’s descent and, ultimately, a vaginal birth.⁶

What is Vocal Toning?

Vocal toning uses your voice to produce sounds of grunts, moans, and groans, as well as open vowel sounds like “ohhhhh” or deep humming while slowly exhaling.^1,3 Data supports that successful vocal toning induces a “meditative” or “calm” awareness or consciousness.¹

Pulling It All Together

When we are scared, stressed, or in pain, our breathing patterns may change in a way that is not beneficial for the body in labor. Hyperventilation (breathing too fast and shallow), holding your breath, and high-pitched noises do not allow pelvic floor relaxation.² Holding tension in the body due to pain, fear, and anxiety will also inhibit pelvic floor relaxation.

Labor coping becomes a marriage of pelvic floor relaxation and breathing, which can be achieved with vocal toning.

Why Vocalize During Labor?

Now that we have all those fun biological details sorted out, why is it beneficial to vocalize during labor? Vocal toning and controlled breathing have physiological and psychological impacts essential in labor.

Oxygen is necessary for you and your baby, and labor increases the demand for oxygen for both of you.⁴ Vocal toning with open vowel sounds has been shown to slow down the rate of breathing while significantly increasing the volume of air moved and heart rate variability — all good things while your body copes with the stress of labor.⁵ A relaxed throat, achieved with an “ohhhh” sound, also means a relaxed perineum. Vocal toning intensifies the connection between the pelvic floor, diaphragm, and vocal cords.

Psychologically, vocal toning can induce a calm, mindful state that combats stress and anxiety.¹ It is often used during meditation for that purpose.

Vocal Toning: How To Do It

Vocalization in labor may seem intimidating. The noises of loud moaning to deep groaning often sound intimate and primal. Vocalizing during labor feels instinctual for many, but you may hesitate for others to hear you. Rest assured, labor nurses have heard it all. Begin practicing while pregnant to find the sound that relaxes you the most.

First, use your fingers to find the notch at the bottom of the throat but above the chest bone. Take in a deep abdominal breath. As you exhale, make a low humming noise. Feel the vibrations in your fingertips. Change the pitch of your humming or moan and notice how it relaxes your throat and body.³

How To Make Yourself Moan for Perineal Control

Relaxing your pelvic floor muscles seems counterintuitive. The practice takes focus and calm, which may be challenging in labor. But the benefits of controlling and relaxing your perineum simultaneously can help you achieve a vaginal birth. And, of course, practice makes perfect.

1. Inhale deeply and do a kegel at the same time.
2. Exhale slowly through your mouth, and vocalize an “ohhhh” sound while releasing your bottom.

Try changing your “ohhhh” to “ahhhh.” Does this change things? Imagery may also be helpful in this practice. As you exhale, imagine your pelvis opening, exhaling out of your vagina.³

Your vocal toning sound variation, depth, and pitch will be very individual. They may even change throughout labor. You may find that deep sounds are better for easing contraction pain. Your moans may become deeper as contraction pain intensifies. Do not be afraid to experiment to see what tone works for you at different stages of your labor.

Labor sounds are as variable as people. Find your confident voice to cope with the sensations, fears, anxieties, and pain of labor. Let your voice wash over you as you ride the ebb and flow of contraction waves.

Each labor can present differently, whether it’s your first baby or you have a couple of babies. What’s more, how you cope with labor may also be different. Whichever way you intend to go through labor, some hospital items can be made available to help you achieve your desired labor and delivery.

You can use some of these common hospital items during labor, delivery, and postpartum. Their availability will differ from facility to facility. Be sure to speak with your provider to verify if they’re available and whether you can use them.

3 Hospital Items for Labor Coping

Here are three helpful hospital items for coping with labor.

1. Peanut Ball and Birthing Ball

A peanut ball is just that, a rubber ball that is elongated and shaped like a peanut shell. A peanut ball is placed between a laboring person’s legs in a side-lying position. Its use promotes an open pelvis as your baby is descending.¹ This is an incredibly helpful labor tool, especially if you have an epidural on board with limited mobility. While more research is necessary, peanut ball use is associated with decreased labor length and lower occurrence of Cesarean delivery.²

Birthing balls are common and comfortably offer an upright labor. The size of the ball requires you to sit with your legs wide and your hips open to encourage the baby’s descent. Bouncing or rocking on the ball during contractions encourages “looseness” in your bottom and may open your pelvis. Research supports using birthing balls as a pain-relieving tool.³

You will want to check if these labor tools are available, but if not, you should be able to bring your own.

2. Rocking Chair

A rocking chair is another great option for upright labor, especially if your legs are weary. Upright or sitting laboring positions take advantage of gravity to encourage the baby’s descent, improve the effectiveness of contractions, and decrease pain.⁴ The repetitive, rocking motion can also bring comfort.

3. Bathtub or Shower

Many love the warm comfort of a bath during pregnancy to quell the discomfort of achy ligaments and a stretching body. Hydrotherapy has excellent benefits during labor as well. Tub or shower use is easy to get going and do independently. Hydrotherapy has pain and anxiety-relieving benefits.⁵ You may even consider a water birth with the support of your birthing facility and provider.

Please know that not all facilities have birthing tubs or private in-room showers.

3 Hospital Items for Pushing During the Second Stage of Labor

The second stage of labor is the time for your baby’s grand entrance! You can use these hospital items during your second stage of labor — pushing.

1. Bed Sheets: Let’s Play Tug of War

Playing tug-of-war is not just a backyard pastime. Bed sheets are readily available at hospitals and can be used during pushing. As a contraction starts, you sit up and pull on one end of a sheet while a partner, nurse, doula, or provider pulls on the other. The sheet can also be tied around a bed-mounted squat bar. This pulling technique significantly promotes an upright, active pushing position with your abdominal muscles if an epidural limits movement and strength.⁴

2. Squat Bar and Birthing Stool

Upright positioning during labor and pushing is associated with shorter pushing times than lying on the back. The squat position during pushing feels natural and desirable to many.^6,7

Most hospital birthing beds are equipped with a squat bar attachment. A sturdy countertop or bedside rail can also support you in a squat position during contractions.

A birthing stool is an age-old tool. You sit on a backless semi-circle-shaped stool with a cut-out in the middle during labor. The stool promotes an upright position like squatting and can be helpful when your legs tire. Not all facilities have one, but you can certainly ask.

3. Mirror

A mirror can be one of the best tools in the labor room. While pushing, your team places a mirror in a location where you can see the efforts of your pushing. Surveys have shown that more than half of laboring parents who use mirrors have a positive experience and that it improves their pushing efficacy. It can be an excellent motivator. However, not all facilities have one, and not all parents want to use one.⁸

4 Other Helpful Hospital Items

A few other handy hospital items might help make your stay more comfortable.

1. Emesis Basin or Emesis Bags

Unfortunately, hormones, medications, epidurals, and slowed stomach emptying can cause nausea and vomiting during labor.^9,13 An emesis basin is a kidney-shaped container that catches vomit. Emesis bags or larger basins are also available. Emesis basins and bags are also helpful if you need to brush your teeth in bed.

2. Cold or Hot Packs

Studies have concluded that hot or cold application during labor can significantly reduce pain and increase laboring parent satisfaction. Options include but are not limited to, ice massage, cold washcloths on the upper back or around the neck, and warm packs or towels on the perineum or lower back.¹⁰

Proper cold or hot packs, as you imagine them, may not be readily available on the hospital unit due to the necessity of physician orders and stocked supplies. But not to worry: Most nurses have some tricks up their sleeves. Ice, warm water, and plastic bags are readily available for make-shift packs. Baby diapers filled with warm water make excellent moist warm packs.

Most units have a microwave you can use to heat a hot pack if you choose to bring your own. You could also bring your own heating pad.

3. Warm Blankets

The blanket warmer is perhaps the most luxurious piece of equipment on the labor floor. Who doesn’t love a warm blanket? Heated blankets can provide some much-needed comfort and warmth during labor and after delivery. They are essential post-Cesarean section when the risk for low core body temperature following surgery is possible.¹¹ Imagine snuggling with your newborn for the first time while enveloped in a warm blanket hug!

4. Room Temperature Adjustment

Do not be afraid to ask if the room temperature can be adjusted. Most rooms are equipped with thermostats that may or may not be accessible to you. Also, pack accordingly in case the temperature cannot be changed.

What Postpartum Items Does the Hospital Provide?

Postpartum units offer several hospital items to ease the burden of what you need to pack. Feel free to bring your own, but know that the following items should be available to you post-delivery:

• Large sanitary pads. Jumbo pads are necessary immediately post-delivery when postpartum bleeding is the heaviest.¹⁴
• Disposable underwear. There is no need to worry about staining your undies with postpartum bleeding.
• Medicated analgesic creams or sprays. An ointment or spray can be applied to your sanitary pad to relieve pain from a perineal tear.¹²
• Witch hazel pads. These will provide a cooling relief to any hemorrhoids that have appeared or worsened during delivery. The pads are also helpful for perineal tears.¹²
• Sitz baths. This shallow basin fits on the toilet and is filled with warm water. It can help with comfort and promote healing of perineal tears or episiotomies.¹² You may need to ask for one, but they should be available.
• Basic toiletries. Forgot your toothbrush or need some lotion? These hospital items should be available as well.
• Lactation supplies. Maternity units are stocked with all your newborn feeding needs, including hospital-grade breast pumps, supplemental nursing system (SNS) supplies, cups or syringes, nipple shields, nipple cooling gels, and nipple ointment. Formula is also always available if needed or desired.

Allow the hospital to ease some of the packing burdens. Be sure to call ahead or discuss the availability of hospital items with your obstetric provider. These tools are often available to help you positively cope through your labor and delivery.

As you prepare for birth, you might wonder how you will cope with the pain of labor and delivery. There are many ways to manage contractions, crowning (the ring of fire), and pushing. One popular method is the use of breathing techniques for labor.¹

Many labor breathing techniques can be used at different points in your childbirth experience. It is best to learn these breathing techniques for labor ahead of time. That way, you can practice them during other painful or uncomfortable experiences during pregnancy. Practicing these pregnancy breathing exercises may help them to become automatic or second nature when the time comes to use them.

How Do Breathing Techniques for Labor Help Manage Pain?

Breathing plays a role in pain sensations’ physical and mental aspects during contractions. Mentally, learning to breathe during contractions distracts you from the pain and gives you something to concentrate on rather than how much it hurts. Getting through contractions one breath at a time feels easier than thinking, “When is this going to end?” for the duration of each contraction. Breathing techniques can aid in mental and physical relaxation during labor.²

Physically, different labor breathing techniques can ensure adequate oxygen delivery to vital organs during labor. This can provide energy to get through labor when you feel fatigued and depleted. Attentive breathing also engages the core and pelvic floor muscles, encouraging activation and oxygenation.^2,3

Not only do breathing techniques for labor help you manage and decrease pain, but they may also help your labor progress and shorten the pushing phase.³

You may find you can relax the rest of your body better while focusing on your breathing. This may prevent you from clenching or guarding against contractions, instead allowing them to do their job—dilate your cervix and move your baby down.

Effective Breathing Techniques for Labor

If you are wondering how to breathe through contractions, you can try different breathing techniques for labor. Before employing any of these methods, take a deep cleansing breath to start and exhale. On that initial exhale, let your body completely relax or go limp before starting the chosen breathing technique for the contraction.

Belly Breathing

Belly breathing is usually the best breathing technique for early labor when you are experiencing contractions, but the pain is not yet severe. To practice belly breathing, focus on how your belly moves when breathing in and out.

First, place a hand on your belly. Inhale through your nose and notice that your belly moves your hand outward on your inhale. Push your belly out as far as possible while breathing in, and try not to move your chest.^4,5

Let your belly fall as low as possible on your exhale as it moves in. Relax your belly and chest completely. Blow out through tight lips so your air is meeting resistance. Imagine your hand is pushing all the air out of your belly.^4,5

Slow, Paced Breathing

As labor progresses and contractions intensify, you may need to change up your pregnancy breathing exercise. Slow and paced or patterned breathing can be used when belly breathing is no longer helping you get through a contraction.

Slow and paced breathing is essentially just taking long, deep breaths. Slowly inhale through your nose, then exhale through your mouth. Try to focus on relaxing a different part of your body during each inhale. It may help to sigh, moan, or vocalize during your exhales. Pause momentarily after you finish breathing out, allowing your body to crave the next breath.⁶

Light, Accelerated Breathing

As you enter the active stage of labor, new breathing techniques for labor may be useful when contractions become stronger and more painful.

Light, accelerated breathing is similar to hyperventilating. Breathe in and out rapidly through the mouth at about one breath per second. Increase the speed of your inhales and exhales as the contraction peaks. The intensity of your breathing should match the intensity of the contraction. As the contraction wanes, gradually slow your breaths. Of course, if you experience lightheadedness, try to return to your normal breath.^6,7

Variable Breathing for Labor

Variable breathing combines light, accelerated breathing with slow breathing. This labor breathing technique is often seen in the movies when a laboring mother makes a “hee-hee-who” sound during contractions.

To practice variable breathing, take a few shallow, rapid breaths followed by one long, vocal exhale. The long exhale can also be more of a blowing breath. You can change up the number of fast breaths you take before a slow one—do whatever feels most helpful and comfortable for you.^6,7

Expulsion Breathing

As the name suggests, expulsion breathing should be used during pushing to help you expel the baby from your birth canal.

As a contraction begins, take some breaths to prepare yourself to push. Take light, shallow breaths to hold back pushing with the beginning of a contraction — let it gain momentum. When you cannot resist pushing any longer, breathe or blow out low and slow. Moan or grunt for a count of six while visualizing your baby moving down and out of your body. While pushing, focus on surrendering or relaxing your pelvic floor. After each push, release your breath and catch it before surrendering to the urge to push. You may feel multiple urges to push during one contraction.⁶

Having tools in your back pocket is good when labor gets intense or even unbearable. Breathing techniques for labor are just one of these tools for pushing through contractions and coming out on the other side, and cuddling your new baby. Learning these breathing techniques is essential, but it is equally important to practice them in advance. Make sure your partner knows these techniques, too. They can refer back and coach you to use pregnancy breathing exercises in the pain and stress of the moment when you may not remember.

Pregnancy is a wild ride, isn’t it? You’re blowing up into a beach ball, you have to pee every seven seconds, and your pregnancy insomnia leads to late-night online searches like, “Do contractions make you poop?” We get it; it’s normal to worry about how labor and delivery will go, especially after everything you’ve already been through the past nine months. The truth is, the childbirth experience is like many things in life — no two are exactly the same. The truth about labor is it could last one hour or 72 hours. You might give birth vaginally or via C-section. And you might meet your new baby at home in your bathtub or a hospital bed.

You don’t know what will happen, and neither does anyone else. That’s the one constant in childbirth and the truth about labor — you can never truly predict how it will all go. Just be your amazingly strong rockstar self, and you’ll come out on the other side proud of what you did. You’ll be sweaty and stinky, and 83 people will have seen you naked, but you won’t care, and you’ll be proud. We promise.

30 Fun Facts About Labor and Delivery

To show you just how relatable every pregnant person’s childbirth experience is, here are 30 fun facts and truths about labor and delivery to laugh about and share with others.

1. Poop Will Be a Part of Your Story

The chances of you getting out of this deal without a poop story in some capacity are pretty much nil. Whether it’s you pooping on the table as you push, that first postpartum poop being the most terrifying moment of your life, or your baby having pooped in utero and meconium shooting out of your nethers as your OBGYN breaks your water.

2. Speaking of Poop, It Might Feel Like You’re Pooping Out Your Baby

We promise you you’re not, but the sensation of a whole human bearing down on your internal organs feels like you have to pass a bowel movement, and because when they tell you to push, you feel like you’re pushing out a giant late-night-large-pizza-nachos-and-mozzerella-sticks kind of poop, it can be weird and confusing. Don’t worry; you’re doing it right, so keep going! And once you’re done, you can order all the pizza, nachos, and mozzarella sticks you want.

3. It’s Not Pretty. It’s Downright Messy and Gross

There are smells. There are liquids. There’s blood. There might be poop. Or urine. And a lot of slimy gunk is coming out from your insides. (Good slimy gunk; it’s kept your baby healthy and safe for months. But still, it’s slimy and gunky.) So you can take a real moment pic, or wait and get your hair and makeup done and wash some of that realness away. It’s your call. But you’ll always know, no matter how much lipstick and mascara you put on, just how messy that room was as you pushed a new human out into the world.

4. Also, You Might Puke

Of course, right? Because why not? Between the pain, the meds, and if you have a full stomach, vomit often becomes a part of the childbirth story, and it fits right in with the other gross stuff anyway.

5. The Whole Room Will Smell (And Not in a Good Way)

Stinky, slimy stuff, plus some sweat, poop, amniotic fluid, and a little pee or vomit for good measure, equals a rancid mix of odors. You probably won’t notice or care much because the baby is finally out, but if you take a deep breath, you might feel queasy all over again.

6. There’s a Whole Other Part of Birth That Happens Afterward

I did not know this—did you know this? Did you know about birthing the placenta? And how nurses will press on your stomach to help your uterus contract back to its original form. Those pushes might be more painful than actual birth, and you’ll look at that nurse with dagger eyes because haven’t you done enough already?¹

For the first few moments of catching your breath and holding your new little person, someone might be stitching you up, cleaning you up, and pulling more stuff out of you. The baby part is great, but others are . . . less great.

7. You Develop Respect for the Metric System

The most wonderful and terrifying number of your life becomes 10 centimeters, and you will never look at a softball the same way again. Also, the length of time to move that needle from 2 cm to 10 cm apparently takes the cervix 1,000 years.

8. The Best-Laid Plans . . . Well, They Often Change

Your “plans” for a vaginal birth may turn into an emergency C-section, and “plans” for happy, exciting rides to the hospital sometimes don’t happen as the baby slithers out on their own schedule in the doorway of your home. You can “plan” for a water birth without drugs, which might work out perfectly. Or you might end up saying, “What the heck was I thinking?”

The truth is, none of us can truly predict how labor and delivery will go. So, we make plans and tell our family, friends, doctors, nurses, and midwives what we want. But we also need to remember that the ultimate goal is a healthy mommy and baby, whatever it takes.

9. Labor May Last 24 hours or 24 Minutes So Be Prepared

My first labor was long. Like looooooong. So, my OBGYN gave me the same induction meds with my second, thinking that would be the best route. Except my body remembered what to do this time, and the medicine worked fast. So fast that my OBGYN barely made it in time. The truth is, there is no way of knowing how long labor and delivery will take. Settle in for a long haul, but prepare to meet your new little one in a few minutes, too, if that’s what the baby has in mind.

10. Have a Back-up Plan (And a Back-up Plan for Your Back-up Plan)

Especially if you have other children who will need childcare, or you live far away from the hospital, or you have unique medical needs, or really for any reason. Because babies don’t follow clocks. Or calendars. My third child was born during a blizzard. After being completely snowed in and having no way to get down our street the week before, we saw another storm coming in the forecast.

Since I’d hit the 40-week mark, we rushed to the hospital for an induction. Sure enough, we got snowed in there. Even the nurses and staff were snowed in with us, sleeping in empty beds. My parents and other two kids couldn’t visit for several days. So, plan for blizzards. Plan for traffic. Plan for going into labor in the middle of the night, the middle of the day, and every scenario in between.

11. You Might Have a False Alarm (Or Two)

Sometimes it feels like “This is it!” only it’s not. Prepare yourself for excitedly heading to the hospital with your overnight bag in tow, only to be met with the disappointment of being sent home by the hospital staff. But don’t worry, your time will come. For now, try to get some sleep if you can and let the baby hang out in there for a bit longer.

12. Nurses Will Bring Your Partner Food, and You Will Loathe Them for It

You will feel a surge of anger from the depths of your soul as you hit 22 hours on only ice chips for nourishment, and you look across the room and see your husband chow down on a double cheeseburger. When he comes over to comfort you during a particularly brutal contraction, and you smell bacon on his breath, you might squeeze his hand harder than you’ve ever squeezed anything.

13. Also, Your Partner Might Say Something Really, Really Dumb, So Brace Yourself

You might hear a complaint about how uncomfortable the chair is that they slept in. Or how tired their legs are from standing next to you. Or that the burger they just ate was slightly overcooked. Brace yourself for this error in judgment as they know now what they say or how powerful you are to boot them to the moon. I mean, you are giving birth, after all. There’s nothing you can’t do.

14. And They May Not ‘Handle It’ Well

Some partners faint or get queasy seeing the shocking reality of childbirth. You could see the toughest person you know break down in tears or look on in horror and turn whiter than a sheet when they see what comes out of you. The truth about labor is childbirth changes everyone, not just Mama.

15. A Lot of People Will See Your Vagina. Like, a Lot

I can remember being on, like, hour 19 of labor with my first. A second round of nurses, plus my doctor, had been elbow-deep inside my body by this point. But then my OBGYN asked if a group of med students could observe. I was like, “Can any of them help get this kid out? The whole city of New York can come in! I don’t care; get him out!” And they did. The whole lot of them marched in and observed while I was knees-up in stirrups. But did any of them help get my stubborn baby out? No. They did not.

16. Your OBGYN May Not Deliver Your Baby, But By the End, You Won’t Care

A genuine truth about labor and delivery is your OBGYN may already be with another patient or not on call that night. Or, maybe your child is like my second and comes flying out like they’re on the fastest waterslide in the world, and the doctor can’t get there in time, so the nurse catches the baby. Or your partner does! Old Grandpa Joe could be down there, arms outstretched, and you’d be like, “Get ready, Gramps! Here it comes!”

17. Screaming and Other Guttural Noises You’ve Never Heard Before May Come Out of Your Mouth

It’s okay. You’re not possessed. You’re pushing out a whole live human. Of course, many women tout their calm, serene birth practices, and I’m sure that works for them. I did not have serenity. I was more of the “thunderous, ear-splitting, fire-breathing dragon” type of mom during childbirth.

18. You’ll Try ANYTHING to Relieve the Pain of Contractions

Birthing ball? Sign me up. Warm bath? Run it. Walk the halls? Listen to music? Taylor Swift dance party? Watch “Friends” re-runs? Yes! Write out baby shower thank-you cards and crumple them with rage as the pain shoots from your chin to your toes? Done! Whatever it takes.

19. You’re Forever Grateful for Ice

From the ice chips that nourished you for 20 hours while you basically ran a triathlon to the ice diapers that now offer a level of joy and comfort you did not know existed before, the truth about labor is ice will be the hero of the story (other than you, of course).

20. The Second That Baby Comes Out, You’re Ordering Food

After birthing my first child (which took over 24 hours), the cafeteria was about to close. So, while I was being stitched up and gazing at my new son for the first time, the nurses asked if I’d like to hurry up and order food, listing the choices as “pizza, burger, ice cream, sandwich . . .” and my response was “YES, ALL OF THAT, PLEASE.”

21. Labor and Delivery Isn’t Like on TV or in Movies

First of all, one truth about labor is that it’s unlikely your water will break and gush out as you walk down the street. Usually, it’s a slow trickle and feels like you’re peeing yourself. (Neat, right?) Also, it’s common not to have your water break at all. Instead, your OBGYN or midwife can do it as your labor progresses and you’re already spread-eagle on the table.²

22. Getting an Epidural is the Most Difficult and Glorious Experience Imaginable

The anesthesiologist appears in a glow — like the angel they are — ready to relieve the constant uterine stabbing, making you question every life choice you’ve ever made. However, they make you hunch over and sit perfectly still, which (spoiler alert!) is damn-near impossible to do through a contraction, but you do it because you know that good juice is coming and you will feel its miraculous power soon.

23. You Might End Up With Tearing or an Episiotomy, and It’s Okay

This was my greatest fear, and these words haunted my dreams for months before my first labor and delivery experience. But once it was all said and done and I’d delivered my first 9-pound baby (I’d go on to have two more), I learned that my body knew how to heal just fine. (The ice diaper was my bestie for a few days, though.)

24. And You Might Have Stitches

Ice diapers are key, as is numbing spray. And hemorrhoid pads! You won’t want to touch that area with coarse toilet paper for a while, so soft, soothing pads and anything to help with the pain and discomfort of peeing, pooping, walking, sitting . . . and well, being awake, you’ll take it.

25. Have You Ever Cleaned Up With a Squirt Bottle? You Will Now.

Your blessed nurses will add this gem to your “going home” kit, and you’ll be eternally grateful. Fill that sucker up with warm water for a nice, soothing wash after your trips to the bathroom, and thank the gods of plastic for sending this invention down to earth.

26. Mesh Underwear Enters the Chat

Just in case no one tells you this, you won’t wear regular underwear for a little while once that little wet, slimy bundle of love is in your arms. Instead, you’ll instantly have a new love and appreciation for disposable mesh underwear. They are large, stretchy, and accommodating for all the pads and diapers essential to your well-being and recovery, and you’ll be grateful for them, even if they creep you out.

27. It’s Going to Be Messy for a While

Picture a really, really, really bad period. Then, add in some blood clots for good measure. That’s your reality for a few weeks, so plan on doing nothing other than snuggling your new baby. You’re not making a HomeGoods run or grabbing lunch with your bestie anytime soon.

28. This is Your Moment, So Soak It Up and Be the Queen That You Are

Want your comfy robe and slippers from home? Bring them. Want visitors? Don’t want visitors? Want your mom there? Don’t want your mom there? Your decision. If the tub feels good, get in. If it doesn’t, get out. If walking helps, walk. If lying down helps, lie down. And the minute that baby arrives, make sure your partner knows you’ll want some real food, and they’ll make that happen. This is YOUR show, Mama, so you can run it however you like.

29. You Might Want To Capture This Moment, the Blood, Sweat, Tears—All of It

You’re in the throes of contractions and having your body ripped in two, so you might not be able to fully appreciate the beauty of what is happening. But a truth about labor is it’s truly beautiful, so consider letting your partner or mom or best friend (or even a professional photographer) capture it on film so you can go back and revisit it all once you’re calm and peacefully holding your baby in your arms. You might be surprised at how proud you are of the goddess you’re looking at and how amazingly strong she is.

30. You’ll Realize How Invincible You Are

Childbirth is painful and messy but also beautiful. It might be only be hours, or it could be days long. It can go according to plan or involve unexpected, terrifying scenarios. But the one constant through it all is you—the mother. Your strength will endure, you will persevere, and your body will do what it needs to do because you’re the mom. It’s your job. And you’re already amazing at it.

The truth about labor and delivery is no experience can compare to the grueling intensity, followed by the joy and beauty of childbirth. Nothing else is as gross and horrifying while also being as miraculous and breathtaking. So, go into it with a plan, knowing that plan might end up in the trash. Don’t hesitate to state your needs because you’re the one doing the work. And try not to break your partner’s hand when they tell you the pillow they slept on is lumpy. Just smile, say I love you, and hand them the baby who just pooped and needs a new diaper. Then sit back, take a sip of your Starbucks latte, and bask in the glory of motherhood. You’re rocking it.

You’ve heard of it. You don’t want it. But you may not be able to avoid it. It’s back labor. Most women have heard of back labor from family or friends or experienced it themselves. It can be excruciating pain in the lower back during labor pains and doesn’t always let up between contractions. Fortunately, counter pressure during labor can reduce your pain and anxiety. There are two main types of counter pressure that you may find helpful. Let’s learn all about them.

What is Back Labor?

Most laboring women have at least some discomfort in their backs, but back labor is different. It’s most painful during a contraction, but constant pain can be present between contractions. Women who have experienced back pain describe it as:^1,2,3

• Intensely painful
• It is more painful than regular labor pains, but it happens in the back
• Worsening with each contraction
• Not going away between contractions
• Pain with spasms in the lower back
• Located in the center of your lower back just above the tailbone

As a nurse midwife, the best description I’ve heard from a woman is that “it felt like a knife was in my back all the time, but then the knife was twisted during contractions. I didn’t even notice contraction pain in my abdomen.”

Causes of Back Labor

People commonly believe back labor is caused by your baby’s head position. Typically, a baby is born with its face and body toward your back. This position is called occiput anterior (OA). The occiput is the back of your baby’s head.^1,2,3

When your baby is the other way up, it is called occiput posterior (OP) or “sunny side up.” Back pain can happen in this position when the back of your baby’s head pushes against your coccyx or tailbone and spine instead of their soft, flat face.^1,2,3

About 15% to 32% of babies are in the occiput posterior position when labor starts. By the time of delivery, only about 5% to 8% are in this position. Most babies find their way into the correct position by the time they are born.²

Some studies indicate that other things besides your baby’s position may contribute to back labor. These factors include the following:²

• The shape of your pelvis
• Tight or loose pelvic ligaments and muscles
• Having a short torso with a long baby
• Bad posture

Remember, babies who are occiput posterior don’t always cause back labor. Also, back labor does not always result from how your baby is positioned.

How Does Counter Pressure Work?

There are several techniques to help with back pain in labor. Counter pressure is one of the most beneficial. It works in two ways.

First, when you experience firm pressure, endorphins are released. Endorphins are hormones made in your brain. These hormones bind to specific receptors in your brain and block pain sensations.^8,9 Endorphins are your body’s natural painkillers.

A second way that counter pressure can help with back labor pain is that it relaxes the pelvis, muscles, and ligaments. Pressure to the lower back helps ease the area’s tension and tightness. Relaxation helps with pain but also makes room for your baby to get into the right position.³

Benefits of Counter Pressure During Labor

Researchers and mothers report multiple benefits of using counter pressure during labor for back pain. These benefits include:^4,5,6,7

• Decreased back pain
• Reduced anxiety
• Increased relaxation
• Partner involvement
• Safety

A Step-By-Step Guide On How To Apply Counter Pressure

There are two main types of counter pressure for back pain during labor. One is direct pressure on the center of your lower back. The other involves squeezing your hips together. We will look at how to do each one. Alternating between these two pressure points for labor is often helpful.

Counter pressure is typically given to the sacrum during labor to relieve back pain. Here is how your support people can provide pressure correctly:^3,9,10

1. Position of mother: The mother should position themselves on their hands and knees, side lying, leaning over a bed or birthing ball, or leaning against a wall. Any position where she has support and can stay balanced when pressure is applied.
2. Location on mother: Apply pressure to the mother’s sacrum. This is the triangular-shaped bone at the lower part of their back, right above the tailbone or coccyx.
3. Position of support person: Position yourself where you can use the weight of your body to apply pressure to their lower back.
4. Balance: It helps if you also hold the front of the mother’s hip bone to balance both of you.
5. Counter pressure: Use your hand’s heel, palm, or fist to put steady, strong pressure on the painful area. A tennis ball also works well. Use your body weight to lean in and give pressure.
6. Timing: Counter pressure is given from the start of each contraction until it ends.
7. Communication: The key is to listen to the mother. They can tell you how much pressure feels the best and exactly what spot to push on.

Pro Tip

Use heat or ice and the counter pressure for even more pain relief.

How To Apply Counter Pressure With a Double Hip Squeeze

The double hip squeeze is also called the labor hip squeeze. One or two support people can use this technique. As the name suggests, squeeze both hips together to relieve lower back pain. Here are the steps your support people can take:³

1. Position of mother: The mother should position herself where she can lean forward. She can stand, sit, be on hands and knees, or lean over a bed or birthing ball. Both hips need to be accessible.
2. Location on mother: Find the right spot on the mother by imagining a line from the top of her hip bones to the top of her butt crack. The area outside the imaginary line is where you will apply pressure.
3. Position of support person: Stand or kneel behind the mother and place the palms of your hands on the fleshy part of each butt cheek right outside the imaginary line. Your fingers should be pointing up and make the shape of a “W.”
4. Balance: Maintain your balance by kneeling or standing with your legs apart on a solid surface.
5. Hip squeeze: Use the flat or heel part of your hands to push up and in on both sides together toward the mother’s shoulders, giving steady pressure. Two people can provide pressure, one on each side. Usually, the stronger the pressure, the better.
6. Timing: Apply pressure during contractions. Continue as long as it helps the laboring mother, or you are tired and need to switch out. Providing counter pressure can be exhausting.
7. Communication: Listen to the mother to know what pressure feels good. They can also tell you if you need to adjust your hand position.

Pro Tip

The pressure helps flare the pelvis slightly, providing pain relief and allowing your baby to find the correct position.

Back labor pain can be relentless, but counter pressure during labor can be a lifesaver for women experiencing this excruciating pain. Counter-pressure techniques are excellent tools your support person can use to help you. By following the steps and communicating with the laboring mother, support people can give effective relief and comfort during labor.

Umbilical cord prolapse is rare but can happen to anyone during any pregnancy, whether it’s your first or your fifth. However, it only occurs in about 1 to 6 deliveries out of every 1,000 births. The odds are in your favor. But this emergency means ensuring you have a qualified and experienced person helping with your delivery.²

The umbilical cord is your baby’s lifeline. It gives your baby nutrients and oxygen while still in your womb. When the umbilical cord prolapses or falls through the cervix into the vagina or birth canal before the baby, this can cause the baby’s oxygen and nutrients to decrease, which could lead to severe complications such as fetal distress, fetal demise, hypoxia, or hypoxic-ischemic encephalopathy, cerebral palsy, brain damage, or stillbirth.^1,3

What Is Umbilical Cord Prolapse?

Umbilical cord prolapse happens after your water breaks, and the umbilical cord slips out of the uterus, through the cervix, and falls into the vagina or birth canal ahead of the baby during labor or delivery. In a typical delivery, your baby drops through the dilated cervix before the umbilical cord. If the umbilical cord comes first, it can get squished by the pressure of your baby’s body. Each contraction of the uterus also squeezes the cord. This life-threatening event requires immediate medical attention as it can create severe complications for the baby, such as compromised blood flow and oxygen supply. This complication usually occurs during labor, typically right before or during delivery.¹

What Causes Umbilical Cord Prolapse?

We can’t predict who will have a prolapsed umbilical cord with their delivery, but several risk factors can increase the risk of a prolapsed cord, including:^{1, 2}

• Premature rupture of membranes: When your water breaks before the baby’s head engages in the birth canal, the cord will have more space to slip through.
• Malpresentation: If the baby is in a breech position (when any other part of your baby comes out first instead of the buttocks), it can increase the chances of a prolapse.
• Multiparity: You are at a slightly higher risk if you have had multiple pregnancies and deliveries (usually five or more).
• Polyhydramnios: When there is excessive amniotic fluid in the uterus, it can increase the chances of cord prolapse.
• Preterm labor: Preterm births are more prone to umbilical cord prolapse.

But umbilical cord prolapse can happen without these risk factors. Certain conditions may increase the chances of a prolapse. These other risk factors include:^1,2

• Fetal congenital disorders
• Placenta previa
• Irregularly shaped umbilical cord (too long, very thin, etc.)
• Assisted vaginal delivery (using a vacuum or forceps during delivery)⁴
• Low birth weight (weighing less than 5 pounds, 8 ounces, or 2.5 kilograms at birth)⁵
• Being pregnant with twins, triplets, or more (also known as having a multiple pregnancy)
• Irregular cord insertion to the baby (velamentous cord insertion)⁶
• High fetal station (the fetal station is the baby’s position relative to your pelvis during labor)
• Macrosomia (your baby is larger than the average newborn).⁷
• Procedures like amniotomy, when your provider breaks your water for you or inserts a balloon to ripen your cervix.⁸

How Is It Diagnosed?

Your provider and staff are trained to watch for this during labor and delivery. They will look for common signs and symptoms of cord prolapse. These may include:^1,2

• Visible or palpable umbilical cord protruding from the vagina.
• Fetal heart rate changes, such as decelerations or bradycardia (when the baby’s heart rate slows down too much).⁹
• Sudden and severe fetal distress.
• A prolapsed cord can be felt during a vaginal examination when they check your cervix’s dilation progress.

How Will Your Provider Manage a Prolapsed Cord?

If umbilical cord prolapse is suspected, your provider will quickly relieve the pressure on the prolapsed umbilical cord to make sure the baby receives adequate oxygen and blood supply. This may involve changing the mother’s position, elevating her hips, or using the Trendelenburg or knee-chest position.¹⁰

Your provider could also insert a gloved hand into the vagina to manually move the baby’s head off the cord. Delivery of the baby must occur as quickly as possible to prevent any potentially life-threatening outcomes. In most cases, the provider will perform an emergency Cesarean section to expedite the delivery and minimize the risk to the baby. A fetal monitor will continuously show the baby’s heart rate, which will help the provider decide what plan to follow.^1,2

Can It Be Prevented?

Unfortunately, a prolapsed umbilical cord cannot be prevented. It’s also difficult to detect during pregnancy because of the frequent movements of the baby and the cord. Some of the risk factors for a prolapsed cord can be noted as part of the mother’s birthing plan so that the parents and the medical providers know the possibility of a prolapsed cord. But it comes down to your provider acting quickly if a prolapsed umbilical cord occurs.

Can Babies Survive a Prolapsed Umbilical Cord?

Most babies do survive a prolapsed umbilical cord. In hospitals, the number of babies that die from a prolapsed umbilical cord is about 3%. However, one study did show the rate as high as 7%. When a baby is born outside of a hospital setting, the infant death rate is almost 20 times higher.¹

Umbilical cord prolapse is a rare obstetric emergency during or just before delivery. Still, your healthcare team will work quickly to deliver your baby if they detect a problem. There’s not much you can do to avoid one, but knowing the risk factors and what action needs to be taken may help you in the unlikely event it happens during childbirth.