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.

Whenever I get asked the question, “What do you do?” I know that I’m about to enter into a conversation — or potentially a monologue — rather than just giving a quick response. It would be wonderful if people understood what a doula does as quickly as they know: “I am a teacher,” “a counselor,” or “an accountant.” But when I reply, “I’m a doula,” I begin to prepare myself to give my explanation.

Most people don’t know what a doula is. So it never surprises me when the person I’m speaking with looks perplexed and has no idea what I’ve just said. Let me say. I don’t mind explaining. It allows me to share my passion and educate someone on a service they or a family member or friend might be interested in using.

What does surprise me and excites me is speaking with someone who DOES know what a doula is. I love hearing their stories about how they heard about doula care. Or how their friend hired a doula or their family member is a doula. Unfortunately, that only happens on rare occasions. I still find myself educating most people on what a doula is and what we do for families.

You, our readers, may not know what a doula is. Today, I wanted to take a few minutes to share the answers to some common questions. So, let’s start from the very beginning. It’s a perfect place to start. 😉

What is a doula?

The word “doula” — pronounced ‘doo-la’ — is an ancient Greek word meaning ‘woman servant, caregiver, or a woman who serves.’ ¹ More recently, it refers to a trained and experienced professional who provides continuous physical, emotional, and informational support to the mother and her partner during pregnancy, labor, childbirth, and their postpartum journey.

There are two main types of doulas: Birth Doulas and Postpartum Doulas. Birth Doulas are trained professionals who support women and their partners during pregnancy, childbirth, and immediately postpartum. Postpartum Doulas are trained professionals who support families during their transition into parenthood during the postpartum period (the first 12 weeks after birth).

A doula’s role has also evolved, and more specialties are available in doula care. There are:

• Antepartum Doulas support pregnant women on bedrest or in high-risk or high-stress pregnancy situations.
• Bereavement Doulas provide emotional, physical, and informational support to women and families processing the loss of a child.
• Adoption Doulas build relationships with the birth mother and the adopting or fostering family. Sometimes, it’s just with the birth mother or the adopting or fostering family.

What does a doula do?

Birth Doulas typically offer to meet with each of their clients several times — two, three, or four times — for prenatal visits to go over each couple’s wants and desires and educate them on the options that are and will be available to them. This allows the doula to better support each family during labor and birth.

Birth Doulas bring an entire toolbox of ideas, tricks, and techniques to the birth. Your doula may rub your back for several hours or trade off with your partner in that role when his hands are aching, and he needs to eat and rest. She may be the quiet, calm, reassuring voice whispering in your ear or the firm and anchored voice that will help you get back on track when labor starts to feel intense and overwhelming. She can help you focus on natural ways to help your labor progress (if you want to have an unmedicated birth).

Or she can help you decide which medications you want to use and when the best time is during your labor to get them. Your doula can help straighten out a baby that’s slightly malpositioned in the pelvis, and she can give you ideas on negotiating with the staff to achieve some important elements of your birth plan.

Birth Doulas offer a lot of support to the husband or partner, showing him and other loved ones how they can best help you and reassure them about what’s normal. Your doula might offer a hand massage to help you rest and relax. She can explain your options and help you brainstorm questions when facing medical interventions for you or your baby. Occasionally, doulas’ help and reassurance after birth might be key to establishing your nursing relationship.

Every labor unfolds in its unique way. A doula’s job is to bring her expertise in birth to the table. She will stay fully present and supportive, whatever your family’s needs and desires.

A Postpartum Doula’s role is unique to every family. Essentially, she will come into your home, assess your needs, and jump in to help. Your doula’s role is to nurture you as you transition into life with your new baby. This could include help with breastfeeding, suggestions, information about baby care, and resources to heal your body postpartum. She is like a teacher, sharing evidence-based information and helping you integrate the baby into your family. If you need a shower or a nap, she can help take over baby care. She can also show you how to use several different baby carriers, how to use your breast pump, suggest which diapers, diaper creams, baby detergent, etc., you might want to try, and more. Postpartum Doulas can also do light housekeeping, such as washing dishes, wiping down counters, and doing baby’s laundry.

If you have older children, she can spend time playing or working with them to adjust to the big sibling role. She can also run errands for you and pick things up if you cannot drive yet or haven’t been able to get out of the house. Doulas come in with a keen sense of what new families typically need. She will then work with you to decide how she can best support you through the transition into parenthood.

What are the benefits of hiring a doula?

Numerous studies have documented the benefits of having a doula present during labor and postpartum.^2,3,4,5,6,7 A Cochrane Review, Continuous Support for Women During Childbirth, showed many positive birth outcomes when a Birth Doula was present.² With the support of a Birth Doula, women were less likely to have pain-relief medications administered and less likely to have a cesarean birth. Women also reported having a more positive childbirth experience. Here are some of the stats:²

• Decreases the overall cesarean rate by 50%
• Reduces the length of labor by 25%
• Decreases the use of oxytocin by 40%
• Reduces the use of pain medication by 30%
• Decreased requests for an epidural by 60%
• Reduce the number of days newborns spend in the NICU (neonatal infant care unit)
• Reduce the rates of postpartum depression
• Increase the rates of breastfeeding
• Increase the positive maternal assessments of maternal confidence and newborn health

Studies show that having a Postpartum Doula after childbirth results in the following:⁴

• Greater satisfaction with the postpartum period
• Quicker birth recovery
• More likely to eat healthier and sleep more
• More confidence in parenting and childcare
• Less stress and anxiety
• A more positive opinion of baby
• More affectionate to baby
• Less incidence of postpartum mood disorders
• Higher breastfeeding success rate

These are fantastic results! Who wouldn’t want to improve their chances of having a better overall experience during labor and bringing baby home?

My husband/partner/mom/friend will be my labor support person. Do I still need a Birth Doula?

I know that dads are sometimes nervous that a Birth Doula might take over their role and that they’ll be “shut out” of the labor process. That is not the case at all! Dads and doulas actually complement each other in labor.

A doula is similar to a foreign country tour guide or a team coach. Your tour guide doesn’t take away from your trip. She enhances it for both of you. And how are you supposed to win a game if you have never played the game before? (Assuming your husband hasn’t coached you or any other women in labor.) Your coach can help lead you to victory! The same is true of a doula. She can help you both navigate the healthcare system and understand the process of labor and birth.

Doulas often find themselves reassuring dads/partners about the normal sights and sounds of labor, which can be disconcerting to even the best-prepared support person. A doula shows Dad’s techniques to help the laboring woman based on what is happening in her body—for example, if she is experiencing back labor. “We might try this counter-pressure technique. Let me show you exactly where to put your hands.” Relaxing in the bath? “How about gently pouring water over her belly with each contraction, like this.” Is mom laboring in the bathroom? “Here, let me get the birth ball so she can lean forward into your chest to rest between contractions.”

During labor, moms usually retreat into their own private “labor land.” Doulas often bond with the dad during birth as they work together to figure out the best way to support the laboring woman. This is why dads/partners are generally happy to have another “birth partner” with them for the journey!

Friends and family members can also be wonderful labor support people, but their role differs distinctly from a doula. Doulas bring specialized training in birth and labor support. She has seen many births in various settings and can help familiarize you with what to expect at each stage. She doesn’t have the same emotional attachments as your family, so separating herself from your choices is easier.

A doula is there to support you in whatever kind of birth you want, whatever that looks like for you. You don’t have to worry about what a doula might say or do in any given situation, as you may with some friends or family members. She’s there for your unconditional support. She can also support your friends and family, just as she supports dads and partners in the birth space.

I’m getting an epidural. Do I still need a doula?

Doulas come to your birth with an open mind and an open heart. She is not there to carry out some agenda; she’s there to help you have the best birth possible, whatever that looks like for you. She’ll talk in-depth during prenatal meetings to learn more about what kind of birth you envision. Then she’ll put all of her energy into helping you get there. And if you get into labor and, for whatever reason, plans change, a doula can help you cope with the unexpected turn of events.

There’s a lot a doula can do if you opt for pain medication, including position changes and other tricks to help your baby descend. She can also help you cope with the medication’s physical side effects to continue making your journey as comfortable as possible.

I also hate to say it, but sometimes pain medication doesn’t work as expected, but mom’s movements and coping tools are suddenly limited with those medications — a doula will get you through it.

What if I need to have a C-section? Do I still need a doula?

A doula can do many things to help make a cesarean birth the most loving, family-centered experience possible. For example, she can be with you before the surgery to help with relaxation and brainstorming questions for your healthcare team. She can help advocate for some things you might want during the surgery. For example, working with surgeons and anesthesiologists to allow skin-to-skin contact on the operating table while the surgeon finishes the operation. This is so much more family-centered than taking the baby to the nursery or the recovery room to wait for you, and we have found that it significantly decreases birth trauma for the mother. But it often requires some advocacy with the staff—a doula can help with those negotiations.

Doulas can sometimes stay with you and your partner in the operating room during the surgery. However, this is always a case-by-case decision by your surgeon and anesthesiologist. If a doula is allowed in the OR, she can help explain what is happening during the surgery. She can show your husband or partner some physical comfort measures that may help you deal with the sensations of surgery. Sometimes, a baby needs to go to the nursery or the NICU after a cesarean birth. In this situation, the dad or partner generally goes with the baby, and the doula will stay by your side. This helps mothers not feel so alone as the surgery is finished and recovery begins, and it helps partners not feel so torn between mom and baby.

In most cases, the baby will go with the mom to a recovery area, where a doula can help you establish nursing and skin-to-skin bonding. And finally, if the cesarean is unexpected, a doula will offer a compassionate, listening ear to help you process the birth. She can also connect you with resources.

I will have help from my family after the baby is born. Do I still need a Postpartum Doula?

Your husband/partner, family members, and friends can offer wonderful support in the days and weeks postpartum! Some of their skills may spill over into the postpartum doula realm, and others are quite different. Postpartum Doulas are great listeners and can support you in forming your parenting philosophies based on research-based information. Postpartum Doulas are an objective source of information and support. They can help you and your husband or partner adjust to life with this new little person. Many family members and friends have found that they are actually more involved in caring for mom and baby with a Postpartum Doula’s help. This is because they learn exactly how to be most supportive.

Caring for a new mom and baby can also be overwhelming for others. Postpartum Doulas can help share that nurturing role. She can also help dads and partners know how to help the new mom. Additionally, she will reassure them about what is normal for babies and postpartum mothers. Siblings have a big adjustment, too, and a Postpartum Doula can help ease that transition. They can spend time playing and talking about their new role and help the parents with tips on interacting and entertaining older children during the intense weeks when mom is healing and a newborn needs so much attention.

Postpartum Doulas can also help new families recognize the symptoms of imbalance and connect them with resources for help. They are good listeners and can lend an empathetic ear to the new mom. Or help take care of other household responsibilities while she is focusing on getting well. There is also some evidence that using a Postpartum Doula can help reduce the chance of developing postpartum depression.⁸

Overall, a doula believes in ‘mothering the mother.’ She has the experience and training to support women during these different times to make their experiences during pregnancy, birth, and motherhood the best they can be.

For more, listen to our podcast episode where two doulas talk about a doula’s role.

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.

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.

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.

If you are having a vaginal delivery, a non-complicated birth is what you would likely want. But sometimes you and your medical provider may require assistance through forceps delivery. Going into labor is exciting, but it can also be nerve-racking. You are excited to meet your little bundle of joy, but you may also have a million questions running through your mind, like what are forceps, and what is a forceps delivery? These questions are entirely normal, and though you might be informed on a gazillion pregnancy and delivery-related topics, it’s normal to worry about your child’s birth.

What is Forceps Delivery?

Forceps delivery is a form of operative vaginal delivery involving forceps to deliver the baby. Though there are over 700 different types of forceps, they are classified into three main groups:^1,2

• Outlet forceps
  • Scalp is visible
  • Fetal skull reached the pelvic floor, and the head is on the perineum
  • Rotation does not exceed 45 degrees
• Low forceps
  • Leading point of fetal skull at >= +2, not on pelvic floor
  • Rotation 45 degrees or less (LOA/ROA to OA or LOP/ROP to OP); or rotation greater than 45 degrees
• Mid forceps
  • Baby’s head is above +2 centimeters

Typical components of forceps include handles, a lock, shanks, and blades. Though all forceps look similar and have similar features, medical providers use different ones depending on the baby’s position.²

How Common is Forceps Delivery?

The use of forceps has declined in recent decades, and a study, which took into account 22 million vaginal deliveries from 2005 to 2013, found that forceps were used only in 1.1% of cases. The decline in forceps deliveries has been associated with fears of an increase in the risk of tearing, injury to the baby, and lack of experience among doctors.³

What Causes You to Have Forceps Delivery?

Your medical provider may suggest forceps delivery for several reasons:^1,4

• You’re too tired to push anymore.
• Your health history may mean pushing for too long may be a problem.
• Your baby’s heart rate is a concern.
• Your baby doesn’t want to come out, and labor stalls.

A forceps delivery isn’t a choice your doctor can take lightly due to the increased risks of injuries. Hence specific criteria must be fulfilled to go ahead with it. The following criteria are recommended for a forceps or vacuum-assisted delivery to take place:³

• Complete dilation of the cervix.
• Membrane rupture
• The head of the fetus is engaged.
• The fetal position is known.
• There’s an estimate of the weight of the fetus.
• Mom’s pelvis should be adequate for the baby to pass through.
• Administration of anesthesia.
• The mother’s bladder is empty.
• Consent is given with an explanation of the risks and benefits.
• A backup plan is in place.
• When pushing isn’t feasible, the mother has a cardiac or neurologic disease.

How is the Procedure Performed?

Depending on the baby’s position, your provider will select the proper pair of forceps for the procedure. The fetus naturally undergoes a set of movements to negotiate the birth canal called cardinal movements. There is some professional disagreement on whether there are seven or four of these cardinal movements, which include engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion.^1,5

If the fetus does not complete all the cardinal movements, your provider can use forceps to help it. For example, if your baby only engages your pelvis, it will need help completing the rest of the movements to descend through the birth canal.

If all the conditions for a forceps delivery are complete, your provider can begin helping the baby through the birth canal. You’ll continue pushing, and someone will use rest periods between contractions to place the forceps on either side of your baby’s head or feet. They’ll use a contraction to apply gentle traction with the forceps to guide the baby out while you push. Your provider may also perform manual rotation to get the baby in an appropriate position.¹

Risks vs. Benefits of Forceps Delivery

Forceps delivery isn’t risk-free, though it does have many benefits, which has led to doctors calling for training in obstetrics to use forceps.

Evidence suggests the use of forceps in deliveries is associated with a lower failure rate than a vacuum. Using forceps also means a Cesarean section isn’t performed, which means less time in the hospital compared to a woman who has undergone a C-section and a faster recovery time. Another significant benefit is that forceps can come in handy when a baby needs to be delivered quickly, as in the case of fetal distress.²

Trauma due to the use of forceps can occur to the mother or the fetus. Maternal trauma includes increased perineal and vaginal trauma such as third or fourth-degree tears, urine and fecal incontinence, hematomas, and long-term complications of pelvic organ prolapse.³

Fetal trauma includes injury to facial nerves, trauma to the skull and brain (skull fracture and intracranial hemorrhage), and even death.³

Forceps Delivery vs. Vacuum Delivery

Despite forceps and vacuum delivery being operative vaginal deliveries, they have considerable differences and benefits.

The advantages of forceps over vacuums include the following:^2,3

• Faster delivery of a fetus in distress
• Lower failure rate
• Unlikely to detach from the fetus’s head
• Allows rotation of the fetus
• Less encephalopathy and bleeding from the scalp
• Fewer cases of cephalohematoma
• Fewer cases of retinal hemorrhage
• It can be used in premature fetuses

The disadvantages of forceps include:²

• Stronger anesthesia is needed for the mother.
• Facial bruising and injury to the facial nerves resulting in paralysis palsy are more common while using forceps.
• Greater perineal trauma, which means trauma to the mother’s genitalia.

Delivery assisted by a vacuum is generally better for the mother, whereas delivery assisted by forceps is usually better for the fetus.³

Recovery

Recovery from a forceps delivery is usually shorter than a C-section and about the same time as an unassisted birth which is why there are calls to train medical professionals to use forceps. Forceps can also prevent other complications due to a C-section, such as infection, repeat Cesarean sections and pain.

Forceps delivery can cause tearing, so appropriate measures must be taken to prepare to suture the lacerations while preparing for the delivery itself. Severe tearing may take longer to heal.¹

The use of forceps delivery has declined over the years, and not all hospitals or medical colleges train physicians and students to use forceps, leading to its decline. It is essential to ask your medical provider if they are trained in using forceps for delivery in case you need to undergo this procedure. A trained professional can ensure the best possible outcome for you and your baby.

Many amazing events happen in childbirth. But one of the most fascinating is the en caul birth. With an en caul birth, your baby is born inside the amniotic sac or bag of water. This phenomenon has fascinated parents and medical professionals for centuries.¹

An en caul birth is considered rare. There are many cultural beliefs and superstitions regarding this unusual birth. Some people believe an en caul birth is magical and brings fame and fortune, but there are few benefits or risks. Some parents desire to try to have this type of delivery because it is natural and unique.⁴

What Does En Caul Mean?

When the amniotic sac doesn’t break before your baby is born, you have an en caul birth. A baby born in the bag may also be called a “mermaid birth” or a “veiled birth.” It’s not a good or bad thing. It’s simply unusual.⁵

Usually, the amniotic sac breaks before contractions start or during labor or pushing. The fluid releases and continues to leak until your baby is born. A doctor or midwife may break the bag of water to induce or stimulate labor. If the bag is still intact when you start pushing, it will likely break with the increased pressure created. But if it doesn’t, you may have an en caul birth.⁶

“En caul” is different than “caul.” Caul means that a piece of the membrane is over your baby’s face, head, or chest when she is born, but the bag is not intact. The portion of the membrane may look like a veil or helmet.⁷

What an En Caul Birth Looks Like

During an en caul birth, your baby is born in what looks like a large squishy water balloon full of fluid. Often, a portion of the bag delivers first filled with liquid as it pushes out of your vagina. The rest of the sac with your baby’s head and body follows.⁶

The bag of water has two membranes that are fused. You can see through the membranes. Your baby will be curled up in the bag and get oxygen through the umbilical cord. You can see how your baby was nestled in your uterus before birth.⁶

After Delivery

Once your baby delivers en caul, the doctor, midwife, and nurses all ooh and ahh over the wonder and point it out to you. Then, your provider gently snips the bag with scissors or another instrument or pokes a hole with a finger. The water pours out. The membranes then cling to your baby. Your doctor or midwife carefully pulls them away from your baby’s face so she can breathe. Finally, you get to hold your baby for the first time. Cutting the cord and how your placenta delivers will be like any other birth.⁶

 

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How Common is an En Caul Birth?

Very little information is available about how often an en caul birth occurs. The commonly quoted statistic is less than 1 in 80,000 live births. At this rate, many doctors, nurses, and midwives have never seen an en caul birth.¹

En caul births can happen with both vaginal and Cesarean deliveries. With a cesarean birth, the surgeon can attempt to deliver your baby in the bag without breaking it. However, this is not a typical surgical procedure.¹

An en caul birth is more likely with a preterm or small baby. They are also more common if you haven’t had any previous births.¹

Midwife Perspective

En caul births are not tracked at delivery, so any statistic is only an educated guess. I’ve been a midwife for 22 years and a labor and delivery nurse before that. I have not kept track of how many en caul deliveries I have done, but it’s between 5 to 10 vaginal births. I have delivered over 5,000 babies. These numbers do not match with the 1 in 80,000 births estimate.

My numbers made me curious about how common en caul birth is. So, I surveyed 71 United States nurses, midwives, and OBGYN doctors, and this is what I found:

• Who: The survey included 58 labor and delivery nurses, one director of nursing, seven midwives, and five OBGYN physicians. Experience levels varied among those surveyed from under five to over 20 years.
• Percent: Of those surveyed, 80% have seen at least one en caul birth.
• Number: There was a wide range of how many en caul births those surveyed have seen, from only one in over 20 years of experience to “countless” in less than 20 years of experience. The majority have seen one or two such births.

What I take away from this small survey is there is a wide range of experience with en caul births. It happens more than the often reported 1 in 80,000 births. More research can help determine accurate numbers.¹

Benefits of an En Caul Birth

The benefits of an en caul delivery involve avoiding the risks present when the amniotic sac breaks before delivery. Such risks include the following:²

• uterine infection
• placental abruption, when the placenta pulls away too soon
• umbilical cord compression leading to your baby not tolerating contractions

The most severe, umbilical cord compression happens in cord prolapse. A prolapse occurs when your baby’s umbilical cord falls through your cervix and into the vagina before your baby’s head. The cord gets squeezed between your baby’s head and the pelvic bones depriving your baby of oxygen. This almost always leads to an emergency Cesarean delivery.⁸

Amniotic fluid provides a cushion around your baby. It helps protect him and the umbilical cord from squeezing and bruising during labor and birth. An en caul birth gives this protection through the birthing process.⁹

Risks or Complications

An en caul birth has few potential complications. One case study found a severely low number of blood cells (anemia) in a baby born by Cesarean via en caul delivery. But the anemia was most likely caused by an abnormal umbilical cord and not the en caul delivery.³

If labor is not progressing, breaking the amniotic sac can stimulate labor. Your provider may recommend an internal fetal heart rate or contraction monitor. Either of these requires your water to be released. Hoping for an en caul birth could delay labor progress or recommended interventions and lead to complications.¹⁰

How to Increase Your Chance of an En Caul Birth

Labor must progress without breaking the amniotic sac to increase your chance of an en caul birth. It means not breaking your bag of water to speed things up if everything progresses normally. Induction of labor can make this difficult. You can still use Pitocin to stimulate contractions if needed.¹¹

Whenever you have a cervical check to evaluate your labor progress, your doctor or midwife’s fingers risk breaking the amniotic sac. Limiting vaginal exams can increase your chance of an en caul birth.¹²

It is essential to talk with your doctor or midwife about your desires. Many doctors routinely break the amniotic sac during labor. Even if you decline this intervention, your body may have its own plans, and there is little you can do to control when your water naturally breaks.

En caul birth is fascinating, but there needs to be more research on how common it is or its risks and benefits. When a baby is encased in the amniotic sac, we get a small picture of how life was in the womb. It is one of the most natural and safe types of birth. But this type of birth is also difficult to plan for. Talk with your delivery provider to attempt this type of birth. It could also be their first time experiencing this type of unique delivery.

Birthing a human is the most surreal thing I have ever (and will ever) experience. Every woman deserves the utmost support in how she chooses to put her body through such an experience. So, if pushing your baby out at home is your style, you’re in good company because plenty of celebrities have also had successful home births.

15 Celebrities Who Had Home Births

Here are 15 celebrities who had home births and shared their stories with the world.

1. Hilary Duff

 

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Among the many celebrities who had home births, Hilary Duff has always been willing to share her motherhood journey publicly. Her home birth with her daughter Mae was no different. “Feeling ready to share some photos of Mae Mae’s birth day!!!” she wrote in a very personal and heartfelt IG post. “For me to feel safe during birth and get to where I need to go, it’s crucial to have the right support system. The perfect amount of space, counter-pressure, humor, stillness and people that support my power. My hubby is the most calm anchor in the room when I feel like climbing the walls and my little Molly is an extraordinary doula who sat with me when I needed to be still and quiet. She quite enjoyed the fact that I was sitting on doggy puddle pads as my water had broken hours before 🤣 My own mama was there to make all the snacks and watch with a big nervous smile as her baby brings her a new grandbaby earthside. The help that I have to support my other children while I am not able is maybe the most comforting thought of all. All hands on deck. Forever lol.”

She also gave her love and support to mothers for all their labor. “This is hard work…every way a woman brings a baby in is. From getting pregnant, to C-sections, hospital or home births, the breastfeeding journey (oy vey that one gets me every time) and raising these little beings responsibly to be stand up, confident, kind citizens of the world. It’s completely consuming. A tedious, magical, miraculous adventure…So cheers almighty mothers. You make mountains move daily ♥️”

2. Gisele Bündchen

The Brazilian model says in “Man in the Arena” by ESPN that her ex-husband Tom Brady initially resisted the idea of home birth. “He was like, ‘Absolutely not,’ and I was like, ‘Excuse me, you don’t get to choose that, it’s my body.’ He was like, ‘Who has a kid at home in 2000…?’ I do.”

Luckily, Bündchen stuck to her guns, and Brady eventually came around. The proud dad shared that he fondly looks back on the home birth. “Me being there with G at his birth in our home, it lives in my mind. I think we brought this boy into the world in the most precious way,” he says.

3. Kehlani

 

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Singer-songwriter and dancer Kehlani announced in 2019 that she’d given birth to her daughter Adeya at home. “& to my greatest flex of the decade…” her IG caption reads. “In the bathroom at the crib in Oakland in the morning in March… thank you 2019 for the greatest gift of all time. hardest and greatest thing i’ve ever done. a year i will never ever ever forget. Adeya Nomi Parrish THANK YOU FOR ALL THAT YOUVE GIVEN ME!”

She also added in another IG post: “Unmedicated home birth was the absolute hardest yet most powerful thing I’ve ever done.”

4. Alanis Morrisette

 

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Alanis Morrisette shared in an interview with People that her home birth with her daughter Onyx was fast but “gnarly.” “It’s not meant to be all clean and perfect,” she says. “We are animals.”

Morrisettte also describes how her midwife couldn’t arrive in time, so her husband Souleye coached her and caught the baby. “I’d seen so many videos of women giving birth in water with dolphins and fields. I knew that the babies, when there’s a low-risk birth, come out in whatever way they come out.”

The singer also confessed to learning not to shame other moms. “I was one of those horrifying younger women who had a lot of opinions for a woman who didn’t have a baby. And then, as soon as I had a child, I just shut my mouth and just celebrated any way a child comes into the world, any way a mom wants to do it: ‘How can I help?'”

5. Alyson Hannigan

 

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“How I Met Your Mother” star Alyson Hannigan says a home birth made complete sense for her. “I don’t like hospitals and the idea of being in labor somewhere I don’t like at all wasn’t how I wanted to bring my kids into the world,” she tells Yahoo Parenting. “I thought, ‘Where am I most comfortable?’ For me, the choice [to give birth at home] was phenomenal. We had a midwife but we asked our doctor if he needed to be there. He said, ‘Sure, but you don’t need me. A midwife does everything I do.'”

She adds this adorable tidbit about how her older child responded when it was time for her baby sister to arrive. “We asked Sati if she wanted to watch her sister being born and she said, ‘Call me and check in.’ So we did and she said she was busy playing Barbies. But she did want to change Keeva’s diaper.” We wonder when the novelty of diaper changing wore off for big sis.

6. Ashley Graham

 

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Powerhouse supermodel and supermom Ashley Graham is also among celebrities who had home births. She gave birth to all three of her children at home — a son in 2020 and twin boys in early 2022. An article in Shape reports that the experience made Graham feel invincible. “I have to say, now that I gave birth and I did it naturally and I felt everything, I feel like there’s nothing I can’t do,” Graham said in an episode of her podcast “Pretty Big Deal.” “There’s nothing that could come my way where I say, ‘Oh, that’s too hard, I can’t handle that.’ I went through laboring for six hours naturally at home.”

That belief in herself and her body led the proud mom to do it again but this time with twins. Graham explained in her podcast that having her babies at a hospital would have been anxiety-inducing, leading her to opt for a calmer at-home experience.

7. Gigi Hadid

 

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When COVID restrictions meant her mom and sister wouldn’t be present at the birth of her baby, Gigi Hadid also joined the ranks of celebrities who had home births. The soon-to-be mom says she was influenced by the documentary “The Business of Being Born,” which looks at hospital interventions and shows successful home births. “What I really wanted from my experience was to feel like, ‘Okay, this is a natural thing that women are meant to do,'” Hadid said to Vogue.

The new mom also describes the experience as primal, saying with pride, “I was an animal woman.” She tells Vogue the pain was intense, but she knew she had to endure it. “I had to dig deep. I knew it was going to be the craziest pain in my life, but you have to surrender to it and be like, ‘This is what it is.’ I loved that.”

8. Teyana Taylor

 

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Teyana Taylor gave birth to both of her daughters with her husband, Iman Shumpert, in their home bathroom. After her first daughter was born, Taylor shared an adorable picture on Instagram, saying, “On Dec 16th at 6:42am in our bathroom Junie decided she wanted to take her first breath into this world. She came out as a wonderful surprise to everyone! Not knowing I was in labor until I felt her head…it took two ten count pushes with my fiancé playing Dr and she entered this world into his bare hands!” Taylor continued, sharing how Shumpert “handed her to me wrapped in our bath towel and wiped her face for me to see what LOVE really is.”

For Taylor’s second home birth, singer Erykah Badu (who is also a doula) was present to help with the delivery. Badu shared a video on Instagram to welcome the baby and thank the couple for letting her assist them. Taylor proudly captioned her own post, “Now…when we buy homes, we always find a bathroom with great energy… but not in a million years would you be able to tell me we’d deliver both of our daughters in a bathroom without the assistance of a hospital! Our newest edition entered the world in the water and came out looking around and ready to explore!”

9. Rachel Platten

 

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Rachel Platten lived her ultimate “fight song” through 2 ½ days of labor while joining other celebrities who had home births. She says she has no regrets about giving birth to her daughter Sophie via home birth, which made her feel incredibly strong.

“When I thought I couldn’t take anymore, this amazing, wise little one kept whispering to me, ‘We can do this mama, we can do this.’ So I kept going one contraction at a time. I feel like a warrior and I will NEVER doubt my strength again. Thank you Sophie for showing me what I am made of and for completing our family. And Thank YOU all so much for your love and support and for allowing me the privacy these last couple of months to just be with my family and prepare for this new life. Sending you all the coziest new baby snuggles 💕” her IG post reads.

10. Mayim Bialik

 

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In a personal essay on Today Parents, actress and neuroscientist Mayim Bialik detailed her experience with home birth. “My second son was born at our house, in the middle of our living room, just under three hours after my labor began in the darkness of dawn,” she writes.

Bialik cites a few reasons women often shy away from home births, including thinking that “birth needs a hospital.” She says this is untrue, as women have labored at home since the dawn of humanity. She affirms that women shouldn’t fear the pain of labor and delivery, as many natural methods can help, like baths, massage, and homeopathy. Bialik adds that birth is “gritty and primal,” so it’s normal for women to complain and scream during it. She also says midwives know when medical intervention is necessary and can handle things like unwrapping umbilical cords but will call paramedics for a ride to the hospital if needed.

Ultimately, the proud mom says home births are “right for people who want to take natural birth to the next level: Let me birth in the place this baby was created. Let me labor on the floors I paced in anticipation, let me labor in the rooms of the house where I mused on sleepless nights what this moment would be like.”

11. Kimberly Van Der Beek

 

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Kimberly and James Van Der Beek have a brood of beautiful children and are huge fans of the home-birth process. And this time, the proud dad shared the “realness” of home birth on IG right after one of their kids was born safely at home.

“The category is: Home-Birth Realness. (Word of caution, if you’re squeamish, just double-tap and move on 👍)” Van Der Beek’s post reads. “Messy bed ✔️ Plastic sheeting underneath old sheets ✔️Old towel crumpled on the floor ✔️ Vomit bag (unused) ✔️ Inflatable birthing tub (also unused 😬)✔️ Shirtless Dad ✔️Boy in Spider-Man pajamas ✔️Happy, healthy baby ✔️ Happy, healthy Mom in her own shower right after giving birth ✔️ Water bottle ✔️And… placenta in a mixing bowl ✔️ (I warned you 😬)”

12. Ricki Lake

 

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Ricki Lake is known for her ’90s talk show, but she’s also a staunch advocate for home births and the voice behind the documentary “The Business of Being Born.” Lake says she felt a pull toward home birth with baby No. 2 after having a bad experience giving birth in a hospital her first time. She wanted to push other women in that direction once she’d experienced a successful home birth.

Lake shared pictures of her home birth on Instagram for this year’s International Home Birth Day. In her caption, she shared, “Found these gems from almost exactly 22 years ago. My home water birth in my 🛀 bathtub changed every cell of my being. Full stop.” Lake also honored birth workers and asserted, “I found my power, my passion and true calling that day in my west village apartment.”

13. Bekah Martinez

 

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“The Bachelor” star Bekah Martinez is never one to hold back or be shy on IG, so her followers probably weren’t surprised when she shared a video of what she calls “one of the most powerful, magical moments” of her life — the home birth of her son, Franklin James.

Martinez says she hesitated before sharing such a “primal” and “raw” video, but ultimately, she realized that’s exactly what birth is. “I realized that I felt uncomfortable watching myself in that much POWER,” her IG caption reads. “I realized I still had so many negative, subconscious, deeply-embedded thoughts telling me that I wasn’t feminine enough; that I looked and sounded weird. I projected so many insecurities onto an experience that was truly one of the most powerful, magical moments of my life. This is a moment worth sharing; so in advance— f*ck the haters. ♥️”

The mom of two is now expecting baby No. 3, so we anticipate another birth video soon!

14. Morgan Miller

 

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Morgan and Bode Miller happily shared the news on IG that their twin boys, Asher and Aksel, had been born at home. She says they are gifts from their big sister Emmeline, who died in 2018 in a drowning accident at 19 months old.

The twins’ birth story is one for the books, too, as the babies were born so fast that the midwives hadn’t arrived yet. Bode shares that he had been pushing on Morgan’s hips, but he says, “As soon as I let go, the baby came out… he was fully in the sac of water.” Miller says his son was in a “clear water balloon” until his feet broke through and was “covered in vernix but completely healthy and happy.”

The couple then expected a break before baby No. 2, but that didn’t happen either. “The second one came out in one push. He was totally mellow,” says Bode. After the boys were born, the midwives burst into what the Millers describe as “a jumble of mayhem.”

“It was incredible. It couldn’t have been any better if you had scripted it,” Bode says with joy and pride. And, as a bonus, they got through the entire experience while the other kids were at school. Imagine coming home to that news!

15. Thandie Newton

Actress Thandie Newton tells Today that she felt “beautiful and healthy and wonderful” when she was pregnant, so giving birth at home made more sense to her, as that is where she feels the most “relaxed and comfortable.” She adds, “For me, it feels normal, but there was a time when everybody had their babies at home and it wasn’t such a big deal.”

That’s why Newton chose to give birth to her daughters, Ripley (born in 2000) and Nico (born in 2004), and her son Booker (born in 2014) at home. When asked about her son’s birth, Newton replied, “he was born on the bathroom floor,” which was as simple as that for the proud mom.

There are many ways women can safely give birth, and in the end, we all need support, just like the many celebrities who had home births. Home births have been a successful method of bringing babies into the world since the beginning, and today, many women feel the most comfortable giving birth from their homes. It’s your body doing the work, so do what feels right for you!

Childbirth can feel like heading into the great unknown. There are so many options, preferences, and expectations to consider. Birth positions, pain management, medical interventions, skin-to-skin, enemas, and the seemingly inevitable perineal tear. What if I have a 1st-degree perineal tear, 2nd-degree perineal tear, 3rd-degree perineal tear, or even a 4th-degree perineal tear?

The most common question I receive next to pooping during labor is, what happens if I tear? Perineal tears are a normal worry and an expected outcome of vaginal deliveries. Up to 90% of women will experience some degree of perineal tearing or laceration. Below, we will answer all your questions about perineal tears during delivery so you know what to expect.¹

What is a Perineal Tear?

Your body starts preparing for delivery in early pregnancy. Hormonal changes result in increased blood flow to your vagina, which can cause swelling, softening, and elasticity of the inside tissues. You may experience a difference in vaginal discharge. The microbiome of your vagina also changes to ensure a suitable environment for your developing baby.^5,6

The delivery of a baby causes a great deal of stress on the tissues of the cervix, vagina, vulva, and perineum. Your perineum is the area of skin, mucosal tissue, and muscle between your vagina and vulva and the anus and rectum. It is the most frequent place where tears or lacerations occur during vaginal delivery.¹

As you bravely push your newborn into the outside world, your body does its best to stretch and accommodate the head and body of your little one. A tear occurs when the tissues give way, as they often do.

What Causes a Perineal Tear?

Perineal tears occur for a few reasons, a couple of which are beyond our control:¹

• First vaginal delivery
• Large baby
• Rapid delivery
• Episiotomy

Despite your best efforts to prevent tearing during delivery, it is not so easily avoidable. But do not be dismayed. Your work to avoid tearing may decrease the severity of a laceration and aid in a seamless healing process.

Risk Factors for Perineal Tears

There are additional risk factors that may increase your chance of tearing during delivery:^1,4

• Forceps or vacuum-assisted delivery
• Fetal presentation. A “sunny side up” presentation is called an occiput posterior position or a compound hand position where your baby has a hand or arm alongside its head.
• Episiotomy. Though not routinely used in the United States, an episiotomy may be warranted in fetal distress.
• Prolonged pushing
• Asian descent

Four degrees of perineal tearing

The perineal area is full of muscles and soft tissue that provide stability and function to your pelvic floor. Perineal tears are classified by their degree of injury to the structures of the perineum:^1,4

• 1st-degree tear: As the least severe tear, this laceration involves the first layer of vaginal tissue and perineal skin.
• 2nd-degree tear: This most common laceration extends deeper into the vaginal tissue and the perineum muscles.
• 3rd-degree tear: This tear extends deep through the perineum muscles to involve your anal sphincter. The sphincter muscles surround your anus, helping you to control your bowel movements.
• 4th-degree tear: The most severe laceration extends through the anal sphincter muscles into the rectal mucosa.

Tearing in Other Places

It is possible to tear in other places aside from your perineum. For example:

• Your vaginal wall and labia are susceptible, especially if your baby’s hands are near their face during their exit.^1,3,8
• Cervical tears, though uncommon, can occur and often require surgical repair. Lacerations around the urethra and clitoris may also occur.^1,9,10

How Are Perineal Tears Treated

Thankfully, not all injuries to your perineum will require stitches. You may hear your obstetrician or midwife refer to “skid-marks,” especially if it’s not your first delivery rodeo. “Skid -marks” are scratches or cuts that do not require stitching. They only need time to heal and attentive perineal care, much like a scraped knee.

Most degreed tears will require repair with dissolvable sutures or stitches. Tears are repaired as quickly as possible to control bleeding. A local anesthetic such as lidocaine may be superficially injected into the torn tissue for pain control during the repair. If you have an epidural, pain-relieving medication will continue to flow while your tear is fixed. Tissue layers are sutured one at a time, with skin-to-skin being the final layer.¹

Your healthcare team will review the basics of perineal care with you, including a peri-bottle, an endless supply of sanitary pads, and, perhaps, disposable undies.

Complications of a Perineal Tear

Complications of a perineal tear can include pain and infection. Here are the most common complications.

Pain: The Most Common Complaint

Perineal pain is an unfortunate and annoying expectation while healing from a tear. Though this discomfort should not last long, here are some suggestions that may help:⁷

• Rest. We know this is hard, but so crucial in the days following delivery.
• Sitz baths
• Pour water over the area. Those peri-bottles are great for keeping clean and avoiding more abrasive toilet paper.
• Use of stool softeners
• Ice packs or padsicles
• Analgesic creams or spray
• Over-the-counter pain medications

In a few days, the pain will subside and be replaced with soreness and possibly itching as the tissues heal. Speak with your healthcare provider if your pain is significant. Extreme discomfort could indicate more severe complications.

Other Complications of a Perineal Tear

Perineal tears, especially third and fourth-degree lacerations, can potentially cause postpartum complications. Some physical complications include:³

• Wound infection
• Wound separation or dehiscence
• Bowel incontinence
• Urinary incontinence
• Sexual dysfunction

Healthy sexual activity contributes to overall well-being. Wait for the go-ahead to resume sexual activities from your obstetric provider. If you are experiencing discomfort and pain during sex, or are experiencing incontinence, speak with your provider about your concerns.

Perineal tears are a significant concern for many, but you will heal with prudent care and rest. Want the good news? Even if you experience a 1st-degree, 2nd-degree, 3rd-degree, or 4th-degree perineal tear during your first delivery, your risk of tearing a second time is significantly reduced.