So you’re having a baby? Tips to prepare for delivery

I bumped into a friend I hadn’t seen in awhile and was surprised to discover that she was 8 months pregnant! I only had a few minutes to give her some advice on how to prep for delivery and to prevent her own injuries as best she could. I came up with three things I thought were critical to get her ready and optimize her post-partum outcome. So I am passing my ‘sidewalk-session’ suggestions on to help you prepare for delivery, too! 

First, I recommended the blog on my site- How DO you push the baby out?  Written as a guest blog by a colleague it is great info on how to push to avoid mama injuries. Let’s avoid getting into trouble in the first place!! Hint: Learn how to shoot for the hoop, in other words practice where and how you are applying forces south. Active link in bio:

Next, I recommended my online course for women: Pelvic Floor Piston: Foundation for Fitness. Not trying to sound like a salesman, but it is the more complete version of all the advice I didn’t have time to provide in our brief interaction. It is a step-by-step guide to connecting the components of system directly impacted by pregnancy, and learning to re-balance the muscles and pressures that comprise our stability system (watch a clip explaining this here). Practicing coordinating these components and building habits now before she delivers will help make those strategies accessible out of the gate immediately post-partum. A key component is to learn to “blow before you go” (exhale BEFORE exertion, read more about that here). This helps to trigger the system automatically and blow off any pressure that could push against stitches from either a C-section or Vaginal delivery. This is critical to promote tissue healing in those first few weeks. This also prevents any added pressures on diastasis, urethral sphincters and bladders, and pelvic organs. 

Finally, I suggested she have a discussion with her provider regarding avoiding forceps delivery. Research indicates that there is a significant increase in birth injury risk to the mama with a forceps delivery. The most serious injury due to forceps is an avulsion. This is when the #pelvicfloor tears away from the pelvic bones. Approximately 50% women with forceps delivery experienced a pelvic floor avulsion, a similar percentage had an anal sphincter laceration. This can and often does set mamas up for a pelvic organ prolapse or incontinence issues. I am not trying to scare anyone, but this particular cause of prolapse and incontinence is avoidable. Some hospitals are actually doing away with this as a practice. You can choose instead to have a C-section if your labor is not progressing before things get to the point that the doctor may have to choose forceps delivery (vacuum deliveries, do not seem to statistically have a much greater risk). Think about it ahead of time for yourself so in the heat of the moment the you and the team are clear on what you want to do. I know some mama’s are very committed to vaginal delivery, but I want then to be informed of their options and the risks associated with their choices. Informed choices and #educatedhope!! PS In an emergent situation you may not have get a choice, but a convo prior may help with preventing things going too far before things become emergent.

I was so glad we connected before she delivered, and in enough time for her to start practicing and preparing! 

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2 thoughts on “So you’re having a baby? Tips to prepare for delivery”

  1. Randi says:

    I have really enjoyed your content, but suggesting that a woman opp for a c-section instead of a operational vaginal delivery, seems absolutely crazy to me. Your suggesting that the woman have major abdominal surgery, that carries its own risk often greater than forcep or vacuum delivery. To avoid possible prolapse or incontinece issues. How about you avoid possibly disrupting the woman’s entire obstetrical future, with a c-section.

    I’m a practicing midwife, I had a operational vaginal delivery my daughter, had a 3rd degree tear that took a full year to heal and had some major pelvic floor issues bc of it. Sign me up for that healing process and the work I had to do to get better, over a c-section any day. C-sections are great, amazing tools when used properly, they save lives and I’m grateful to have them, the use you are promoting does not seem appropriate.

    1. Julie Wiebe says:

      Thank you so much for weighing in with both your personal and professional experience and informed medical opinion on the idea. I am glad for everyone to see that opinions vary on this in the medical community. I guess I can only offer you my own professional experience and clinical reasoning as to why I made the suggestion. First, I think most women do not realize the potential consequences of forceps delivery, many don’t even know what it is or that them may have one. Conversely, every pregnant women knows what a C-section is (or should), and if they are not informed by a physician or midwife of the possibility and potential consequences, then the internet is chock full of information to help them. In addition, major abdominal surgery, while a big deal is a recognized hurdle if you will. You see the scar, can talk about discomfort you are having post-surgically without any shame associated with it, and likely if it didn’t seem to heal well or you had lingering symptoms you would seek help without hesitation. Most physicians are well versed in how to recognize, address, and advise a woman with complications or issues after an abdominal surgery.

      This is generally not the vibe around pelvic health issues post partum. I appreciate that you are an example of a success story, and I want folks to know that recovery is absolutely possible, bc some may not have a choice in an emergency situation or are reading this after a forceps delivery and experiencing symptoms. But while you preferred your year of pelvic floor rehab, others may not share your opinion of their experience. Prolapse and avulsion are often misdiagnosed, and/or undiagnosed post partum, in part because women don’t know the symptoms or that what they are feeling post partum aren’t normal. Many live with issues of incontinence (urinary and fecal) post partum bc they think that is what is supposed to happen once you have a baby. Many women don’t know how to get help, or are embarrassed to divulge symptoms they are experiencing, and not all medical folks know how to screen or address these issues.

      While I appreciate that C-section is a surgery, and carries risk immediately and for their obstetrical future. Generally from a healing standpoint, most moms heal from the procedure with scar tissue (sometimes problematic for sure).Healing the incision is not the end of their story. They absolutely need rehab and recovery strategies to help them restore their systems, function and fitness.. But a lot of women have multiple c-sections during their child bearing years, without need for revisionary surgeries years down the line.

      Again, pelvic surgeries and pelvic health have different issues to be aware of. A pelvic floor avulsion does not have a surgical option, and rehab must provide support by training the remaining tissues/muscle. Absolutely possible! But there is a whole lot more abdominals to make up for impacted abdominal tissue than there is pelvic floor IMHO. In addition, our current prolapse surgeries have a 3-5 year failure rate, and incontinence surgeries are often repeated at 5-10 years. (There are reasons for this that we can change…IMHO…and a post for another time perhaps, but for now this is very common). I don’t want women to have surgeries for these things, but in many areas there are NO pelvic health rehab providers to help them, or women are unaware of the existence of pelvic health rehab, so surgery or a pessary are offered to them as their only option. In addition, my primary focus clinically is active, athletic moms. Post-op prolapse surgery weight lifting limitations vary from surgeon to surgeon but generally are between 10-25#.. That’s not a lot for an athletic female. So if I could help someone stay off that path with information to help them start a conversation with their doctor/midwife, then I think that has a lot of value. I want women to be informed. I also know of many of my patients and folks I interact with online who are struggling with the decision to have another child because of the prolapse they experienced during their previous delivery. So pelvic injuries are also disruptive for many women’s obstetrical futures. I offered the information and presented as best I could to offer them information to be able to stimulate a conversation with their physician or midwife, who might disagree and make a different suggestion as you have. Women should be presented with their options, I was presenting an option they may not be aware of. I honestly don’t think that is crazy, but you are absolutely entitled to your opinion.

      One last thought, while I absolutely believe that a vaginal delivery offers the baby things that a c-section doesn’t we are making strides for natural c-sections to provide that for the baby and mama (baby is pushed out by the uterine contractions, smearing secretions to help with immunity, immediate contact with mom, clear drapes, etc). But I think culturally there is some shaming of women who have a c-section, that their deliveries are “less than” or people comfort them (“sorry you had to have a c-section”). I think we really need to take a look at that as a women’s health community. I know it is not the outcome some women want….but IMHO it is a success and special and their birth story and something to celebrate. Period.

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