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.
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 you and your 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 get a choice, but a convo prior may help with preventing things going too far before things become emergent.
Edit Jan 29, 2018: New information has come to light that I want to add to this post (published Jan 23, 2018). Please read the results of a long term study on the long term risks and benefits of C-Section. The link goes to a summary in the New York Times, but has a link to the actual study. I am posting this again, so that you can be completely informed of the choices you are making, particularly as it relates to the magnitude of the risks (the NYT article highlights this in the last paragraph). Please read and as with all advice, please have discussions with your provider as to your risks and the benefits of your options.
I was so glad we connected before she delivered, and in enough time for her to start practicing and preparing!
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