Best exercises for first trimester

Best Exercises for First Trimester

Safe first trimester exercises

You’re pregnant! Most likely googling what you should do now- what vitamins should you take, what things should you now avoid, and what first trimester exercises you should (and shouldn’t) do. You may be feeling a new level of tired that you have never experienced and anything from slight nausea to “should I even leave the bathroom, this is going on all day why do they call it morning sickness?!”

The best things you can do to counteract nausea and fatigue is:

  • Listen to your body and rest
  • First Trimester Exercises! It sounds strange to tell someone to exercise when they are feeling fatigue, but it actually give you more energy and even minimize nausea for many. It also helps to set a good habit for pregnancy.

A lot of people are eager to prepare for birth and ask us if it’s too early to do prenatal exercises routines in the first trimester. The first trimester is the perfect time to begin! It is much easier to prevent pregnancy-related aches and pains than to eliminate them once they have popped up. We find that when people begin prenatal specific work in the first trimester, they may be able to prevent and minimize issues such as hip pain and core and pelvic floor concerns. For example, building stability in the hip musculature may help prevent the hip and back pain that is so common during pregnancy. Once the pain is there, it can be harder to work on it because movements that used to be available- now cause pain.

Below is our list of first prenatal exercises that you should begin in your first trimester

1. Candles Breath, core activation strategy

Benefits:

Candles is the basis for core engagement in the One Strong Mama world. We at BRM®️ strongly believe that no one should ever be walking around with their core engaged all the time. That is known as core tension and not core strength. However, we do teach our clients to use candles whenever they need support: picking up something heavy or another child, twisting and reaching for things, leaning forward to clean up, pulling open a heavy door. Anything that requires support. The default for many folks for these moves is to “let go” –which means to not engage, to bear down, bulge, brace– to default to a non-supportive pattern. To do this exercise, stand or sit and imagine that there is a birthday cake with 100 candles on it in in front of you and you need to slowly blow out the candles – feeling how your core tightens and pulls in as you do that. That is candles. As you blow out the candles, you can and should gently help your core by pulling it in as you blow. Your core should feel very tight and engaged at the end of that exhale.

Candles Breath, core activation strategy

2. Hip Hinge/ Deadlift

Benefits

This is a great prenatal exercise for learning how to move your pelvis! So often, we round our spine, rather than hinge at the hips in activities of daily life. Learning to hinge at the hips will help to create more active mobility of the pelvis and take the strain off the back. Place your fingers on your ASIS (anterior superior iliac spines – two bony knobs in the front of your pelvis) and feel them move as you hinge. It is helpful to do this the first several times in front of a mirror. Notice when the curve of the back starts to flatten, which will indicate that the pelvis has stopped moving and the back has begun to flex. If you are having a hard time with this, place a broomstick on your back and feel how the back shape does not change as you move forward through the motion. To rise, exhale, press into heels. This exercise is foundational and should be understood prior to moving onto the squat, which starts with a hip hinge. Holding weights or a kettlebell in the hands is another great option for the hip hinge.

Hip Hinge_ Deadlift

3. Aligned squats

Benefits:

This exercise for the first trimester is great for creating space in the pelvic floor. As the body squats the hamstrings lengthen and the pelvic floor gets an eccentric (lengthening) load. We encourage clients to door squat daily during pregnancy. Grab onto either the two handles of an open door, a TRX band, or anything sturdy that can support body weight. Hinge at the hips, and booty moves back  like it’s looking for a chair to sit on. Stop before the butt tucks under, indicating the max range of the hamstrings at that moment in time. If there is low back pain, try not excessively pushing the booty out to go down farther without tucking pelvis. To stand, exhale with candles deep core engagement and press into heels. Common cheat is to either overarch the low back or excessively thrust the ribs.

Aligned squats

4. Open twist

Benefits:

People, especially when pregnant, can become very rigid in their chest and rib muscles. When the chest and ribs do not move so well, we get added pressure in the abs and core so this move really helps to load these much neglected muscles. This exercise also doubles up as a core exercise. The common cheat here is to twist the pelvis and not the ribs and chest. Keeping the pelvis totally immobile can cause SIJ gapping and instability so a small amount of pelvic twist is fine. The issue is if they can ONLY twist by initiating from their pelvis. This can be done seated on a stool or a chair as well.

Open twist

5. Walk

Walk

Benefits:

While it sounds simple, walking is one of the best exercises you can do during pregnancy. Get in the habit of going for a daily walk, or walking to places you would normally drive to but technically could walk. And no, you cannot replace your daily walking with running… it’s a completely different movement. If it helps, consider tracking your steps to see how many you can get in a day.

6. Consider your alignment

Consider your alignment

Try relaxing (not forcing or muscling!) the rib cage down. Often we are taught that ribs lifted in “good posture,” but in reality it is compressing the spine and pulling the core out of alignment.

For more information on exercises that are appropriate for the first trimester and throughout the entire pregnancy and postpartum time, check out the Body Ready Method program. Many moms join our Body Ready Method program in the first trimester exercise. They love that it allows for them to just hit play and follow along and not have to think so hard about what moves are best for their pregnancy, their body and their birth. They also love that they get extra education about how to do each exercise so they are getting the most benefit. BRM®️ is truly a ‘one stop shop’ for prenatal (and postnatal!) exercise and takes the guesswork out of the equation. Check out our different targeted programs for each stage of your journey into parenthood.

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Prevent tearing during birth

Tips to Prevent Tearing During Childbirth

Many people’s biggest fear about childbirth is tearing.  Tearing is indeed painful and ranges in different degrees of severity. We have seen many women birth large babies without a tear and others tear birthing not-so-large babies. There are things you can do to prevent tearing or more accurately – minimize the risk of tearing. Here are our top tips of what to do, these are things you should do both prenatally and some great tips to do during birth to prevent or minimize tearing.

Prenatal Preparation Tips for Preventing Tearing

The list below is of things you should do during your pregnancy that will help reduce the risk of tearing during birth, it is easy to follow and require a relatively small effort to implement.

Hire a doula, take a Childbirth Education class, and learn relaxation techniques.

This one is huge because being calm during birth, finding good positions, possibly choosing to forgo the epidural (no judgement and we support all) is going to lessen chance of tearing or lessen amount of tearing.

Orgasms!

It’s not crazy- more blood flow to those tissues=good thing.

Nutrition.

Learn more about nutrition for better skin elasticity. Look into foods with Omega 3, Vit E, Vit C, and Zinc.

Lengthen and Release tension in the pelvic floor.

Find out how in a video posted to our FREE Facebook group. We should not have to PUSH SO HARD. If the pelvic floor is too tight (hypertonic) and does not yield well, it can make the pushing stage more difficult, which can increase the chance of tearing.

Balance the body.

We know there are certain fetal positions that are easier to get a baby out and certain positions that can be more difficult for some moms. If mom’s body is balanced, baby is more likely to find a more optimal position. The prenatal program has exercises and techniques designed to create balance in mom’s body so that baby can find a more optimal position.  We also recommend our friends over at Spinning Babies for techniques to be done during the 3rd trimester of pregnancy and during birth. Sign up for our prenatal program to get all the information you need for a pain-free pregnancy.

Birthing Tips

This list is of tried and true tips for how you approach your birth in order to reduce the risk of tearing during. I suggest you prepare yourself before the birth, arm yourself with knowledge and communicate your expectations with your provider ahead of time.

Consider going epidural free.

(note: we are not anti epidural) This will give more variety of positions for mom and also help mom to feel what is going on when crowning. If you do decide to go for the epidural, consider laboring down/passive descent where you allow your body to push the baby down most of the way, passively.

Optimal fetal positioning. 

During birth, have some Spinning Babies techniques in your back pocket, or hire a doula who knows them, so that if needed they can assist you in gently encouraging baby into position. Ideally, this is not something that the birthing mom should be having to remember and think about during the process. Rather, it is best to let mom relax and go inward while having external support to encourage the best positions as baby makes their journey down and out.  

Avoid the episiotomy.

An episiotomy is a cut performed by provider and is more likely to extend into a more significant tear. They were done much more commonly in the past, but new evidence suggests that it is not often needed and can cause long term issues (1). Additionally, it is easier for our bodies to heal from tearing than cut because tears tends to happen around the cells and an episiotomy cuts through them.

Pair of scissors

Safe environment.

This goes back to prenatal preparation. We need to get out of the fear-tension-pain cycle. Tension is not ideal for the mind OR the tissues. Create a safe place, wherever you are birthing. This may include things like dim lights, sounds and smells you enjoy, your own clothing, and people who love and support you.

a woman giving a birth

Mother-directed pushing vs. coached breath holding

(*****see our article on breathing the baby out) Additionally, when baby is crowning, slowing down!! When baby is on the perineum and there are strong sensations happening, sometimes we want to just push quick to get past it. But those strong sensations are our bodies way of telling us to slow down and let the tissues stretch.

Maternal positioning.

When we push on our back it decreases the diameter of the pelvis, which will mean we may need to use more force to get baby out. More force can put a greater strain on the tissues. If a baby needs help getting out, squatting is amazing, as it increases the diameter of the outlet of the pelvis. But if baby is coming fast or upon crowning, switching to hands and knees, kneeling in some way, or side lying is optimal as these positions puts less strain/force on the tissues.

woman after childbirth holding baby in her arms

Tearing is not something one would mention as the “highlight” of giving birth and it’s best when it’s avoided. This article offers a wholistic approach for preventing tearing during childbirth rather than a one “silver bullet” type solution that may address one root cause. Please read thoroughly and see if it makes sense to you. Please feel free to comment or ask question on our email.

(1)Lappen, Justin R., and Dana R. Gossett. “Changes in episiotomy practice: evidence-based medicine in action.”
Expert Review of Obstetrics & Gynecology
5.3 (2010): 301-309.
FitzGerald, Mary P., et al. “Risk factors for anal sphincter tear during vaginal delivery.”
Obstetrics & Gynecology
109.1 (2007): 29-34.
Samuelsson, Ellen, et al. “A prospective observational study on tears during vaginal delivery: occurrences and risk factors.”
Acta obstetricia et gynecologica Scandinavica
81.1 (2002): 44-49.

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How to have an easier birth

Prep for a smooth, efficient birth

Easier and childbirth are not typically words that are put in the same sentence. And of course there are many factors outside of our control. But we might as well take advantage of the factors within our control to make the birthing process easier. 

Easier meaning that the birthing process is optimized for a smoother and more efficient process. Not only is an easier birth is of course easier in the moment, but it also helps the recovery process to be smoother as well. Many people are talking about the importance of mental preparation and this is CRUCIAL to eliminating that fear-tension-pain cycle and making birth less painful. But what if the mind stuff is all figured out but the pelvic floor is still really tight and unyielding, or baby is in a less favorable position? Ideally we want to work on preparing the mind AND preparing the body. This article addresses the preparing the body for birth component. Something crucial yet rarely talked about. Rather than buying into the assumption that we are just victims to whatever is going on with our bodies, we must get into the driver’s seat and take control.

Why will preparing the body for birth make the process easier?

5-tips-when-your-baby-is-breech Lindsay

1. Better Baby Positioning

One of the reasons that body preparation for birth makes the process easier is that it helps baby to find an optimal position. Baby accommodates the space they are given.

 If they have less space, or that space is more roomy on one side, twisted, kinked, they are more likely to find a position that may not be as easy to birth. The simple fact of the matter is, baby’s tend to have an easier time going through the birth canal in a position like LOA, which stands for Left Occiput Anterior (see image), with chin tucked, smallest part of the head coming first. Posterior positions (baby’s spine against your spin. Sometimes called “sunny side up”) do not fit through the pelvis as well and can be accompanied by back labor, where contractions are felt very intensely in the back.

Proper body prep for birth takes baby positioning into account. When we balance and prepare the body we are not forcing baby into optimal positioning, we are just opening up the space for them to find it. Through balance, alignment, breathing and core support we support and give baby room. Babies are smart and they want to find the optimal position, we just need to give them the opportunity and room! Check out our different targeted programs for each stage of your journey into parenthood.

Occiput posterior

2. Body Balance + Alignment

When we find balance in the body- through the soft tissues (muscles) and boney structures (like the pelvis- which baby passes through), we help baby to find an optimal position which, as we mentioned above, can make the birthing process shorter, easier and more efficient. Additionally, when we learn how to carry ourselves throughout the day (alignment, as taught in One Strong Mama program) and use exercise techniques to create body balance, we optimize the function and space in the uterus, pelvic floor, pelvis. Unfortunately, not all exercise classes, even prenatal ones, have a solid understanding of pelvic floor, core, and alignment. So even though they feel good and are mentally extremely helpful, they are not necessarily helping to prepare the body for birth in a more specific and thoughtful way.

Woman squatting

3. Sacral Mobility

The back of the pelvis, called the sacrum, is designed to MOVE via the sacroiliac (SI) joint during the birthing process. This movement is called Nutation and Counter Nutation.

Modern life has made our sacrums much less mobile than they used to be. We sit on our sacrums all day and we don’t use our body’s in a way that allows freedom of movement for the amazing sacrum. Let’s learn how to free the sacrum via freeing up all the muscles attaching to it and sitting and moving through life in a way that doesn’t smash it. The first step is literally just untucking the pelvis through the day. The next step is supporting the movement of the sacrum through your exercise program so that you can free this amazing part of the body up so that it can do its job easier during the process of birth.

Sacrum movements in the pelvis

4. Pelvic Floor Yield

The pelvic floor must yield (open up) to allow baby to pass through. The goal is not a TIGHT pelvic floor. It’s a functional pelvic floor that holds everything (like our organs!) up and in when it is supposed to, but yields to allow a baby to pass through. Short and tight muscles do not yield well and if the pelvic floor is extremely tight, it can make childbirth much more difficult and can contribute to issues such as pelvic pain and sexual dysfunction. There is some thought that too much tension in the pelvic floor can contribute to a prolonged pushing stage. There are many different causes of a too tight pelvic floor and we see this issue come up in athletes and desk workers alike. Often the advice we are given to prepare our pelvic floors for childbirth is the kegel. While we are not anti-kegel, we do not think 100 kegels a day is the best approach for body preparation for children. Too many kegels might actually contribute to the problem. It is imperative that we learn how to prepare our pelvic floor in a way that allows it to strengthen to support our continence and pelvic health for life, but also allows yield for a baby to pass through.

Pelvis (left) superior view, (right) inferior view

To sum up, preparing the body for birth is important. Just as we must prepare our bodies for running a race, we too need to prepare our bodies for birthing a baby. Not only will preparing the body make the process easier, it will also set us up for long term health and vitality! And guess what? Body prep for birth is kinda our thing and we’ve got you covered if this sounds like something you’d like to work on. After years working with pregnant individuals in person, we knew we had to share this birth changing information with the world and developed the comprehensive online prenatal body preparation for birth program- where all of these topics of body preparation are addressed through exercise and education.

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5 tips for when your baby is breech

5 tips for when your baby is breech

5 tips for when your baby is breech - Baby

Don’t Panic.

Your baby may not stay in breech (head up) position. It is common that a baby will be breech between 27 weeks and 34 weeks of pregnancy. Most of those little nuggets will find their own way head down.

Some breech baby’s may need a little assist to find their way head down. Find out what techniques are safe, available, and supported in your community.

Often, you have many choices and opportunities to help your sweet baby find their way head down, and plenty of time to do it.

It's Okay.

  • You can do nothing. Many families choose to wait and see if baby turns back to head down on their own. It is okay take this route. However, if baby does not turn head down by 36 weeks your providers will propose an external cephalic version (ECV). This is a relatively safe procedure where an OB/GYN or Midwife will use their hands to try and turn baby head down. It can be very comfortable to down right painful. There is a 50% chance it will be successful. If you are working with a well experienced ECV doc the chance can increase up to 70%. So ask them, what is your success rate?
  • You may also choose to do nothing, and opt for a cesarean section. This is the most common choice of families who find out their baby
    is breech.

Complimentary Therapies

Let us talk about complimentary therapies that have been shown to be helpful in creating room in the body for baby to find their own way head down.

  • Acupuncture has a long history of assisting baby’s to find their best position. Several studies have shown that the combination of needling and moxabustion (the burning of mugwort herb) are effective methods of helping baby find their way into best position.
Woman receiving acupuncture on her face
  • Hypnosis is another therapy many find helpful in encouraging baby to find their way head down. Studies show that this is particularly helpful right before attempting an ECV.
Pregnant woman listening to music with headphones
  • Soft tissue therapies can be helpful to reduce your stress and help your soft tissues (muscles, tendons,
    ligaments, fascia) become more responsive and functional. These therapies can include, but are not limited to, massage therapy, myofascial release, Rolfing, Feldenkrais, Traeger, and many more. These therapies can potentially create more space in your belly for baby to find their way head down.
Pregnant woman lying on her back, two hands touching her belly
  • Dynamic Body Balancing™ taught by Dr. Carol Phillips is another method of bodywork that has been quite successful in helping babies find their way head down. Carol has a listing of practitioners on her website.
  • Spinning Babies™ has a series of exercises that have been helpful for many families to help get their baby into best position. Starting these exercises early, and doing them often garners the best outcomes according to data collected by Spinning Babies™ practitioners. Here is a link to the Spinning Babies™ website.

Use Your Brainn

Whenever you are presented with a method of helping to turn your baby, run through the BRAINN acronym. It is a good method to be sure you are doing what is correct for you and your family. What does BRAINN mean?

  • B – benefit – What are the benefits?  Everyone is happy to give you lots of benefits.  This is an easy one. 
  • R – risk – What are the risks?  Do not let anyone tell you there are no risks.  There is always risk when you choose to do an intervention.  Some risks are minimal, and some are a bit scarier.
  • A – alternative – What is the alternative?  There is always an alternative if the risk outweighs the benefit for you
  • I – intuition – What does your intuition tell you?  Do what feels right
  • N – next – What happens next?  Typically with any intervention, there is a next step.  Sometimes it is homework, sometimes it is rest, sometimes it is medication.  Know what procedure is for the practitioners you are working with
  • N – nothing – What happens if we do nothing?  Often, you have this choice.

Only do as much as feels right

Your care providers will be full of advice and suggestions for you and your family. It is easy to feel overwhelmed. Between going to work, going to appointments, caring for your family, and doing your breech homework, it may feel ridiculously exhausting. So, only do what feels like is working for you and your baby. You may try a therapy, and decide it isn’t right for you. That is totally okay. Everything is not for everyone. The appointments and homework need to fit into your lifestyle. This should not feel like a chore, but a choice.

  • Delegate. Reach out to your partner, your family, and your community to give you hand around the house. Check out our different targeted programs for each stage of your journey into parenthood – with tips and movements to help prepare you for your birth!
  • Get someone to help schlep your kids to and from their places.
  • Allow a friend to come in and clean your house, do a load of laundry, fix a meal for you, or sit and have a cup of tea with you.
  • The more you can reduce your stress, the more likely it is that you can get the self care you want to help your baby find their best position.

Adrienne C. Caldwell is a bodyworker and educator. She specializes in helping create space in the human body for baby to find their best position for labor and birth.

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How to prepare yourself for a natural birth

How to prepare yourself for a natural birth

So you like giving birth naturally…. Now what?

The Body Ready Method secret sauce for how to achieve the natural birth you desire.

Let me start with a little story. When I was pregnant with my first I decided that I wanted to have a natural birth. I did not really know much about it, except that I wanted to avoid the epidural. My thought was “women have been doing this for thousands and thousands of years, right? I am sure if they could do it, I can too.” And with that, I did very little preparing beyond reading all the natural childbirth books I could get my hands on.

Why I dedicated my life to childbirth

I will have you know that I googled “doulas near me” and did find that there was one an hour away. This was 2007 and doulas were not quite as known as they are now. I thought to myself, meh… I don’t want to spend the money and that is too far away. So on I went with my pregnancy.  Blissfully unaware of what was to come. Without making this entire article about my first birth story we will say that I ended up with what felt like every intervention in the book while still having the baby come through my vagina. After that birth, I vowed to learn everything I could…. And now I have dedicated my life to childbirth! I went on to have 3 natural water births and I serve hundreds of families as a childbirth educator and doula and I have learned a lot in my 12 years in the field. I am here to tell you want REALLY helps when planning a natural birth.

What are the Benefits of natural birth

Natural Birth Tips

Body Ready Method Recipe for Smart Natural birth preparation

So, what is the point of natural births? First of all, there are no medals in birth and this is not about bragging rights. Every birth is valid and every birthing person is amazing. Natural birth does have some amazing benefits to birthing person and baby and here are a few:

  • Decrease chance of cesarean
  • Freedom of movement
  • Avoid the cascade of interventions
  • May make labor and birth shorter and easier
  • Helps baby’s gut flora
  • Easier recovery
benifits of natural childbirth

1. Consider Birth Location:

Natural Birth Preparation

This and choice of provider are the most important decisions that you will make for your birth. Dr Neel Shah, OB/GYN, says that your number 1 predictor of cesarean birth is your place of birth . Do not enter into this decision lightly.

Natural birth in a hospital:

If you are planning a hospital birth, it is important that you research your hospital choice, including their cesarean rate. Here is an analogy: If you are wanting sushi, don’t go to the Italian restaurant. Even if they are nice and want to help you have some sushi, it will not taste the same as sushi from a restaurant that specializes in making it. So too, if you want a natural birth, you want to go somewhere that sees it regularly and knows how to support it well. If the hospital has a 50% cesarean rate and an 85% epidural rate, they do not see normal physiological birth very often. It is true that natural birth can happen anywhere, but you don’t want to have to fight for what you want and you want staff who knows how to support it well. Even well-meaning providers and staff may have a difficult time support normal, physiological birth if they do not see it very often.

Freestanding Birth Center birth (natural birthing center):

Freestanding birth centers are on the rise! While they are not yet in every community, they are a great option for low risk pregnant people. Do not confuse a hospital maternity ward with the words “birth center” in their name with an actual freestanding birth center. Some L&D wards have inaccurately started to market themselves as birth centers due to their growing popularity. While there is nothing wrong with choosing the birth in the hospital, it is very different than birthing in a birth center and should not be marketed as such.

Low Risk Pregnancy

Freestanding birth centers do not offer labor induction or augmentation with pitocin, epidural or other pain medications (though many offer nitrous oxide!), or cesarean sections. They are also not a good choice for someone who is higher risk. The provider (typically a midwife) will monitor the birthing person and the baby similarly to monitoring in the hospital and if needed, will transfer to the hospital in case of needed interventions or distress. If an epidural is desired, transfer will happen for that as well. The statistics show that 84% of those who begin labor in a birth center will birth there and 93% will have a spontaneous vaginal birth, regardless of if they transfer in labor or not. That means, that birth centers have a 6.1% cesarean rate , which is amazing! Freestanding birth centers are a good option for those with a low risk pregnancy who want a natural birth.

Home Birth:

Home birth is similar to birth center birth, just in your own home. Despite much misunderstanding among the general public, the same emergency equipment is brought to the birth including anti-hemorrhage medication and oxygen. Home birth providers, typically midwives, are trained to monitor pregnancy and birth well, transfer if the individual risks out during pregnancy or birth, and intervene when needed. Also similar to birth center birth, home birth is a good option for low risk pregnancies.

Also similar to birth center birth, home birth is a good option for low risk pregnancies. Stats show a 5.2% cesarean rate and primary reasons for transfer were non emergent “failure to progress .” When considering home birth, it is important to interview midwives and ask important questions about how they handle different situations and about their training and experience. Home birth midwives are trained and experienced in physiological birth and know how to support it well. If you want sushi, they are the sushi chef!

Birth location is a personal decision. There is not one right way to have a natural birth. Consider where you would be able to let go the easiest. Interview and tour different providers and facilities. And also listen to your intuition.

2. Choose provider wisely

After considering your birth location, you will want to consider your provider. There are generally three types of providers who attend birth: OBGYNs, Family Practice Doctors, and Midwives. Each tend to approach birth differently and it is important to research the differences. It is important also to consider the providers general policies and beliefs around the birthing process. Ask lots of questions . What is their cesarean rate? Why do they tend to induce (including if they induce at 41 weeks)? What is their episiotomy rate? There are many important questions to ask your provider during interview. I think we sometimes forget that we are in charge and we are the one hiring them, not the other way around. It is also helpful to ask the local birth community, if you have one, which providers tend to be most supportive of natural birth. Doula groups, for example, tend to know which OB/GYNS are natural birth supportive (rather than just paying lip service to it) and which family practice doctors and midwives are especially awesome. Depending on where you live, your options may be more limited. Even if there are not many options, it is still important to ask questions and make your preferences known far ahead of time.

3. Hire a Doula

Doulas are statistically proven to decrease cesarean rate, increase satisfaction with the birth experience, and decrease the use of pain medication and labor augmentation medication like pitocin. They offer a continuity of care, physical, emotional, and informational support that is absolutely essential to those planning a natural birth. While not all those who hire a doula will have a natural birth, having one by your side can significantly stack the cards in your favor. Additionally, a doula is an essential part of a medicated and cesarean birth team. They have a special role that is different and complementary to the role of the partner, nurse, and medical provider.

the evidence for doula

4. Take a solid Childbirth Education Program

Some childbirth classes are mostly “here is how to be a good patient at our hospital.” These are not the best childbirth classes for those planning a natural birth. The best childbirth classes will cover things such as:

  • pros and cons of different interventions
  • physiology of labor
  • comfort measures and techniques
  • how to write out your birth preferences

Childbirth education is not just for the pregnant person, it is extremely helpful for the partner as well. This is something that they have maybe never done, or only done a few times, and learning about the process and the choices that can be made is important for the birth partner because during the labor process they will be needed to speak to the staff and help the birthing person consider their options when the birthing person is in “labor land” and not as much in their “thinking brain.” Our favorite birth classes are Hypnobabies and Lamaze based classes.

5. Prepare your body

Pregnancy and birth is a unique and amazing physiological event and preparing well for. It includes specific body preparation to optimize the process. Our prenatal program, Body Ready Method , teaches how to specifically prepare the body for birth through our innovative Body Ready Method. It focuses on exercises that help create mobility and balance of the pelvis, yield of the pelvic floor, support with the core, and more. Preparing the body is an important, yet often overlooked part of preparing for natural birth and we do not recommend the old school recommendation of 100 kegels a day, which can actually create issues.

Pregnancy Exercises Tips

6. Prepare your mind

You would not go into an athletic event thinking “I can’t do this” and during the event you would not think “I can’t, I can’t, I can’t.” This is a recipe for a really difficult experience. High level athletes prepare their brains just as much as their bodies. The same is true for birth. We need to do the work ahead of time to prepare our minds to be able to let go during the strong sensations of birth. There are many ways to do this.
Hypnosis , pregnancy affirmations, and practicing having a calm mind during more challenging yoga poses  are all excellent options.

Distressing one’s life also helps prepare the mind to be able to be calm and collected during birth. If milk spills on the floor we can not control that it happened, but we can control our reaction to it. We can choose to freak out or we can choose to sigh and calmly clean it up. Of course there is a range between these two reactions. Choosing our reactions to life’s stress and having tools to be able to de-stress in hugely important before entering the birthing process and also for being a parent! Life skills!!

We cannot control everything about the birthing process. Even among those planning a natural childbirth who do “everything right,” sometimes unanticipated interventions will need to occur. Maybe even a cesarean. Yes, many interventions are used too frequently and that is why it is so important to educate yourself about them, but truly they are not evil and they are very necessary sometimes. The best we can do is prepare well ahead of time, set the stage and have an amazing team during the process of childbirth, and then let go. The only predictable thing about childbirth is that it is unpredictable. However, when you prepare yourself ahead of the time, you stack the cards greatly in your favor for a natural childbirth! Check out our different targeted programs for each stage of your journey into parenthood – with tips and movements to help prepare you for your birth.

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Preparing for a successful VBAC Birth

Preparing for a successful VBAC Birth

VBAC birth stands for “vaginal birth after cesarean.” VBAC statistics say, about 1 in 3 birthing people (31%) will give birth by cesarean in the United States with some hospitals reporting their cesarean rate to be as high as 60%. This is significantly higher than the World Health Organization’s recommended 10%-15% cesarean rate. Maybe you have heard “once a cesarean, always a cesarean,” however, evidence shows us that VBAC is a safe, sometimes safer, option than a repeat cesarean and should be given as an option, especially considering the fact that risks go up the more cesareans are performed. This article will tell you how to best prepare for a successful VBAC.

With that said, please know that cesarean births are valid and necessary. They’re not “the easy way out.” Nobody goes into a major abdominal surgery lightly. Choosing whether to attempt a VBAC or have an elective surgery is a personal decision, and neither is ‘bad.’ The most important thing is that the birthing person has a voice and is able to choose from a place of knowledge and support, not from a place of fear. And right now, we see  a lot more fear being thrown towards VBAC than the evidence suggests is necessary.

Too often, pregnant people are scared into a decision or choose a particular path because they do not realize that there are other options. And far too often, pregnant people do not realize that VBAC is a safe and valid option. Or they’re scared into believing that a repeat cesarean is the only way. 

This article aims to educate on the facts. So birthing people can decide for themselves which way is right for them. We also aim to educate on how to best stack the cards in your favor to achieve your VBAC birth, if you decide that’s the way you’d like to go!

Natural Birth after Cesarean (VBAC) Statistics

Most individuals who have previously had a cesarean, choose to have a repeat elective cesarean. Currently, there is an 89% repeat cesarean rate and an 11% VBAC statistic rate in the United States. Of the 11% who have a trial of labor after cesarean (TOLAC for short), approximately 60-80% will have a vaginal birth. While a VBAC is not right for everyone, it is a safe and valid option. 

vaginal birth

Those who have had a VBAC often describe the experience as empowering and often note that the recovery is easier than their recovery from a cesarean, which is a major abdominal surgery. While not all who attempt to birth vaginally after cesarean (TOLAC- – trial of labor after cesarean) will have a vaginal birth, there is some evidence to support the idea that laboring, even without being birthed vaginally, is actually good for the baby. 

What are the risks and statistics of VBAC?

Maternal morbidity, by method of delivery and previous cesarean history

Successful VBAC Birth

Are VBACs usually successful?

According to studies, 60-80% of folks who attempted a VBAC are successful. That is roughly 3-4 out of 5 birthing people! And we believe this stat could go even higher with the right preparation and support.

Is VBAC riskier or safer than a repeat cesarean?

According to the research, if there is no medically indicated reason for a cesarean, VBAC is likely to be safer. Additionally, the risks associated with cesarean increase the more they’re performed. So someone who is planning more pregnancies may want to consider VBAC as a safe and valid option. Multiple cesareans increase the risk of complications such as placenta accreta, placenta previa, and placental abruption. Interestingly, the risk of uterine rupture (which is 0.87% of those planning their first VBAC) actually decreases with each subsequent vaginal birth. The risk of uterine rupture is actually about the same as the risk of other birth complications that can occur, even amongst those who have never had a cesarean, such as shoulder dystocia and hemorrhaging.

While this can sounds scary, it is rare and not more risky than complications that can occur during  a cesarean section. With that said, it is important- no matter whether you are planning a VBAC or a Cesarean that you have a provider that you trust that, in the event of a rare complication, knows how to appropriately intervene. It is also important to not only look at the research, but to listen to your gut. Only you get to decide and your choice, no matter what it is, is a valid one.

I was told that my pelvis was just too small for VBAC

The pelvis is not a fixed entity. It has joints and is mobile! Moreover, it’s impossible to know for sure what it will do during the process of labor and birth. The pelvis is held together by muscles and ligaments, and these muscles and ligaments are not fixed. Meaning, the pelvis shape can change,  both during the birthing process and based on how we move it throughout our lives. This is one of our WHYs behind the BRM program 𑁋 we know that how you move throughout your day matters, so we give you moves you can easily incorporate into your day along with workouts that are designed to create the most space in the pelvis for the baby.

Here are some VBAC success stories from our own BRM®️ users:

“It is because of the program I was able to have a vbac with no pain meds due to all the breathing and classes you provided!”

Kathleen Zimmerman, BRM®️ user

 

“…my second vbac, my water broke as I pushed her out (I swear I pushed less than 10 times) and I was left without a tear…” 

Jessica Thomson, BRM®️ user

 

Cephalopelvic disproportion (CPD) is a real thing, but it happens much more rarely than it is diagnosed as the cause for cesarean. Often CPD is associated with pelvic anomalies.

Image of the inlet pelvis with a baby's head coming through
Interior Pelvis

In the past, when nutrition wasn’t as readily available, CPD was observed in those who were malnourished as children while the pelvis was growing. Another occurrence that is commonly overlooked when the CPD diagnosis is slapped on, is the position of the baby. A baby whose chin is not tucked, whose head is tipped to the side, or who is in the posterior position has a greater surface area that needs to make its way through the pelvis. It’s rather common that I see individuals who were told they were simply “too small” to birth their babies go on to birth babies that are 1-2 pounds larger vaginally with no issue. With this said, there will be a small segment of individuals who truly have CPD. And for those individuals, a cesarean will be needed.

Line graph, showing risks for a uterine rupture decrease with each additional planned VBAC
Risk for Uterine Rupture

VBAC uterine rupture stories

Less than 1% (.87% to be exact) of those laboring for their first VBAC will have a uterine rupture.

There’s a lot of fear and misinformation being spread about uterine rupture, so let’s just lay out the stats. Less than 1% of those laboring for their first VBAC will have a uterine rupture. This is roughly equal to, if not slightly lower, than the % of complications that can occur across all those giving birth, not just those planning for VBAC.  Shoulder dystocia and hemorrhaging, though risk of hemorrhage is higher during cesarean birth, are some complications that can arise during birth.

This isn’t to say that uterine rupture isn’t a valid concern, it is. But we must also look at it from a statistical standpoint. It is indeed a rare occurrence. Additionally, after each vaginal birth, the risk of uterine rupture goes down. But with each cesarean performed, the risk associated with the surgery actually goes up.

How to avoid a second c-section and have a successful VBAC Birth

Preparing for VBAC

How to Prepare for VBAC Birth

1. Find VBAC friendly doctors

The #1 way to stack the cards in your favor for a VBAC is having a provider who is truly supportive of VBAC. There are too many stories of “bait and switch”, where providers seem to be on board with plans to VBAC until the last minute, suddenly changing their tune. This is not only stressful, but also makes VBAC much more difficult. 

 

The best way to figure out if you have a supportive provider is to first, reach out to your local ICAN (International Cesarean Awareness Network) chapter and your local birth community (doulas, childbirth educators, etc). Ask them which providers they see as the most supportive of VBAC. The next step is to look at the following chart and ask your provider questions to learn if they are VBAC Supportive or just VBAC Tolerant. VBAC tolerant providers attend them sometimes, but everything has to line up a certain way.

2. Prepare your body

Lindsay McCoy (left) helping a woman (right) squat correctly and safely
Squats One Strong Mama
Preparing the body for birth is an important but often overlooked step of preparing for a VBAC birth. Our body responds to the input placed upon it. Meaning, when planning for birth, it’s important we input it with movement that allows for a mobile, balanced pelvis. Having a pelvis that MOVES well is hugely important. At BRM®️, we have a multi-pillared approach to preparing the body for birth. Two critical pieces of the puzzle that I would like to discuss are sacral mobility and pelvic floor yield. Check out our different targeted programs for each stage of your journey into parenthood.

Pelvic Outlet

The sacrum is part of the pelvis that is designed to MOVE via the sacroiliac (SI) joints. There are certain movements, such as sitting on the sacrum all day, that can create immobility and lack of balance in the sacrum. For this reason, it is incredibly helpful to learn workouts, alignment, and nourishing movements that allow for sacral movement, so that it can move more freely during childbirth.  

Sacral Mobility:

Sacral mobility + pelvic floor yield

Pelvic Floor Yield:

Superior and inferior view of the pelvis
Inferior-Superior Pelvis

Sometimes, if the pelvic floor is hypertonic or “too tight,” it can make it more difficult for it to yield to allow for a baby to come through. We ideally want a pelvic floor that’s strong enough to hold up our organs (and our pee when we sneeze!), but is also able to yield. A muscle that’s too tight isn’t a stronger muscle, it’s just tighter. And tighter often equals less functional and can also be associated with a lot of pain. Learn how to keep the pelvic floor strong AND yielding throughout pregnancy (and life!). Hint: 100 kegels a day is not the ticket and can actually create issues for many.

3. Prepare your mind

Just as we should prepare our body for birth, we also should prepare our mind. Many times, when someone has had a previous Cesarean (and even many who haven’t!), there is birth trauma. It’s so important to be able to release that trauma and fear prior to going into the next birth experience. There are many ways to do so, including speaking to a therapist who is trained and experienced in birth trauma, mind-body modalities, and one of my favorites are Hypnobabies or other hypnosis for childbirth programs. I am partial to Hypnobabies as I used it for 3 of my births and attend many Hypnobabies births, including VBACs. 

I explain it this way: If you go into a marathon, even if your body is ready, and the entire race your inner dialogue says “I suck, my legs hurt, I’m tired, I can’t do this, this is hard”, how far do you think you’ll go?  Similarly with birth, we need to prepare our minds, ahead of time. There is so much going on beneath the surface that is better to address prior to birth. If not addressed, it may be much more difficult to let go in the way birth necessitates.

Pregnant woman seeking advice on laptop

4. Hire a doula

Lindsay McCoy helping a client give birth

Hire a Doula

Doulas improve birth outcomes…

Research has shown that doulas improve birth outcomes. They lower the risk of cesarean by anywhere from 28%-56%, depending on the study. They can help you know your options, support you while you consider the pros and cons of interventions, support the emotional journey of TOLAC, cesarean or VBAC both prenatally, during the entire birthing process, and postnatally. Many are trained to help with baby positioning and creative birth positions to make the birth process go smoother. We train birth professionals to understand how to encourage a smoother labor and delivery 𑁋 check out our directory of trained pros.

The Evidence for Doulas

As a doula myself, I attend many TOLAC/VBACs, and everyone needs support a little differently. Some need a lot of emotional support prenatally, others need more use of creative birth positions, and others maybe need more postpartum support in processing the birth experience. Support will look differently each birth and with each family, but what doesn’t change is that continuity of care. A doula is with you through your pregnancy, entire birth experience including time you labor at home, and is there to check on you after the birth. Interview a few doulas to find the right fit for you. Look for someone who is experienced with VBAC and understands baby and body positioning (if they are Body Ready MethodR  trained, even better).

the evidence for doula

Whatever you decide for your birth, decide it because it is what YOU want, not because of fear or what other people think you should do. Truly, there is no one right way to give birth.

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Exercises to Prepare for a C-Section

Exercises to Prepare for a C-Section

At Body Ready Method®, we believe that every birth is amazing and beautiful and having worked with many families who have had a cesarean birth, we know that our cesarean parents are freaking rockstars!
What the belly looks like after a c-section
Regardless of the type of birth, your pregnancy and growing baby can cause a lot of stress on your core and pelvic floor. It’s important to give special attention to your deep core system while planning for a cesarean birth to prevent diastasis recti and pelvic floor dysfunction after birth. A lot of the exercise prep work is the same, regardless of the mode of delivery. However, there are certain moves that a person planning a cesarean birth may want to pay special attention to. Here are some of them:

1. Spinal Segmentation

When preparing for an epidural/spinal, it’s very helpful to be able to segment the spine! Pay special attention to spinal flexion (back rounding). As pregnancy progresses, avoid excessive spinal extension, but some is just fine! Having a mobile spine is important for a functional core, as well!

2. Candles/Deep Core activation

It’s so important to connect with your core. On its own, and with movement. Exhale and engage. We teach people how to train their core to be responsive and reflexive. That starts with learning HOW to activate it. This will be very helpful as you learn how to reconnect with your core post cesarean birth. This can help you have a smoother recovery and connect with your core more easily post-birth.

3. Side Bend

Mobility in the trunk is crucial for core (and thereby pelvic floor) health. Make sure you actively resist the movement, as if moving through syrup. Notice the tendency to flop… Deeper isn’t always better!
Group of pregnant women doing Seated Side Bend

4. Hip Hinge + Slide

Getting those glutes and the whole backside long and strong is critical for pelvic floor health. Research shows that you can have pelvic floor dysfunction no matter the mode of delivery – so learn how to have a responsive pelvic floor!
These are some exercises to prepare for a c-section. If you are preparing for a cesarean birth, give these simple moves a try!
Check out our different targeted programs for each stage of your journey into parenthood- with tips and movements to help prepare you for your cesarean birth!

Are you ready to rock your pregnancy with a free workout on us?

We would be honoured to support you on your marvelous journey.

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Baby Is In Breech Position, Now What?

Baby Is In Breech Position, Now What?

Don't panic if baby is breech.

The baby may not stay in breech position. It is common that a baby will be breech between 27 weeks and 34 weeks of pregnancy. Most of those little nuggets will find their own way head down. Some breech babies may need a little assist to find their way head down. Often, there are many choices and opportunities to help breech babies find their way head down, and plenty of time to do it.

breech baby

Know your options if baby is breech.

  • Your client can choose to do nothing.  Many families choose to wait and see if baby turns back to head down on their own.  It is okay to take this route. However, if baby does not turn head down by 36 weeks an external cephalic version (ECV) should be suggested.  This is a relatively safe procedure where an OB/GYN or Midwife will use their hands to try and turn baby head down. ECV can be very comfortable to downright painful for your pregnant client.  There is a 50% chance it will be successful. If you are or know of a well experienced ECV doctor your client can see, the chance can increase up to 70%. Whatever the case may be with your client, make sure they are asking ECV doctors for their success rate.
  • Your client may also choose to do nothing, and opt for a cesarean section. This is the most common choice of families who find out their baby is breech.

Use your BRAINN:

Whenever presenting a method of helping to turn a breech baby, run through the BRAINN acronym with your client. It is a good method to be sure they choose what is correct for them and their family. What does BRAINN mean?

  • – benefit – What are the benefits? This is an easy one.
  • – risk – What are the risks?  Every method will have risks. There is always risk when you choose to do an intervention.  Some risks are minimal, and some are a bit scarier.  
  • – alternative – What is the alternative?  There is always an alternative if the risk outweighs the benefit for your client. Make sure you are ready to offer one.
  • I – intuition – Make sure your client is listening to their intuition. They should do what feels right to them.
  • N – next – What happens next?  Typically with any intervention, there is a next step.  Sometimes it is homework, sometimes it is rest, sometimes it is medication.  Make sure your client knows what the procedure is for the practitioners they have chosen to work with.
  • N – nothing – What happens if we do nothing?  Often, clients have this choice.

Let your client know it is okay to only do as much as feels right.

Massaging Tummy

It is easy for your pregnant clients to feel overwhelmed. Keep in mind they are going to work, going to appointments, caring for their family, and doing breech homework, it may feel ridiculously exhausting. Make sure they are only doing what feels right for them and their baby. Let them know it is more than okay to try a therapy and decide it is not for them. Everything is not for everyone. Appointments and homework need to fit into their lifestyle. It should not feel like a chore, but a choice. With the BRM® Pro Training, YOU become the expert, equipped with a thorough understanding of their pregnant and birthing body, what it’s capable of, and the tools it will best respond to. Learn more today!

Author Bio: Adrienne C. Caldwell is a bodyworker and educator. She specializes in helping create space in the human body for baby to find their best position for labor and birth. 

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