No one — not your
doctor, midwife, or even your mother — can reliably predict how your labor will
progress. Fortunately, there are a few exercises you can do now to help prepare
your body for what's to come.
Kegels: Kegel
exercises are small internal contractions of the pelvic floor muscles that
support your urethra, bladder, uterus, and rectum. Strengthening your pelvic
floor muscles improves circulation to your rectal and vaginal area, helping to
keep hemorrhoids at bay and speeding healing after an episiotomy or tear, if
you have one during childbirth. There's even some evidence suggesting that
strong pelvic floor muscles may shorten the pushing stage of labor.
You can do Kegels
anywhere — sitting at your computer, watching TV, even standing in line at the
supermarket.
Here's how:
• Tighten the
muscles around your vagina as if trying to interrupt the flow of urine when
going to the bathroom.
• Hold for a count
of four, then release. Repeat ten times. Try to work up to three or four sets
about three times a day.
Pelvic tilt :
This variation of
the pelvic tilt, done on all fours, strengthens the abdominal muscles and eases
back pain during pregnancy and labor.
• Get down on your
hands and knees, arms shoulder-width apart and knees hip-width apart, keeping
your arms straight but not locking the elbows.
• As you breathe in,
tighten your abdominal muscles and tuck your buttocks under and round your
back.
• Relax your back
into a neutral position as you breathe out.
• Repeat at your own
pace, following the rhythm of your breath.
Squat
It may not be the most elegant position, but squatting is a time-honored way of preparing for and giving birth. This exercise strengthens your thighs and helps open your pelvis.
It may not be the most elegant position, but squatting is a time-honored way of preparing for and giving birth. This exercise strengthens your thighs and helps open your pelvis.
• Stand facing the
back of a chair with your feet slightly more than hip-width apart, toes pointed
outward. Hold the back of the chair for support.
• Contract your
abdominal muscles, lift your chest, and relax your shoulders. Then lower your
tailbone toward the floor as though you were sitting down on a chair. Find your
balance — most of your weight should be toward your heels.
• Take a deep breath
in and then exhale, pushing into your legs to rise to a standing position.
Tailor or Cobbler Pose
This position can
help open your pelvis and loosen your hip joints in preparation for birth. It
can also improve your posture and ease tension in your lower back.
• Sit up straight
against a wall with the soles of your feet touching each other (sit on a folded
towel if that's more comfortable for you).
• Gently press your
knees down and away from each other, but don't force them.
• Stay in this
position for as long as you're comfortable.
Remember to start
slowly and work at your own level for each exercise.
In addition to the
well-known benefit of relieving urinary incontinence in pregnant women, regular
pelvic exercises (also known as Kegel exercises) make them less likely to have
a prolonged second stage of labor (pushing stage), according to a study in the British
Medical Journal (2004;329:378–80). Pelvic exercises consist of alternately
squeezing and relaxing the muscles of the pelvic floor, as when stopping and
starting the flow of urine.
Following the first
stage of labor, characterized by contractions that lead to increasing dilation
of the cervix (the opening of the uterus), the second, or active, pushing
stage, ends with the birth of the baby. (The placenta is delivered in the third
stage and the fourth stage is the recovery phase during which the mother’s
condition stabilizes.)
Women who have a
prolonged second stage of labor are more likely to damage the tissues around
the birth canal and to need an episiotomy (a surgical cut into the vagina and
surrounding tissues to facilitate delivery).
They are also more likely to bleed
excessively after the birth and to need a Cesarean section to deliver the baby.
The goal of the new
study was to determine the effect of pelvic-floor-strengthening exercises on
labor in 301 pregnant women. The women were assigned to either a
pelvic-exercise-training group or a control group.
The women in the
exercise group trained with an exercise therapist for 60 minutes one time per
week for 12 weeks between the twentieth and thirty-sixth weeks of pregnancy.
The women were also
encouraged to perform 8 to 12 intensive pelvic muscle contractions two times
per day at home during this period. The control group was not given pelvic
exercise instruction, but was not discouraged from doing the exercises.
The duration of the
second stage of labor and the number of prolonged second stage labors were
recorded. Women in the pelvic-exercise-training group were far less likely to
have a prolonged second stage of labor (lasting more than 60 minutes) than
women in the control group.
The new study
provides more evidence of the benefit of pelvic-exercise training in pregnant
women. Pelvic-floor exercises also increase circulation to the area, and may
help speed healing time and decrease pain after delivery.
Previous studies
have shown that these exercises also improve urinary incontinence, which occurs
when the muscles in the pelvic area become stretched during pregnancy, losing
much of their strength and elasticity, and providing less support for the
uterus and bladder.
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