The anxiety and stress about birth can be really intense. It seems like every mom you know wants to tell you their horror story. You read forums and are in moms’ groups.
Moms who exercise are also told that labor will be a cinch. No problem at all because you’re fit. This is really well-intentioned and sometimes it is true, but we need to be careful. Birth is a very crazy and somewhat complicated experience. There are so many scenarios that can happen. Sometimes your fitness helps you and sometimes it doesn’t. Your birth story will play out in its own way and it will be unique to you. We really don’t want a mama to feel like they “failed” in their labor. Especially if they repeatedly were told that it would be no problem because of their exercise routine. We’re here to tell you, you did NOT fail. Things that happen in labor outside of our control.
So how can pregnant athletes (or any mama) prep for their labor? Well first we think it is super important that you know what happens. Then we give you five tips for how you can cope the best you can with it.
There are three stages of labor but for most people the first two are what matter the most. The first stage of labor is early labor. When you are pushing, that is active labor. We’ll break down both.
When people tell you “they were in labor for 26 hours or 48 hours or 6 hours”, they are telling you the amount of time from start to finish. This is not that they were in active, OMG I’m swearing pain that ENTIRE time. This is important to consider.
When you’re in the first stage of labor, that is when you start having contractions. They’re usually less intense, more spread apart and don’t last as long. You re considered to be in the first stage from 0 cm dilated to 6 cm dilated. This is the phase that lasts the longest. It can be from 8 hours to 36 hours. But during this phase, you’re usually at home and you can (at least try) to relax.
The rule of thumb GENERALLY for going to the hospital is when your contractions become less than 5 minutes apart, last for a minute and have been doing that for an hour. This is called the 5-1-1 rule. If you have any bleeding or are concerned in any way, go into your medical centre or make sure you keep in contact with your midwife.
The second stage of labor is when you are pushing. Again, what many women don’t know is this comes in waves too. This is when your baby has descended further into your pelvis and is trying to come through the birth canal. People think this is where fitness athletes thrive. Where you take two pushes and you’ve got your baby out! That doesn’t always happen and sometimes maybe shouldn’t. Listen to your body here. Let yourself wait in between contractions. This is when you want to relax your pelvic floor which seems so impossible to think about. Once you have delivered the shoulders, the rest of babe falls out and you listen for that wonderful first cry.
We often advocate for early skin to skin contact and delayed cord clamping if possible. Early skin-to-skin contact is when baby goes right onto mom’s chest. It’s also when you can start trying to breast feed. There is some thought that this can make for less issues with breastfeeding later on if you get that good early attempt right after birth. Delayed cord clamping is to keep the umbilical cord attached for several minutes post-delivery before cutting. The thought is that there is lots of nutrient rich fluids going to baby still and it can help with the immune system.
Second stage is where there can sometimes be issues with baby trying to progress. If your pelvic floor is too tight or you’re having trouble relaxing, pushing can last longer because baby can’t descend. This is often called a failure to progress. (Evidence based birth has an amazing podcast on this topic, you can find it here).
During this time, baby will often be monitored for signs of distress. It may occur that because of a complication or issue with baby, a C-section will be required. We have another blog post coming up about that topic!
The second stage of labor can last anywhere from 20 minutes to 3 hours. Longer times are normal, especially for first time moms. It is also important to know that if you have an epidural, your pushing phase will likely be longer. Again… that’s normal.
The third stage of labor is the shortest and often the most forgotten about. This is the delivering of the placenta. It can last for 15-45 minutes. It seems so much less exciting after baby is in your arms. It is still very important. Having your placenta or a piece of your placenta not getting delivered can be dangerous. Your healthcare team will make sure everything is okay.
Then what?! Baby is with you and then you’re just … done?
Your midwife or OB will assess you for any tearing of the perineum (a blog post is coming on this). Your perineum is the skin and muscle from where the bottom of your vagina to the top of your anus. If you have had tearing (which is very common), you might need to get stitched up. If you had an unmedicated birth, this would require freezing. If you have had an epidural, that freezing will already be there.
If you were unmedicated during delivery, once you have been stitched up, you’ll be able to get up and move around if you want to or you’ll be wheeled to recovery. Some women are able to get up very shortly after delivery and have a truly wonderful shower. You will continue to be monitored for anywhere from a couple of hours to a couple of days depending on your circumstances. They’ll start to make sure that the size of your uterus starts to go down by touching on your stomach which can be a bit uncomfortable. They’re looking to see that your body is going into recovery mode.
If you decided to go for the epidural, the medications will have to wear off before you can move anywhere. There is a catheter in place that will need to be removed. Before you can go home, your healthcare team will want to know that you’ve been able to go to the bathroom.
Some women will experience some soreness around where the needle went in for the epidural. If this is you, normally this subsides after a couple of days.
That all seems like a lot. Knowledge really does help. If you are looking for more information, I really encourage you to find a Birth Prep course for you or you and your partner. Especially if you have a lot of anxiety about birth, this can be a gamechanger.
For now, we want to leave you with a couple of tips that we think are relevant specifically to the athletes among us.
When we are pushing, we need to think about relaxing. I know. It’s easier said than done. But when the baby is trying to get into the birth canal, you need to let him or her! If we tighten up, our pelvic floor can be prevent baby from getting lower and it can make us have to push for longer! That is something no one wants to do.
We recommend practicing this BEFORE your big day. Barbell athletes are very good at tightening their pelvic floors. We have to all the time to make sure we don’t pee when we lift. The opposite needs to happen. We want to bear down, relax, and let baby come into the world!
Fitness can help you during labor and delivery FOR SURE. Some research seems to think we recover a bit faster if we’re more active than if we weren’t. But during active labor, this might not be 100% accurate. We have seen mamas who had births by C-section or had longer labor times think they failed in some way. They thought their fitness would prevent these things. Birth is a wild ride. Our fitness helps us but there are so many twists and turns along the way that sometimes we can’t control. Fitness can help but it doesn’t guarantee things will be easier or shorter. I’m sorry! I know we want to believe that is true 100% of the time!
As barbell athletes, we’re used to tightening our pelvic floors as we hold our breath. This is the opposite of what we want during active labor. Practice before you go into labor cause when you’re in pain, sometimes it’s hard to think about anything else. We usually recommend trying to relax your pelvic floor or do some relaxation exercises after you lift weights during pregnancy. This is when you tend to be used to flexing and when it might be hard to relax. It’s the perfect time to practice. We did an Instagram post on three exercises to use to relax your pelvic floor. You can find them by clicking this link!
It can be like a badge of honor if you only pushed for 30 minutes. But we want to tell you that that is not always the goal you want! You want to listen to your body. Contractions always come in waves. The signal to your body to push does the same thing. Relaxing when the baby’s head is right at the edge of your vagina is TOUGH but it can give your body time to stretch. This is important! A relaxed pelvic floor can prevent tearing. Trying to active labor “for time” can make things progress too quickly and might lead to tearing. Let your tissues stretch and move. Push when your body is signalling for you to do it. You’ll thank us later. You might not thank us at the time.
When you’re in the middle of a long labor, it can be hard to even be listening to those who are speaking around you. It can be hard to even think clearly. So when a member of your healthcare team is presenting options to you or telling you about what is going to happen next, it can be a blur. This can be hard because women may not feel in control of their birth experience.
That is where your support team comes in.
It is important that the person or persons in the room with you, knows what you want. Let them know your birth plan. Let them know if you are open to an episiotomy or not. What you think about birth position. If you want any medications, certain medications or none. Let them be your advocate. Getting a doula either virtually or in person is another great option. Doulas (link to doula organization) help to support your birth. They know the ins and outs and can be a wonderful help to moms. Feeling supported and like you had some control over your experience can be a game changer. Feeling out of control can put a negative spin on your birth story if you weren’t ready for it.
Birth never goes according to plan. It doesn’t happen like the movies. It can be complicated and confusing. It can last longer or shorter than we expected. Knowing a general idea of what you want is important. Being rigid and thinking it HAS to go that way can make any small change seem like a big one. Think of your birth plan as a general outline that has some flexibility.
Birth is a wonderful experience. But it can also be traumatic. Being prepared can help manage expectations and help increase your chances of a positive outcome.
You got this mama!!
Christina Prevett is a pelvic floor physiotherapist who has a passion for helping women with different life transitions, including postpartum care and menopause.
