Medications and vaccines

Immediately after giving birth, routine care for newborns includes a few different treatments. It can be really helpful to know more about these recommendations ahead of time!

An antibiotic eye ointment, called erythromycin, is a clear gel that is gently squeezed into each eyelid. It looks greasy, but should not cause your baby any discomfort. It helps to protect against an eye infection called neonatal conjunctivitis that can be caused by many different bacteria present in the vagina, or rarely in amniotic fluid. Neonatal conjunctivitis can cause serious complications like blindness and requires IV antibiotics for treatment. In some states, you may not be able to sign refusal for this medication, it is mandated by law. 

Vitamin K is a small injection of — you guessed it — Vitamin K. Vitamin K is essential for forming blood clots. After infancy, our bodies develop bacteria in the gut that make Vitamin K for us. But when they’re born babies don’t have this in their bodies yet. The shot gives them protection against bleeding while they develop their own gut bacteria to take over the job of making the vitamin for them. 

Not having enough vitamin K can cause bleeding issues that range from minor — like a little extra bleeding after getting a shot — to a severe condition called Vitamin K Deficiency Bleeding, which can be fatal. Many parents are curious about using oral Vitamin K as an alternative to the shot. This is an option, but because Vitamin K in this form is processed through the digestive system (instead of going directly into the muscle and being absorbed into the bloodstream with the shot), oral doses have to be given weekly and are less effective than a one-time injection of the vitamin. Therefore, they are not typically offered or recommended. 

Hepatitis B is the only vaccine recommended for newborns. It is part of a 3 dose series, which is continued at your well-baby visits. If you have tested positive for Hepatitis B during pregnancy, the routine for your baby’s care will be slightly different.

Hearing, hearts, and jaundice

Some routine testing, like a hearing screen, cardiac screening, or bilirubin scan, are brief and non-invasive. Checking your baby’s hearing, pulse oximetry, and their jaundice level are all things you can expect before going home. If there are any red flags on those tests, your pediatric provider will discuss your options and next steps (which are often just re-checking the tests at a later hour or day). 

You might wonder why it’s so important to do these tests in the first days of your baby’s life. Let’s break it down. 

Hearing test 

A hearing test is important because even a newborn baby is already learning language. If their hearing is impaired (even in just one ear) knowing and addressing it early on can make a big difference for your baby’s language development. 

Oxygen levels

A pulse oximetry test of your baby’s oxygen level in different parts of the body — usually done by putting a sticker with a red light on your baby’s hand and foot. This test can help to catch worrying heart problems that happen in about 1 in 1,000 babies and might otherwise go unnoticed. 

Jaundice screening 

Jaundice screenings, often also done with a special light placed on your baby’s skin, make sure that bilirubin levels aren’t getting too high. Sometimes instead of a skin sensor, this is checked using a blood test, collected along with the blood sample discussed below. High bilirubin levels can cause problems like lethargy, poor feeding, and in some rare extreme cases, brain damage.

Newborn screening

Newborn screening is another test that is typically done after your baby is 24 hours old. It involves a small blood sample. You might picture having your blood drawn in your arm as an adult, but this test requires a very small sample and it can be tricky to find a tiny newborn vein. So most of the time, a heelstick is used. Your baby will have their foot warmed and then a small prick is made in their heel. Some babies barely notice, others might cry. Blood is collected onto a paper form, which is sent to your state’s processing lab by the hospital. 

But why?

The biggest question is, what are they screening my baby for? And that’s a great question! The answer varies because testing is a little bit different in each state. In general, the test covers multiple conditions that a baby can be born with and are impossible to see on a physical exam. Most of these conditions have treatments that are important to start early in life, so testing is essential.

It can be helpful to check what the testing requirements and suggestions are in your area, and discuss any particular concerns you have with your pediatric provider — such as a family history of a metabolic disorder. You can look up what your state tests for here if that information isn’t provided by your hospital. If you give birth outside of a hospital, it’s recommended that you have newborn screening done between 24 and 48 hours of life. This can typically be done by your home birth or birth center provider, or at a lab. 

Reviewed by the Ovia Health Clinical Team

Read more

• Recommended immunization schedule for baby’s first year
• Baby check-ups

Early baby movement

Many feel those first swishes and flutters some time between week 16 and week 20, but it can be tough to distinguish between these tiny sensations and gas. Still, these first movements are exciting and reassuring. They’re generally not consistent, and it’s very normal to go days without feeling any movement at all during these weeks. 

Baby movement during weeks 24-28

By this time, most people are able to sense their baby move daily. You might have a sense of their natural rhythm (do you have an early bird or a night owl?). By 28 weeks, many healthcare providers recommend a daily “kick count” if you have any concerns about how often baby is moving. You can find out more about how to do that with the Ovia Kick Counter here.

Which movements are normal?

As your baby grows, you may be able to distinguish between kicks, punches, and stretching. After a big meal, you may notice baby moving much more than usual. This is not cause for alarm — it’s a natural reaction to an increase in your blood sugar. Increased movements are generally a very reassuring sign of how baby is doing. Sometimes you may notice a rhythmic bouncing feeling — generally these are hiccups! They are very common (some babies get them every day), and again, not a cause for concern (just super cute). 

What if I’m not feeling anything?

If you’re early in pregnancy (before 20 weeks) it is completely normal not to have felt baby move quite yet. After that point, the types of sensations people have varies. In particular, those who are pregnant with their first baby and those with anterior placentas are less likely to notice all of their baby’s movements. You and your provider can work on a plan after 28 weeks to count movements or use another method to check on baby’s wellbeing. 

For any parent after 28 weeks, losing the sensation of baby moving can be really scary and should be addressed. If kick counting doesn’t offer any reassurance, you should always feel empowered to contact your provider or seek more urgent care, as there are many ways to check on your baby!

Reviewed by the Ovia Health Clinical Team

Read more

• Counting baby’s kicks
• Pregnancy by week

Sources

• Aya Mohr Sasson, Abraham Tsur, Anat Kalter, Alina Weissmann Brenner, Liat Gindes & Boaz Weisz (2016) Reduced fetal movement: factors affecting maternal perception, The Journal of Maternal-Fetal & Neonatal Medicine, 29:8, 1318-1321, DOI: 10.3109/14767058.2015.1047335
• Mangesi L, Hofmeyr GJ, Smith V, Smyth RMD. Fetal movement counting for assessment of fetal wellbeing. Cochrane Database of Systematic Reviews 2015, Issue 10. Art. No.: CD004909. DOI: 10.1002/14651858.CD004909.pub3. Accessed 26 May 2022. https://www.chop.edu/conditions-diseases/fetal-movement-counting.

Hand expression

Even if you don’t want to collect and store colostrum, learning how to hand express colostrum at the end of pregnancy is so valuable. It is much easier to learn a skill when you’re well rested and have some privacy than when it’s an immediate or urgent need just after giving birth. 

Your body starts to produce colostrum as early as 20 weeks. Some people find they leak small amounts of it or that their bra is stuck to their nipples at the end of the day. If you’re interested in collecting and saving colostrum during pregnancy, experts generally recommend waiting until 37 weeks. Your OB provider can help you create a timeline that works for you!

Hand expression can take some practice to master, and you may find that each breast needs a slightly different touch or technique. We love this short video that shows some different ways to express those precious drops. The best way to save colostrum is in very small syringes that are about 1-3 mLs in size. You can label and freeze the syringes until you’re ready to thaw and use them.  

Who does it help?

Colostrum collection can benefit many parents. Those who have experienced low supply or who have risk factors for low supply may want extra colostrum on hand to avoid excessive newborn weight loss or reduce the risk of jaundice. 

Those with gestational diabetes or who take beta blockers may want to collect colostrum to use in case of low or unstable blood sugar instead of using formula. 

Parents of multiples, babies who have IUGR, and babies with diagnosed genetic or physical differences may also benefit from having extra colostrum saved. There are a variety of reasons why it can come in handy. Talk to your provider or a lactation professional about the pros and cons. 

For some people, hand expression causes temporary but uncomfortable cramping, so it’s always a good idea to check in with your OB provider beforehand to see if there are any activities you should avoid that may cause contractions. Again, it’s generally recommended to wait until 37 weeks to try hand expression or colostrum collection.

Helpful tips

The best time to practice hand expression or collect colostrum is when you’re relaxed and not in a rush. Often people find that being warm and post shower/bath is a great time. Some gentle breast massage can help warm things up as you get started. Once a day is generally enough for practice until you get the hang of it. You may consider expressing more than once a day if you are actively collecting and storing. Keep in mind that at first, you may see just a hint of clear wetness or nothing at all.

If you’re collecting colostrum you’ll want to:

• Wash hands and have clean spoons, container/syringe ready
• Express for few minutes on each side collecting drops (aim for 10 drops and measure how much this is to make future collection easier, for example 10-15 drops might equal 1 mL)
• Date and store your colostrum in the freezer

Now that you have a little bit more information about hand expression and colostrum harvesting, you can make an informed decision about what is right for you!

Read more

All about colostrum

Breastfeeding basics

 

Content created withThe National Birth Equity Collaborative

Preterm birth increases the risk of complications and often results in a NICU (Neonatal Intensive Care Unit) stay. Preterm delivery can be scary to think about, but there are many ways that you can prevent it, in some cases with zero complications. Read on to learn more. 

Preterm birth impacts Black women and babies 50% more than their white peers. This disparity exists due to racism and bias within the healthcare system itself. Still, there are actions you can take early in your prenatal care to advocate for yourself and your baby.  

Understanding the risk factors

We don’t know all of the causes of preterm delivery, but what we do know is that the chances of preterm birth  can be impacted by the following conditions:

• A history of having a procedure done on your cervix after an abnormal pap smear
• Shortened cervical length early in pregnancy
• A previous preterm birth
• Carrying multiples (twins, triplets, etc.)
• Using tobacco and/or other substances 
• Hypertension
• Diabetes

Becoming pregnant shortly after delivering a previous baby (less than 18 months)

Ask what you can do

Talk to your provider about what you can be doing to minimize your chances of delivering early. Providers will frequently recommend:

• Quitting smoking or drug use, if applicable
• Eliminating alcohol 
• Checking your cervical length
• Taking a progesterone treatment if you have a history of preterm birth 
• Managing your blood pressure and blood glucose through the use of medication and physical activity alongside a nutritious diet

Listen to your body

You know your body best, so if you’re ever concerned that something is wrong, reach out to your provider right away. If you’re not sure that what you’re feeling is normal and want to get a better understanding of what people at your point in pregnancy typically experience, reach out to an Ovia Health Coach any time, 7 days a week. You have a right to understand what is going on in your body and to receive care and support throughout your pregnancy.

Read more

• The power of preparing for preterm birth
• Risk factors for preterm labor and birth

Sources 

• “A Health Crisis Impacting Women and Babies of Color.” March of Dimes. March of Dimes. https://www.marchofdimes.org/mission/health-disparities.aspx. 
• “Premature Birth.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. November 1, 2021. https://www.cdc.gov/reproductivehealth/features/premature-birth/index.html. 
• “Preterm Birth.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. November 1, 2021. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm. 
• Office of Communications. “What Are the Risk Factors for Preterm Labor and Birth?” Eunice Kennedy Shriver National Institute of Child Health and Human Development, U.S. Department of Health and Human Services. https://www.nichd.nih.gov/health/topics/preterm/conditioninfo/who_risk. 

 

Content created withThe National Birth Equity Collaborative

Blood pressure (BP) measures the force that your flowing blood applies to the walls of veins and arteries — in other words, BP measures how hard your heart is working to pump blood throughout your whole body.

Blood pressure is measured using a sphygmomanometer (also known as a blood pressure cuff), and given as a two-number result, “systolic” and “diastolic”. Only one of these numbers needs to be above or below normal to be considered diagnostically elevated. High blood pressure (hypertension) can be especially dangerous during pregnancy, so it’s important to do your best to keep your blood pressure in the optimal range, which is generally under 120/80.

High blood pressure during pregnancy

High blood pressure can be problematic for everyone, but when you’re pregnant, it could put both of you at risk. High blood pressure may not be the direct cause of a certain complication but can indicate a greater problem. There are many possible risks of high blood pressure during pregnancy.  

• High blood pressure and protein in the urine are the two main symptoms of the pregnancy condition known as preeclampsia. In rare cases, preeclampsia can lead to other conditions causing internal bleeding, seizures, and strokes.
• High blood pressure may often indicate excess stress. Stress has been linked to a higher incidence of miscarriage and overly intense pregnancy symptoms. While it is certainly not always possible to just “stress less,” tracking your blood pressure along with your emotions may help you recognize when to seek advice from your healthcare provider.
• Sometimes, high blood pressure can cause conditions that increase the risk of your baby being born prematurely. A placental abruption, when the placenta is separated early from the baby, is another possible complication of conditions related to high blood pressure during pregnancy.

Heightened risk factors

According to the U.S. Department of Health and Human Services, high blood pressure is 40% more common in Black adults than white adults. This is due to a range of factors including racism and bias in the healthcare system and socioeconomic inequalities and inequities. According to the Healthcare Cost Utilization Project, Black women are also about 60% more likely to develop preeclampsia during pregnancy than white women.

Knowing your body and how it changes during pregnancy, especially your blood pressure, empowers you to seek care accordingly. Monitor your blood pressure and communicate to your healthcare provider any concerns you may have.

Taking control

Blood pressure levels can be an excellent indicator of the health of your pregnancy, and is a great way to monitor against certain complications like preeclampsia. Tracking your blood pressure along with other data can also help draw patterns between certain behaviors. You’ll know how your sleep, nutrition, activity or other behaviors may affect your blood pressure, and vice versa. It’s important to let your healthcare provider know if your blood pressure is consistently elevated.

Read more

• Pregnancy complications and your risk of cardiovascular disease
• Lowering your blood pressure with heart-healthy foods

Sources

• P Kristiansson, JX Wang. “Reproductive hormones and blood pressure during pregnancy.” Human Reproduction. Vol.16, No.1 oo. 13-17. Web. 2001.
• S Kulkarni, I O’Farrell, M Erasi, MS Kochar. “Stress and hypertension.” Wisconsin Medical Journal. 97(11):34-8. Web. Dec-98.
• “Preeclampsia and High Blood Pressure During Pregnancy: FAQ034.” ACOG. American College of Obstetricians and Gynecologists, 9/14/2015. Web.
• “High Blood Pressure in Pregnancy.” National Heart, Lung, and Blood Institute. National Heart, Lung, and Blood Institute, n.d. Web.
• “Placental abruption.” March of Dimes. March of Dimes, 1/12/2015. Web.
• Norton Healthcare. “Pregnant African-American women far more likely to have pre-eclampsia than white women.” Norton Healthcare. Norton Healthcare. May 16, 2018. https://nortonhealthcare.com/news/pregnant-african-american-women-pre-eclampsia/. 
• Heart Disease and African Americans. Office of Minority Health. U.S. Department of health and human services. February 11, 2021. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=19#:~:text=Although%20African%20American%20adults%20are,to%20non%2DHispanic%20white%20women
• Kathryn R. Fingar, Ph.D., M.P.H., Iris Mabry-Hernandez, M.D., M.P.H., Quyen Ngo-Metzger, M.D., M.P.H., Tracy Wolff, M.D., M.P.H., Claudia A. Steiner, M.D., M.P.H., and Anne Elixhauser, Ph.D.

Dear Ovia, I feel like my partner isn’t putting any effort into preparing for our baby. I’m running around trying to make sure everything is organized. I’m reading up on parenting styles. And he’s just so low key about it. It’s annoying me/dampening my excitement. How can I get him to care more?

I hear you on this one! It can feel especially overwhelming and annoying because when you’re pregnant, you’re also doing the lion’s share of the work.

Some food for thought

If you enjoy this preparation, don’t let his perceived lack of excitement about it dampen your spirits. Talk to friends, family or whoever else gets excited about buying furniture, clothes, books, etc. Think about times in your relationship when you didn’t have the same level of enthusiasm for something. It’s okay to be different — even though baby related things seem inherently exciting to you.

Lack of organization or prep at this point doesn’t equal not caring about this new chapter. Pregnancy often feels a little less real for the non-pregnant parent. There may be some major anxiety or uncertainty at play that he doesn’t care to burden you with. Many partners will also say that time is not as pressing — he may feel like he has AAAAAAGES to get things done, whereas you know that’s not the case! This is not meant as a series of excuses, but more of an encouragement to allow a clean slate when you begin talking (which is what you’ll need to do).

So, how can you get him more involved moving forward? 

Ask for what you need! Are you bored of picking baby items? Do you need something picked up or put together? Whatever you want off of your plate — delegate. We can all get tripped up on delegation (shouldn’t he know what to do without you asking him anyway?), but if you can start to let that go, you can begin to have fun with knocking things off your list as a team. 

If you’re worried he won’t get a task done, I’d encourage you to say something like, “The stress of “X” and remembering these details is a lot. I’m asking you to do this, and I’m not going to remind you. It’s off my list as of now.”

If you’re excited about preparing for baby as a way to spend time together, frame it that way. “I’d love to do this class together so that we can both learn about newborn care.” Finding ways to come together, even if it’s small — like listening to a podcast or picking out family pjs — just get the ball rolling. 

I want to end by saying this is not predictive in any way of how your partner will be as a parent! This is a very different phase than the one that’s coming, and it may be that his time to shine is yet to come.

Read more from this series

• Will we still have time for each other?
• How to deal with my controlling mother-in-law?

Leasa Wright has been practicing yoga and meditation her entire life. She joins us today to speak a bit more about the benefits of prenatal yoga, how to get started, and why she’s so passionate about making time for a prenatal yoga practice. When she was pregnant with her first child, Leasa says, “I fell in love with empowering pregnant people. They need to feel strong and safe in their bodies.” She’s been teaching a prenatal yoga practice weekly ever since. 

While movement in general, and yoga specifically, can be beneficial at all times in your life, there’s something different about prenatal yoga. “Once I realized I was pregnant, I felt a sense of responsibility for that little being,” says Leasa. Plus, pregnancy can be hard on the body and it’s common to feel very sore if you’re not moving around every day. Prenatal yoga is a great way to integrate that movement, connect with your baby, and form a community. 

A couple safety notes before we dive in:

• Most people should wait until after the first trimester before starting a prenatal yoga practice.
• If you’ve never practiced yoga before, it’s a good idea to be a bit more cautious when starting out. Check in with your provider to make sure it’s a good fit for you. 
• To prevent injury, do all the modifications your instructor recommends and don’t push yourself. Especially if you haven’t practiced yoga before, it can be hard to know your limit, so go easy on yourself.

How is prenatal yoga different from a yoga practice for those who are not pregnant?

​​Prenatal yoga is a curated collection of customized asanas/yoga poses that cater to the shape of the pregnant body. A person’s center of gravity changes during pregnancy and they lose the ability to fold inward. This leaves a person with an unbalanced yoga practice if they continue to sit out postures in a traditional class. Prenatal yoga classes offer a balanced sequence of joint mobility exercises, seated postures, standing postures, hip openers, breathing, and relaxation exercises — leaving out the contraindicated postures, but still offering an overall, accessible, and whole body practice.

How can it benefit people during pregnancy (physically and emotionally)?

There are so many reasons to choose to participate in prenatal yoga. It offers the opportunity to connect with your baby and it gives you the chance to connect with other people who are making the same healthy lifestyle choices as you. It’s common to form friendships and build relationships in a class environment. And that community can help alleviate anxieties you may be having about becoming a parent. 

As far as physical benefits: prenatal yoga can improve your sleep, reduce stress and anxiety, and increase the strength, flexibility, and endurance of muscles needed for childbirth. Additionally, it can help to decrease lower back pain, nausea, headaches, and shortness of breath by lengthening the muscles around your rib cage. From your physical body to your emotional state, prenatal yoga can be a key ingredient to a healthy, happy pregnancy.

Where should we start?

For many, pregnancy is a time to make your health a top priority. Ensure you get plenty of sleep overnight, as a growing baby uses up a lot of energy. A well-balanced diet of nutrient-dense foods will also help to boost your energy. Finally, staying active is a key aspect of pregnancy self-care and can be extremely beneficial for managing certain symptoms associated with pregnancy.

Any advice for slowing down when the stress of pregnancy is overwhelming?

Try mindfulness, yoga, meditation, and massage to bring your mind into a peaceful state so you can cope better with the busyness of daily life. Take yourself to a place where your mind and body can be still, allowing you to focus inward and breathe deeply.

Simple things like getting enough rest, eating well, exercising regularly, and seeking support from trusted friends and family can increase your resilience in stressful times. And check in with your partner. You and your partner can act as a support system for one another during this time.

What about creating space in your day?

If you can, try to schedule naps during your day to get more sleep and restore your energy. Take catnaps during the day, even if you just rest your eyes for 15 minutes with your feet up. Book yourself regular pamper sessions at home. A night in with a favorite facemask is a lovely way to treat yourself.

Set aside time for the hobbies and activities that were a part of you before you became pregnant. And try to keep in touch with the friends who add value to your life by scheduling an assortment of standing dates with your circle. 

Any tips for integrating a prenatal yoga practice into your routine? 

A simple first step is to make sure you have correct posture at work by learning some good stretches to practice at your desk during breaks. 

Sign up for an in-person workshop at a local studio who specializes in prenatal yoga. And don’t apologize for making yourself a priority. If it’s easier, try an online yoga class so you can practice from the comfort of your own home. 

If you’re having trouble getting started or staying consistent, ask a friend to be your accountability buddy to ensure you show up to practice. 

How can people make sure they’re staying safe in their practice?

Start by asking your doctor, midwife, or doula for local recommendations. Always attend your scheduled prenatal visits and talk to your provider if you have questions or concerns about your pregnancy. They are a great resource you should take advantage of during this time.

If you’re wondering if a yoga studio offers certified prenatal yoga classes, call and ask if they are certified in prenatal yoga by Yoga Alliance, the organization that sets standards for yoga teachers nationwide. Knowledge of the dos and don’ts of prenatal yoga is one of the most important reasons you should seek out a qualified prenatal class. 

You should always avoid internal twisting, belly compression, and heated yoga classes. Any balancing poses should be done with extreme caution, against a wall.

How can I safely continue my practice postpartum?

The best way to ensure you’re ready to resume practice is to get the approval of your healthcare team first. The standard guidelines recommend waiting 6-8 weeks after birth before continuing your practice. Sometimes that can be longer, depending on your birth experience – ask your provider. 

What’s your favorite part of your yoga practice?

Community. I taught my first prenatal yoga classes during my first pregnancy and have remained connected to those mamas to this very day. You can expect to form beautiful connections with others during prenatal yoga. The bond you create with other pregnant people is one that carries into postpartum and beyond. If there’s anything a community needs, it’s to be full of strong, empowered, and supportive mothers.

Yoga has brought me strength, mindfulness, breathwork, and awareness of my body, which has helped my physical and personal growth tremendously. I am so grateful for this practice and how it has manifested itself into my life’s work.

Read more

• Prenatal pilates
• Low-impact exercise during pregnancy

Why does this happen?

Experiencing anything new and unknown is scary — especially when it involves your body and your baby. You may be worried about the health of your baby, the pain of giving birth, being left alone in the delivery room, or the unknown delivery time. 

Beyond the fear of childbirth, it’s common for pregnant women to also fear motherhood. “Will I be a good enough mother?” “Will I be able to provide my baby with everything they need?” “Will I still be able to juggle a career and social life with a child in tow?” These are just a few questions that might be popping up in your head before giving birth. Like childbirth, motherhood can be overwhelming. And also like childbirth, you will know what to do when the time comes. Talk to those who have been through it before. Establish a support network to help through the early days.

And if you’re feeling very anxious or anxious for prolonged periods of time, it’s time to speak with your provider about finding professional support too. 

Can anxiety about childbirth affect childbirth?

Women who experience disturbed labor due to stress can limit the amount of oxytocin they produce during childbirth. With more oxytocin, contractions can increase in speed and strength. Other disturbances can lead to longer labor like bright lights, muscle tension, and pain. 

Staying calm during labor is difficult but can improve your experience. Think about the things that make you feel calm in your day to day life: practicing breathing exercises and visualization, listening to music, looking to your partner or family members for support. You might also want to consider hiring a doula to help you feel calm and confident going into labor and supported throughout it. 

Additionally, particularly for first time parents, having more information about what the process of giving birth is like can help decrease fear and anxiety.

Knowledge can mitigate fears

Learning about the process of giving birth and the techniques to ensure your labor goes as smoothly as possible are both key components to easing your anxiety. Here are ways to face your fears head-on. 

• Speak to your provider about what to expect 
• Pack a hospital bag filled with your essentials
• Hire a doula to support your throughout pregnancy and postpartum
• Talk to your friends who can positively speak about childbirth and motherhood 
• Work through your fears with a therapist
• Attend Lamaze classes to learn breathing and relaxation techniques
• Find a support group for mothers-to-be
• Remember: Your baby doesn’t expect you to be a perfect mother and neither should you

Reviewed by the Ovia Health Clinical Team

Read more

• How to take care of your mental health during pregnancy
• Prenatal exercise and movement FAQ

Sources

• Arfaie, Katayoun, et al. “The Role of Fear of Childbirth in Pregnancy Related Anxiety in Iranian Women: A Qualitative Research.” Electronic Physician, Electronic Physician, 25 Feb. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410899/. 
• Slade, P., et al. “Establishing a Valid Construct of Fear of Childbirth: Findings from in-Depth Interviews with Women and Midwives.” BMC Pregnancy and Childbirth, BioMed Central, 18 Mar. 2019, https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2241-7. 
• “Can Fear Prolong Labour?” BellyBelly, 17 Feb. 2021, https://www.bellybelly.com.au/birth/can-fear-prolong-labour/.

If you have given birth vaginally before, perineal massage can still be helpful as it’s been shown to decrease perineal pain at three months postpartum. 

What is perineal massage?

Perineal massage is a process of applying pressure to the pelvic muscles, by inserting one or two clean fingers into the vagina a couple inches and applying pressure. While there’s still more we need to learn about exactly how often and how long it should be done for maximum effectiveness, a couple times a week for 5 minutes is a good rule of thumb. You can start at week 34 of pregnancy.

What’re the benefits?

This practice has the most significant benefits during your first pregnancy. It decreases the relative risk of perineal trauma by 10%. It also decreases perineal pain after birth and can also be done during labor, to decrease the severity of a tear.  

How do I start perineal massage?

You can either massage your perineum yourself, or ask your partner to help. Do it after a shower or bath, when you’re feeling relaxed and comfortable.

Get some lubricant, sit comfortably, and insert a clean finger or thumb a couple inches into your vagina, gently stretching the skin to the side, then toward the back of the body, then toward the other side. Continue this U movement for 5 minutes. This will help prepare your muscles and tissues for the stretching that will happen during birth.

It can be helpful to use a handheld mirror to see what you’re doing. You may feel a bit of burning or a stretching feeling at first, but perineal massage should not hurt.   

This content was reviewed by Dr. Lisa Hickman and Dr. Katie Propst. Dr. Hickman runs the Childbirth Pelvic Floor Disorders Clinic at The Ohio State University Wexner Medical Center. Dr. Propst runs the Postpartum Care Clinic at Cleveland Clinic. 

Read more

• Vaginal delivery and that first bathroom trip
• Perineal massage during pregnancy

Sources

• Jen Gunter. “Massaging Away a Potential Complication of Birth?” The New York Times. January 31, 2019. https://www.nytimes.com/2019/01/31/well/live/massaging-away-a-potential-complication-of-birth.html. 
• Healthwise Staff. “Childbirth: Perineal Massage Before Labor.” Healthwise. University of Michigan Health. October 8, 2020. https://www.uofmhealth.org/health-library/tn10339. 
• Sharon Muza. “What Is the Evidence for Perineal Massage During Pregnancy to Prevent Tearing?” Lamaze International. Lamaze International. December 18, 2012. https://www.lamaze.org/Connecting-the-Dots/what-is-the-evidence-for-perineal-massage-during-pregnancy-to-prevent-tearing. 

1. Prepare for uncertainty 

While we can probably all agree that accepting “uncertainty as the only certainty” is easier said than done, most of us worry less about uncertainty when we feel prepared. Writing a birth plan helps channel any anxious energy into something productive. Use your sense of accomplishment from creating your rock-star birth plan to help you conquer your fear of childbirth.

2. A birth plan helps you get to know your provider better

Talking early (anytime after 25-30 weeks) and often about your childbirth and postpartum plan helps you confirm that you have chosen the right provider for you. The right provider for you is someone who listens to you and who you can trust. When you trust your provider (or provider team), you can feel more confident that they have your best interest at heart.

3. Choose who should attend the main event

Just as you need to know that your provider has your back, you want to make sure the right people are around you when contractions start for real. (Who knows, maybe you have always been waiting for the chance to be able to tell your MIL to take a hike?) A birth plan can be a tactful way to have these difficult conversations before you’re in labor. Nobody wants family drama in their delivery room!

4. Birth plan = partner’s prep

Even if your partner is an OB/GYN, that doesn’t mean they know exactly how to support you in the delivery room. Every birth partner needs to prepare, regardless of who they are. Researching, writing, and talking about a birth plan together can help ease your birth partner’s worries too. The last thing you want to be worrying about in labor is your partner worrying about you.

5. Let your knowledge help you reclaim your power

Learn about what is and isn’t normal during pregnancy, delivery, and postpartum. There is a reason why What to Expect When You’re Expecting was such a blockbuster success — expectant parents need information to prepare. So geek out all you want on crafting the mother-of-all birth plans — doing so will help you prepare for the main event. You’ll feel more confident, powerful, and in control because less will be new, unfamiliar, or unknown during your delivery and postpartum.

6. Establish open lines of communication

Many people who are afraid of childbirth worry that they will not have a voice in decision-making. When it comes to a good birth, over communication is the name of the game. Talking about your birth preferences early and often with as many people as possible will likely help reduce your anxiety. Think of your birth plan as your opportunity to tell your doctor and labor and delivery nurses what you do and don’t want to happen at your delivery. The more practice you get talking about complicated health information with healthcare providers, the more your self-confidence and power will grow. It is time to claim your seat at the table (or birthing stool in the delivery room as the case may be).

Worrying less during pregnancy is good for you and your baby. A June 2013 review in ​Obstetric Medicine​ also found that prenatal stress — like fears about childbirth — can have lasting physical consequences for both expecting parents and their babies, including low birth weight, premature delivery, and gestational diabetes. Writing your birth plan can help you meet uncertainty with acceptance, not anxiety. When your birth plan is flexible and comprehensive, both you and your birth team can turn to it as a good birth wishlist — a guide to what matters most to you as you enter the next chapter of your life as an expectant parent.

Read more

• Building a birth plan
• Finding an OB/GYN or midwife