How to: Birth Prep + Induction Tips
- Chardá Bell, IBCLC, CBE, CD
- Apr 25, 2022
- 19 min read
Updated: Jul 10, 2022
Let’s learn ways we can prepare ourselves for birth physically, mentally and emotionally.
Photo Credit: my real client, Mama Danielle (the millionaire realtor extraordinaire) & I was her doula & lactation consultant with both babes. One natural water birth & one natural earth side birth. She did an amazing job and if you need to buy a house, she's the perfect agent for families!
We will learn:
Hi, I’m Chardá, a mom, doula and lactation consultant in San Diego, California and I love teaching families how to have a more healthy and positive pregnancy, birth, parenting & breastfeeding experience! My focus is on empowering Black moms, babies and families to be resilient, informed and protected on their life journey!
Read my blog at www.melaninmilksd.com
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Connect in the comments.
We are still dying. I’m tired and distraught after doing the work for years now and still seeing the same catastrophic headline year after year–Black women are STILL 3-4x more likely to die of pregnancy, childbirth and postpartum related causes than our non-Hispanic White women. Don't look at us, this isn't out fault, but it is our fight. This isn’t because we aren’t educated on childbirth, this is because we aren’t educated on all of our options. We aren’t educated on these options because the medical “care” systems and institutions in which providers are taught, don’t care at all and remain inherently racist and therefore the neglectful ways of medical racism and toxic stress still exist and harm Black families. For black birthing folks in America, successfully surviving childbirth transcends socioeconomic factors. Healthcare providers of all backgrounds, often reflexively categorize educated, middle-class or affluent Black women as low risk and overlook red flags that may even be very obvious. This is exactly what happened with Serena Williams, as she had to demand life-saving treatment for known complications after she gave birth. Birth should be a sacred time, not a time to be scared. For many Black women giving birth, our experience is not as positive due to having to fight for basic rights like bodily autonomy. This doesn’t have to be the case, and I’m here to tell you how you too can plan for birthing liberation! This is why I created Melanin Milk SD.
Birthing While Black - Melanin Milk SD FREE Community Birth Plan Coming Soon!
Birth plans are a guide to having patience, allowing time and practicing or planning for as many scenarios as you can control in your birth. You can create a birth plan alone, but I highly recommend doing it with a supportive partner, doula, midwife or your OBGYN if you like them and trust them with guidance, but do keep in mind doctors have strict protocols at their institutions and therefore they will likely have to “err on the side of caution” due to the constraints of hospital policies.
Your preferences are your own and important to improve your chances of a more positive birth experience and to increase your knowledge around your body and the process.
This is a sample of a birth plan that I use with my clients:
To book a birth planning session with me, click here!
This is a custom birth plan I use from a shop on Etsy called The Birth Plan Co. the owner and creator, Sarah, is amazing and very responsive. Please consider using her if you are birthing or have a doula business and need custom content.
A free & easy to understand birth plan I like to refer my clients to is by March of Dimes
What can I do to prepare my body for birth?
Perineum Massage
Can be done to prevent tearing, a perineal massage is done by gently massaging the lower half of your vagina using a u-shaped motion for 2-3 mins at a time, do this 2-3 times a day.
Don’t start this until after 35 weeks
Reduces your chances of tearing & stitches
Lowers your risk of episiotomy (a doctor performed cut to of the vagina during pushing)
Helps with scar tissue
Try a warm bath before doing it
Lubricate! Use something safe and natural
Try using the thumbs
Partners, with consent you can do this on your birth giver!
Pelvic Floor Preparation
During pregnancy, the pelvic floor stretches to make room for your growing baby. Over time, these muscles become weak from being weighed down.
Find a pelvic floor therapist prenatally or postpartum
Browse around on social media and ask doulas, birth centers or OBGYN’s in your area
My favorite two personal recommendations are:
Dr. Jenny Santamaria of Femme-Strong (West coast)
Dr. Alison Zebron of The Birth PT (East coast)
Breast/Chest Prep
There is nothing you need to do to prepare your breast/chest or nipples for feeding and lactation! Baby will be fine on the drops of colostrum you provide in the first 0-3 days, because while the amount is small, the caloric and nutrient content is rich. Your baby also only needs a tsp or so of milk per feed session in the first few days, so it works out perfectly. Allow your body to do its thing and if you need help, find a lactation consultant near you.
Take a breastfeeding class
Wait for your milk to increase in volume around 3-5 days postpartum
If you or baby struggle, contact an IBCLC
Watch for output; if they are peeing and pooping normally it's a good sign of intake!
Hospital vs Natural Induction
Labor induction or Induced Labor is the use of medications or other methods induced to stimulate contractions of the uterus. This can be a lengthy process, longer than an average spontaneous birth, especially if your cervix, body, baby and mind are not ready for this to naturally begin.
To prepare for birth, the cervix begins to soften or ripen, thin out, and open. These changes usually start a few weeks before labor begins. Sometimes when labor is going to be induced, the cervix is not yet "ripe" or soft. A good way to know the firms they are checking for is to do this, try touching the tip of your nose push it and see how firm it feels there, now touch your lip, see the softness of this is what they are looking for with a ripe cervix, a cervix that is not quite ready would feel more like the tip of your nose and this means that labor cannot progress until it's softer like your lip. This is all so that the baby has a clear and easy pathway out, and for the birth giver to have an easier time. The provider may use a Bishop score to rate the readiness of the cervix for labor, and the scoring ranges from 0-13, your doctor is looking for the cervix to be an 8 or higher to be considered favorable for induction.
Ripening the cervix is a process that helps the cervix soften and thin out in preparation for labor. Medications or devices may be used to soften the cervix so it will stretch (dilate) for labor.
When your water breaks, the fluid-filled amniotic sac that surrounds the baby has ruptured (burst). Most will go into labor within hours after their water breaks. If the sac hasn’t burst already, breaking it can start contractions. Or if the contractions have already started, breaking the sac can make them stronger or more frequent. To rupture the amniotic sac, an ob-gyn makes a hole in the sac with a special device. This procedure, called an amniotomy may be done before or after a birth giver has been given oxytocin. It can be performed to start labor when the cervix is dilated and the baby’s head has moved down into the pelvis.
A few methods used:
Membrane sweep - also called stripping the membranes, is a common way to induce labor. The ob-gyn sweeps a gloved finger between the amniotic sac and the wall of your uterus, separating the fetal membranes from the cervix. This can be done in your doctor's office at an appt, when the cervix is partially dilated. This may cause your body to release prostaglandins, which soften the cervix and may cause contractions.
Pitocin - Pitocin (artificial oxytocin) oxytocin is a hormone that can cause contractions of the uterus. It can be used to start labor or to speed up labor that began on its own. Contractions usually start about 30 minutes after Pitocin is given, they usually slam you harder than normal contractions so be ready for the intensity! I know because I've had a birth with and without Pitocin. Can be turned up or down, on or off at anytime! Do not let them fool you. It is often administered through an IV (intravenous line) A pump hooked up to the IV tube controls the amount given. Your condition, your contractions, and the fetus’s heart rate will be monitored when you are given this medication. Funky things will probably happen, don't be surprised, just know you control it. Read the risks here.
Prostaglandins - are medicines used to ripen the cervix such as misoprostol aka Cytotec or Cervidil, are both commonly used in the US hospitals for inducing labor. These medications can be inserted into the vagina or taken by mouth. Some prostaglandins are not used in folks who have had a previous cesarean delivery or other uterine surgery to avoid increasing the possible risk of uterine rupture (tearing).
Devices - Laminaria are slender rods inserted into the cervix to dilate it. They are made of a substance that expands when it absorbs water. Foley Bulb - A catheter (small tube) with an inflatable balloon on the end. The tube is inserted through the vagina and into the opening of the cervix. Then the balloon expands, which helps open the cervix. Once it inflates to a few centimeters, it falls out or is removed when you have reached about 3cm.
AROM - "breaking your bag of water" (artificial rupture of membranes) sometimes the doctor will offer this as labor stalls or is not going “fast” enough for their liking. The theory behind it is that if the water bag is no longer intact the baby drops lower and is touching the cervix more directly, the process then speeds up and contractions become more intense, stronger and progressive. Only a doctor or midwife is qualified to do this job!
Don’t forget to use your BRAIN! Your best decision making tool here:
Benefits - of both accepting or declining an intervention
Risks - of both accepting or declining an intervention
Alternatives - What are the alternatives to this proposed intervention?
Intuition - What does your gut tell you, go with it?
Nothing - What happens if you wait an hour, a day or week for this proposed intervention?
A note for military moms: I'm just going to put it out there, the things society doesn't want you to know, is how little they value their female members of service. I work with a high population of military moms in San Diego, both active duty or spouse and many veterans as well, they are almost all being scheduled for induction dates around the 30 week mark, deemed by the government and it’s scary! One day I will write separately about my extremely negative experiences at Balboa Naval Medical hospital in San Diego, CA as a doula and seeing how women are treated like prisoners while in birth. I have several clients who have been forced into inductions and c-sections, all to keep up with the military’s assembly line of workers and to ensure these soldiers can get back to work at the military’s desired time. Whether it’s due to deployment schedules or not, it’s wrong to be taking a baby prematurely before they are ready without logical and evidence based medical rationale.
A note on elective inductions: Now, sometimes people or providers plan inductions for other non-medical reasons, known as elective inductions. You may be feeling a little anxious to go into labor just really want to have this baby! You may live in a rural area too far away from your birthing location. Some feel physically uncomfortable in their pregnant body over time. 41 weeks birth givers may feel pressure to be medically induced by their provider and want other options. Whatever your situation, you may be wondering how to induce labor naturally at home.
You should not induce for the following reasons:
Breech babies - Try Spinning Babies!
Growth restriction or a Large/Big baby
Previous speedy deliveries
Your doctor is off that day
You want to meet your baby sooner
Some possible reasons your doctor may suggest induction include the following:
Your pregnancy has lasted more than 41.4 to 42.0 weeks (past 42 weeks you are at increased risk for stillbirth)
Serious health problems, such as with your heart, lungs, or kidneys
Placental insufficiency
Extreme decrease in amniotic fluid
Uterine infection
Gestational or Preexisting Diabetes
Preeclampsia or Eclampsia
PROM - Premature rupture of the membranes; water breaking before term
Placental abruption; usually immediate c-section
Induction would not be planned for:
Placenta previa (the placenta covers the opening of the uterus)
The fetus is lying sideways in the uterus or is in a breech presentation
Prolapsed umbilical cord (the cord has dropped down in the vagina ahead of the fetus)
Active genital herpes infection
A gentle cesarean is highly recommended by ACOG for these conditions.
There are several natural induction methods that can be helpful for jump starting labor.
A natural induction can be attempted on healthy full term pregnancies, oftentimes I’ve done this with military moms to avoid c-sections and planned inductions. They a date and then we go buy some dates! You’ll get the reference if you keep reading!
How can you begin to safely and naturally encourage your own labor to begin?
When your baby’s lungs have matured and proteins are released, this is when you want to speak with your midwife or doctor to begin this process, around 38 - 42 weeks when the baby is considered full term. Do not attempt any methods or techniques without medical guidance from your personal healthcare team or provider. I am not a doctor or physician.
DATES - have been dubbed the superfruit of birth, and therefore we like to start there. Eating dates increases your chance of spontaneous labor, shorter labors and almost 30% reduction in the use of pitocin (artificial oxytocin). Higher cervical dilation upon hospital or birth center arrival, by almost 2cm, lower rates of artificial induction. Dates are high in sugar, so if you suffer from yeast overgrowth, BV (bacterial vaginosis), or blood sugar/glucose issues, then you should skip the dates and ask your midwife or trusted provider for alternative recommendations.
NIPPLE STIMULATION - can be done by you or your partner with hand massage. In addition, using a breast pump simulates nursing a baby. Any of these methods releases oxytocin, a hormone that can ripen the cervix and cause uterine contractions. Nipple stimulation can be used both before labor as a natural induction method and during labor to increase contractions. This natural induction technique has been pretty well studied, and it’s important to understand that nipple stimulation can be powerful. Researchers have noted that there’s no way to control the amount of oxytocin being released during nipple stimulation. Because of its effectiveness, always check with your midwife before attempting nipple stimulation as a way to induce labor.
ACUPUNCTURE AND ACUPRESSURE - A traditional Chinese medicinal practice, acupuncture involves inserting tiny needles into certain points along the body’s Qi pathways. Studies have suggested that acupuncture can help with cervical ripening, while some researchers believe acupuncture might affect the uterus by stimulating hormonal changes or the nervous system. There’s no evidence of harm for people who have acupuncture during pregnancy. Similarly, acupressure also takes advantage of the same points, but the therapist applies physical pressure, rather than using needles. Acupressure can also be done at home — with your own fingers or those of your partner — but check with your midwife first. Local to SD try www.rootandsoul.com - Dr. Shani Cooper- Black owned provider and military veteran
CHIROPRACTIC CARE - multiple studies have shown that chiropractic care, particularly the Webster Technique, is beneficial for pregnant folks, especially those who experience lower back pain. In addition, chiropractic can help loosen the joints in preparation for delivery. In her book Nurture, birth and postpartum doula Erica Chidi Coen explains it this way: “Some chiropractors use a labor induction technique at 40 weeks combining chiropractic adjustments that stimulate the parasympathetic nervous system, activation of acupuncture points that ripen the cervix, and manual therapy to relax the ligaments around the uterus and pelvis.” Local to SD Try www.natalhood.com for an amazing Black female owned provider and www.radiantfamilychiropractic.com as a second trusted source, a top choice amongst the birth worker community here.
RED RASPBERRY LEAF TEA - This herbal tea may tone and strengthen your uterus, which can help induce labor. It will also keep you hydrated. Some midwives recommend beginning to drink red raspberry leaf tea at about 32 weeks, giving it time to build up in the body. Start with one cup a day and gradually work up to three cups. The evidence on red raspberry leaf is limited, but research has shown no harm in humans. Studies with human participants revealed no difference between the group that drank the tea and the group that didn’t.
Release of natural oxytocin from sexual intimacy
Uterine activity from orgasm, which also releases oxytocin
Prostaglandins in semen
How will I know if it’s working and labor is on the way? Free Handout Here!
Clear out - pooping and peeing frequently or releasing the bowels completely is a sign that the body is preparing for change
Discharge / Bloody Show
Extreme Nesting
Increased pressure in your booty
Lower back pains
Belly tightening (contractions)
Regular rhythmic contractions; you can predict these more and more over time
Feeling shitty like your period is gonna start, if you remember what that was like!
Lightening or baby dropping lower into the pelvis, making you feel lighter in the top half; easier to breathe and way less heartburn or indigestion (ask your midwife about some papaya enzymes for that by the way)
Water breaking before labor begins only happens about 10% of the time, so don’t expect it to be like a movie!
Sometimes labor induction doesn't work. If you and your pregnancy are doing well and the amniotic sac has not ruptured, you may be given the option to go home. You can schedule another appointment to try induction again, or go home and try some of the above practices and don't forget to try Spinning Babies, it is a winner every time!
Other ways to prepare for your baby’s true FIRST birth day!
The baby has a journey to travel and a job to do, they have to make it safely into this world and it is your job to help guide them. Some ways to get ready to be a great team with your baby to prepare for this amazing day to come:
Talk, sing or read aloud to your baby. - If you are bilingual or speak all languages to them!
Singing can be your favorite song, even if it’s Cardi B, whatever makes you feel good and happy!
Connect to your baby through their movements by “playing” with them with a flashlight near your belly or gently nudging them back when you get a wiggle.
Make a keepsake box and write letters to them during the pregnancy
Imagine what your sweet little baby looks like and describe them! Confidence boost in the womb is a great way to send them off to their birth.
Speaking of confidence boost...
Your mental and emotional health is important for this part of the journey.
Here are some ways you can feel more empowered in your birthing experience:
Learn about your body - I love Dr. Aviva Romm MD who is also a midwife, for all things Women's Health!
Watch positive and realistic videos only! Ones that might be more in line with your birth goals
Try different birth stories when watching videos to get perspective and make some decisions on what you may or may not want
Affirmations and meditations daily
Spinning babies will have you understanding birth like no other!
Try hypnobirthing
Stop following people who make birth, breastfeeding and parenting look easy, it’s not! This shit is hard, we need to own it and show the good, bad and ugly side of it all. Follow people who keep it real and show you all parts not just one part of life.
Learn how your love hormones work!
Practice belly breathing and focusing on the breath
Birth plan with a doula! I offer consults
Know and protect your rights for you and your baby!
You pay their salary, they work for you. Never be afraid to ask them for resources and options.
Birth Bags - The Essentials
For birth giver:
Birth plan
Any Intake paperwork from hospital or birth center
A comfortable outfit to wear like a big loose fitting T-shirt; no panties needed!
For the early stages - Birth book, magazine, playlists and podcasts
Portable fan, those misting ones are good too
Snacks (nuts, grapes, energy bars, anything light natural and easy to swallow)
Water, tea, gatorade, and electrolyte or immunity powders like Nuun or Emergen-C
Toiletries - toothbrush, toothpaste, hair items, personal soap or lotion, massage oils
Coconut oil
Lip balm
Memory anchors from home, favorite pillow or blanket, picture or other trinket that reminds you of home.
Eyeglasses if needed and contacts for postpartum if desired
Eye mask can be helpful or sunglasses
Colostrum harvesting kit
Haakaa
Nursing/Pumping bra
Comfy going home outfit; sundress, sweats, or leggings (not too tight) work; easy on shoes; avoid heels for this occasion
For the babe:
Bodysuit or onesie
Socks
Sleepsuit or sack
1 Burp cloth, 1 blanket
Additional layers if it’s cold where you are, and always remember the baby should be dressed in 1-2 layers more than you.
For the partner:
Change of clothes; or at least one pair of underwear and a coat or hoodie
Cash; for vending machines that don’t take cards
Ipad or Tablet w/chargers!
Toiletries
Book or magazine
Earphones or airpods
One of the final things you can do to prepare for birth, is to start preparing for AFTER BIRTH! So you don’t have to worry about what happens when you get home and not think about it while you are birthing or immediately after.
Plan the fourth trimester now, consider these things to start and speak with your doula:
Plan a snack or meal train
Have the house stocked up with snacks for your return
Create your watch it with the baby list! (a queue on your favorite streaming platform dedicated for binge watching when you are stuck in the house for 2 weeks!) You lived in quarantine for months, you can stay in the house for a few days or a few weeks to allow your body to heal! This pandemic taught us patience.
Find a local spot to take yourself and baby out for some fresh air and to look at greenery.
Ask for help preparing baby feeding stations around the house, stock up with snacks, water and baby items in your most utilized parts of the house.
Stock up on household basics
Delegate tasks and hire out as needed and afforded
Build a good circle of support and don’t forget who you are, you first, parent second.
Practice self care even after baby, to ensure we keep those postpartum blues, that are oh so common, away and at bay!
Summary:
When it comes to inducing labor, a really important point is that babies come when they are ready. Unless there’s a medical reason to induce, it’s best to let your baby decide on his or her birthday. Labor induction is the use of medications or other methods to start (induce) labor.
Labor is induced to start contractions of the uterus for a vaginal birth. Labor induction may be recommended when there are concerns about the health of the woman or the fetus. It also may be recommended when labor has not started on its own. Natural induction by 39 weeks is helpful in preventing risk of surgical birth.
Cesarean delivery is surgery and comes with certain risks, including:
Bleeding, infection, and injury to the bowel or bladder
Longer recovery time than vaginal delivery
Cesarean delivery also increases risks for future pregnancies, including placenta problems, rupture of the uterus, and hysterectomy.
Being born at or after 39 weeks have the best chance at healthy outcomes compared with babies born before 39 weeks. There are several methods to start labor if it has not started naturally. The ways to start labor may include the following:
Ripening the cervix
Stripping the membranes
Oxytocin
Rupturing the amniotic sac
Ripening the cervix is a procedure that helps the cervix soften and thin out so that it will dilate (open) during labor. Before inducing labor, your ob-gyn or other health care professional may check to see if your cervix is ready using the Bishop score. With this scoring system, a number ranging from 0 to 13 is given to rate the condition of the cervix. A score of 6 or less means that your cervix is not yet ready for labor. If the cervix is not ready, ripening may be done.
Sometimes labor induction does not work, called a failed labor induction attempt. Inductions at 39 weeks, you should be allowed to go back home for up to 24 hours or longer for the early phase of labor.According to ACOG, oxytocin at least 12–18 hours after stripping of the membranes will be administered. Risk of medical induction: With some induction methods, the uterus can be overstimulated, causing it to contract too often. Too many contractions may lead to changes in the fetal heart rate. Other risks of cervical ripening and labor induction can include infection in the woman or her fetus.
Pack light to your birthing location, you will hopefully not be there too long. up to 2 days for a healthy vaginal birth and up to 5 days for c-section or belly birth. If you will be staying home with a midwife be sure to ask them questions about what is needed if they provide you with a check list. Your birth location can be birth center or hospital birth and some hospitals having birthing centers inside, an assisted home birth (while I support all choice, I do not condone Free births--unassisted birth alone--this is extremely dangerous and causes an increased risk of mortality of the birth giver and baby, mostly due to lack of knowledge and expertise in the field of perinatology and reproductive health), always do your research but know that you have options.
A black midwife in San Diego, who I have learned a tremendous amount from on this topic & more is Darynee Blount of Birth Roots Babies. She is a wealth of knowledge, + several years of experience, twin mom & currently accepting new clients!
That’s all I have for you for now, until then happy birthing!
Resources & Citations :
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DISCLAIMER
All content and information in this video is for informational and educational purposes only, does not constitute medical, psychological or health advice of any kind and I do not warrant that the information presented herein is free of any errors or omissions. I am not providing medical, health care, nutrition therapy or coaching services to diagnose, treat, prevent or cure any kind of physical ailment, mental or medical condition.
Although I strive to provide accurate general information, the information presented here is not a substitute for any kind of professional advice, and you should not rely solely on this information. Always consult a professional in the medical and health area for your particular needs and circumstances prior to making any medical or health related decisions. For your health related questions, please seek the advice of a licensed physician or any other qualified health care provider immediately.
Melanin Milk SD Birthy Terms Glossary:
PER ACOG:
Amniotic Fluid: Fluid in the sac that holds the fetus.
Amniotic Sac: Fluid-filled sac in a woman’s uterus. The fetus develops in this sac.
Amniotomy: Artificial rupture (bursting) of the amniotic sac.
Anesthesia: Relief of pain by loss of sensation.
Breech Presentation: A position in which the feet or buttocks of the fetus appear first during birth.
Cervix: The lower, narrow end of the uterus at the top of the vagina.
Cesarean Delivery: Delivery of a fetus from the uterus through an incision (cut) made in the woman’s abdomen.
Diabetes Mellitus: A condition in which the levels of sugar in the blood are too high.
Eclampsia: Seizures occurring in pregnancy or after pregnancy that are linked to high blood pressure.
Fetus: The stage of human development beyond 8 completed weeks after fertilization.
Fibroids: Growths that form in the muscle of the uterus. Fibroids usually are noncancerous.
Gestational Diabetes: Diabetes that starts during pregnancy.
Genital Herpes: A sexually transmitted infection (STI) caused by a virus. Herpes causes painful, highly infectious sores on or around the vulva and penis.
Hemorrhage: Heavy bleeding.
Hormone: A substance made in the body that controls the function of cells or organs.
Hypertension: High blood pressure.
Intravenous (IV) Line: A tube inserted into a vein and used to deliver medication or fluids.
Kidneys: Organs that filter the blood to remove waste that becomes urine.
Laminaria: Slender rods made of natural or synthetic material that expand when they absorb water. Laminaria are inserted into the opening of the cervix to widen it.
Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.
Oxytocin: A hormone made in the body that can cause contractions of the uterus and release of milk from the breast.
Placenta: An organ that provides nutrients to and takes waste away from the fetus.
Placenta Previa: A condition in which the placenta covers the opening of the uterus.
Preeclampsia: A disorder that can occur during pregnancy or after childbirth in which there is high blood pressure and other signs of organ injury. These signs include an abnormal amount of protein in the urine, a low number of platelets, abnormal kidney or liver function, pain over the upper abdomen, fluid in the lungs, or a severe headache or changes in vision.
Prelabor Rupture of Membranes (PROM): Rupture of the amniotic membranes that happens before labor begins. Also called premature rupture of membranes.
Prostaglandins: Chemicals that are made by the body that have many effects, including causing the muscles of the uterus to contract, usually causing cramps.
Umbilical Cord: A cord-like structure containing blood vessels. It connects the fetus to the placenta.
Uterus: A muscular organ in the female pelvis. During pregnancy, this organ holds and nourishes the fetus. Also called the womb.
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