Chardá Bell, CLEC, CBE, FSDHow to: Birth Prep + Induction Tips
Updated: Jul 10
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:
Birthing While Black - A Birth Plan; created for Black families by me, Black doula & mom
What is a birth plan, creating one and where to get one made
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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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.