Giving birth is a lot like a marathon, or so I've been told. I will admit that I have never trained for a marathon.  But I know people who have, and here are a few things they have told me about the process that I think apply beautifully to the marathon of labor!

Mental preparedness is key. There are going to be times throughout the process of labor that you'll want to quit, give up, and forget this crazy idea of having a baby (right in the middle of it all!).  I've heard moms very close to meeting their babies exclaim, "That's it!  Never mind, I'm going home.  I'm done doing this!" If you are reading this and you've had a baby, you most likely can relate to this sentiment! I remind moms that when they feel they are "done" and that they can't do this one more minute, second or hour, they are likely very close to the end of the marathon.  The physical stamina is important, yes.  But the mental stamina is an equally important key to finishing the race!  I recommend taking a childbirth education series that will allow you to learn as much as you can about the process so that you know what to expect and how you can prepare. I also encourage positively envisioning, meditating, praying and/or thinking about the birth you want when you look forward to your birth experience.  Some moms may find that it's helpful to practice breathing and relaxation exercises, watch *positive* and affirming births (like this one!), and talk through any fears or concerns prior to or during labor. Going into labor with fear or dread can really hinder the process of labor and the production of oxytocin (the hormone so important to keeping labor progressing).  Listening to others share their own journeys through the births of their babies during pregnancy can be helpful, but I want to emphasize the importance of keeping those interactions positive.  

You have to train.  Physical endurance is really important.  This is why I recommend maintaining some sort of exercise routine (assuming your provider has given you the all-clear).  You do not have to stop fitness activities just because you are pregnant. Even in late pregnancy, you can continue to keep your normal exercise routine as long as it's comfortable for you and there's no medical reason to discontinue.  

Finally, hire a coach! Doulas are gaining popularity as many women have discovered what it feels like to have consistent, continuous support throughout their pregnancies, labors, and postpartum period.  You don't have to do this alone.  One dad recently told me, "I don't know what we would have done without you.  We wouldn't have had the knowledge or expertise to do the things you suggested, and it really made such a difference. Thank you!"

Remember, birth is a marathon and not a sprint.   You CAN finish the race! (And the reward at the end is better than any medal you could ever receive.)

Induction (the process of starting labor using artificial means instead of allowing it to begin on its own) is very common in some obstetric practices. You can read more about what it is and how it is done here.  Some possible reasons providers may give for a medical induction may include:

• Preeclampsia
• Hypertension
• Bleeding
• Gestational diabetes
• Various concerns for the baby/mom
• Infection
• Mom is "overdue" 
• Mom's age
• The size of mom's pelvis
• Baby's size
• Convenience
• Low fluid

NOTE:  While there are definitely times when induction is medically necessary, it is (sadly) fairly commonplace for some obstetric practices to push for an induction when it isn't actually in the best interests of mom and baby.  I am not a doctor and I will not make medical suggestions to my clients as a doula or to readers on this blog, but I do believe knowledge is power and recommend everyone inform themselves of the risks and benefits and seek out the best evidence before making a decision for themselves and their babies.  I also realize that sometimes induction (even when not medically necessary) can be the best choice for some moms for their own personal reasons.  This post is not intended to heap judgment or shame upon the reader but rather be a source of information to consider for themselves!  

That being said, here are a few common, non-medical reasons moms begin to entertain the idea of induction and some things to know to make a decision that's best for you:

"I'm sick of being pregnant and just want this baby OUT already!"
This is such a common sentiment late in pregnancy.  Around the last month (or earlier), many moms begin to get very impatient and, understandably, they just want to meet their babies.  They begin to dialogue with their doctor about this, and many will agree that induction could get them from point A to point B much faster.  Pretty soon, a date is scheduled for induction and mom knows the (approximate) day that baby will be born.
What to know:  Before beginning an induction, it's a really wise idea to ask your provider what your Bishop Score is.  This number is calculated after an exam and cervical check is done and can be a good indicator of how "successful" the induction would be.  The lower the number, the less chance mom has of birthing vaginally, and the higher the risk of needing a cesarean (or surgical) birth.

"It would be so much easier if I could just plan the date baby is born!" 
Of course it would!  Yet...the only thing predictable about birth is that it's unpredictable, and this includes the timing.  It's usually never very convenient for anyone.  Couples are usually very concerned (and rightly so!) about work schedules, care for the other children in the home (if applicable), time off once baby comes, how much leave they have from work, traveling mothers or in-laws coming long distances to help out and their availability, etc.  This is especially hard for type-A, "high D" personalities that live by their planner and a very well thought out and organized schedule.  But when it comes to babies, these things simply can't be predicted and that's one of the hardest parts for many moms.  
What to know:  The key to this issue is taking one day (or minute!) at a time, having several contingency plans depending on the day/week, and then doing your best and waiting patiently for the day baby is to be born.  It's also important to note that it's the baby, and not mom, that is the decision-maker for when labor begins. When your baby is ready to be born, he or she will secrete a hormone called CRH (cortico-releasing hormone) which sends a chemical signal to your placenta. When your placenta receives the chemical signal from baby, it will release estrogen and cortisol, two hormones that will help your baby's lung's mature.  This, in effect, is what "kicks off" labor and is actually quite critical to your baby being able to survive life outside the womb with strong, healthy lungs! 

"My baby is just too big.  I'm not sure he/she is going to fit!"
For many moms, the thought of delivering a full-term baby is daunting and even downright terrifying.  Unfortunately, our culture doesn't help much with this.  Women sometimes scare one another with their stories and for the pregnant woman (especially if this is her first baby), this can only add fuel to the fear she may be already feeling.  After all, she may be asking, how can something that large be ejected from such a small opening?  And so doubt begins to creep in.
What to know:  It is so incredibly important to surround yourself with people who will instill confidence and not fear into you.  If your provider says "your baby is too big," just bear in mind that there is truly no sure-fire way to know the exact weight of your baby, not even through ultrasound.  In fact, they can be off by a pound either direction!  It's also really crucial to remember that if your body made the baby, your body can birth the baby.  For more information on this topic, read this!

These are just a few of the non-medical reasons for induction I hear most commonly that I wanted to address, but I hope it's been helpful.  Let me encourage you...it's your body, your baby, and your birth.  You have the right to ask questions, seek counsel, and know what the evidence and research points to in terms of success rates for inductions.  I strongly recommend that you find out the risks of induction and learn about the intervention spiral that often results.   When we interfere with birth, it negatively impacts the beautiful hormone cocktail of oxytocin in birth, breastfeeding, mother/baby bonding, the way baby adjusts to life outside the womb, and even increases risk of postpartum depression.

Knowledge is power!  Know your facts and do what is best for you and your baby!  

And as always, thanks for reading!

I will never forget the first words my husband said to me after my children were born.  "You were so amazing.  Like unbelievable.  I can't believe you just did that! I'm so proud of you.  I love you so much!  You're a ROCK STAR!"  (15 years later, those words are still meaningful to me.  I mean, what wife doesn't want to be told she's amazing??)

As we gazed at our new, squishy little miracle, in awe of the fact that "we MADE that!," our love for one another was renewed as two became three, and then later four, and five.  

As a doula, I absolutely love helping to facilitate the relationship between mom and partner.  It's really important to me in the birth process that her partner feels included.  Recently, I had a client's husband say, "I have really been preparing for this.  I have taken a childbirth education series.  I mean no offense, but do we really need another person in the room?"  I gently replied, "I'm here for you as much as I'm here for her."  

Birth is intense.  As each contraction comes and mom is working hard, she needs an abundance of love and support.  And she needs just the right "hormone cocktail" happening in her body to help her cervix dilate and to prepare to bring baby into the world.  As she and her partner engage with each other in the labor process, her oxytocin levels rise and that works greatly in her favor. Oxytocin is a crucial hormone to the labor and birth process that is released by the pituitary gland.  Its job is to help bring about contractions of the uterus during labor.  The body makes it naturally, but you may have heard of its synthetic form called pitocin (which is sometimes used when it's necessary to augment labor).  It's a beautiful thing as the rise in oxytocin not only helps mom birth her baby it but also helps her milk come in after baby is born.  So... I work to bring mom and partner together in labor because I know that every hug, touch and connection between them is good for bringing baby closer to their arms.  Also, as the pain of labor intensifies, she may begin to fear childbirth. Fear and pain are the enemy of labor progressing, and so my goal is to help keep mom out of that place and in the comfort of her partner's arms where she feels safe and loved.  

I consider it a joy and privilege helping partners work together in the labor and birth of their babies, especially in the ones for whom it's their first time experiencing it.  It's a powerful moment when baby is born and they know they did it together.  I've been truly blessed to see some AMAZING hands-on partners who supported mom so lovingly and helped bring their babies into the world..  

Remember, love is the antidote to fear.  

And where love dwells, feelings of safety and well-being do as well!  What could be better than that in the process of childbirth?   

As always, thank you for reading!

Happi