There is really nothing that is guaranteed to give you an easy birth. You can watch tons of Orgasmic Birth videos, listen to only happy and empowering natural birth stories, get massaged every week, work with hypnosis, and be fit as an Olympic athlete and still have an unpredictable labor. Alternately, you could be extremely lucky and do absolutely nothing to intentionally prepare for labor but magically be one of the fast birthers who labors for four short hours and never finds it unbearable. As with most things related to the human body and experience, there are complexities and outliers and nothing is certain.
But that doesn’t mean that preparing for labor doesn’t give us better outcomes. It absolutely does; and regular movement practice leaves us stronger and better prepared for whatever labor has in store for us.
Biomechanist Katy Bowman explains movement for birth like this: If you want to train for a marathon, you’re going to need to run a lot. Being an excellent swimmer or gymnast won’t prepare the specific muscles needed to compete in a marathon, because that’s not the way our bodies work. You may be at peak fitness in one area, but totally unprepared for a different kind of athletic rigor. Birth is essentially a natural athletic event that most modern women are underprepared for.
Many of the reasons for this are deeply ingrained in culture, and culture helps to shape our anatomy. While women have been birthing naturally for thousands and thousands of years, one important question to ask ourselves is how have our bodies changed during this time?
For one thing, our western lifestyle has decreased the natural mobility in our bodies, especially in the pelvis.
Before I go on, let’s take a few moments to get really familiar with the pelvis. The pelvis is actually comprised of four bones: two illium, the sacrum and the coccyx. The bones are joined by connective tissues- namely ligaments and fascia- and these connective tissues are dense but mobile, they should have some amount of GIVE. (Having this in mind is incredibly important to keeping your head together when you consider that a baby is coming through the pelvis for the first time,) In fact, the joints of the pelvis are naturally capable of a great deal of movement. Their apparent lack of mobility in the western world is based MUCH more on our movement habits than genetics.
The number one thing that we do to shorten the amount of space in the pelvis is to sit in chairs with our tail bone tucked and our sacrum compressed all day long. This “normal” sitting posture reduces our healthy lumbar curvature and decreases pelvic floor strength dramatically.
Most of us are familiar with the term pelvic floor by now. You probably have some ideas of how to strengthen this area as well because it's taught in every Cosmopolitan magazine and OB’s office. KEGELS! Kegels are the exercise that has been most frequently taught for many decades. And while I hate to rain on anyone’s well-intentioned kegel parade, especially if you love them and do them quasi-religiously, there are evidence-based reasons why doing traditional kegel exercises in isolation may not be giving you the benefits you think they are.
In her 2010 interview with Mama Sweat, Katy Bowman explained, "A kegel attempts to strengthen the PF, but it really only continues to pull the sacrum inward promoting even more weakness, and more PF gripping. The muscles that balance out the anterior pull on the sacrum are the glutes. A lack of glutes (having no butt) is what makes this group so much more susceptible to PFD. Zero lumbar curvature (missing the little curve at the small of the back) is the most telling sign that the PF is beginning to weaken. Deep, regular squats (pictured in hunter-gathering mama) create the posterior pull on the sacrum."
For those of you who have been regularly doing isolated kegels on the advice of your trusted health care providers, I apologize. The good news is that we know more now.
Here are five simple changes can make a big impact on pelvic health and alignment which will support feeling strong and empowered throughout your pregnancy and into labor.
Your goals should be to untuck the pelvis, strengthen the pelvic floor muscles, learn ace-in-the-pocket relaxation techniques, build strong legs and glutes, and perhaps most importantly: align your joints.
More important than doing “reps” of any exercise is trying to make shifts in how we habitually carry ourselves throughout the day. How you hold yourself now — during your pregnancy — also dramatically affects the state of your post-baby body. Take it slowly and always listen to your body. Old patterns are deeply ingrained in both the connective tissue and in the neurology through the “set” length of the musculature.
*Please be sure to consult with a doctor or midwife if you are uncertain whether these practices are appropriate for you. Make that a pretty please.
First change: SITTING (sitting?)
If I can give you one priceless piece of advice, it would be to stop sitting on your tail bone the majority of the time! As I mentioned above, we need untucked tailbones for optimal pelvic floor strength much more than we need the isolated contraction of kegels. To shift your weight off the sacrum and onto your “sits” bones, tilt the pelvis forward. This should return curvature to the lumbar spine as well and make you feel like you are sitting taller. One great way to do this more easily is to regularly sit on a cushion that raises the sits bones above the knees. I suggest a meditation zafu filled with buckwheat or kapok. These firm but giving materials help to give the musculature somewhere to land without having to constantly re-stabilize as when we are sitting on a soft cushion or couch. Midwives also tell mamas to sit this way as much as possible towards the end of their pregnancy to help the baby’s head get into the best position for labor (facing the sacrum).
Second change: SQUAT with intention (see image above)
I'm not suggesting you take up quadricep-powered gym squats. For these squats you want to focus as much attention on strengthening the lumbar curve as you can (think: don’t pee on your feet), while maintaining the integrity of the knee and gently strengthening the legs. A proper natural squat requires that all of the joints from our feet to our hips are working optimally, and for most people this is simply not the case, so moving towards an optimal squat may mean first mobilizing the ankle joints and lengthening the calf muscles with a half dome (not this, but this) or rolled towel. Doing preparatory squats with a chair is a great way to allow oneself to experience the openness and suppleness of the pelvic floor right away. I highly suggest you just go here and read up on squatting because there are pictures and Katy goes into some depth about the mechanics.
You can also use the back of the chair to work on doing small pelvic tilts with a straight spine (without bending the knees) while you feel your sits bones moving away from one another and your booty blossoming. It may not feel “lady-like” but it’s building an essential skill for better birth. Here's a video.
Third change: Move DIFFERENTLY
We are creatures of comfort and habit. Though the joints and articulations of the body are capable of (literally) innumerable configurations, we tend to get comfortable as adults using the least amount of effort to move in predictable ways, which ultimately begins to limit and constrict us (and ultimately contribute to degeneration). This is your invitation to re-inhabit your kid body. Sit on the floor. (You will find yourself wanting to stretch, naturally.) Stretch your body long like a cat in bed before you start your day.
Put on your favorite music (music with a stronger beat helps) and dance in your bedroom. Move those hips and booty EVERY single day. We tend to equate fluidity with sensual movement, so feel into your beautiful sensual pregnant self. Remember that pelvic floor disorder is most prevalent in western and european countries, where we sit in chairs a lot more and move (and squat and booty shake) a lot less. (Please start doing this now so I don't have to keep myself from saying "I told you so" in five, ten or twenty years.)
Fourth change: RELAXATION as an essential practice
Relaxation is not optional. It is an essential part of your movement practice just like the spaces between these words are essential to legibility and ease of reading. A day at the spa is luxurious and wonderful, but often expensive and impractical. But I highly recommend that you find a way to receive nurturing massage from a pregnancy-trained therapist (like me) whenever you can. Massage releases hormones of relaxation and contentment that even your baby will experience. (But avoid painful deep bodywork as any extended mama pain can potentially decrease oxygen to the baby.)
Aside from getting massaged when you can, it is equally important that you learn to relax throughout the day. Until I create my own (soon!), I recommend this guided meditation from my Restorative Yoga Mentor Jillian Pransky. A prenatal yoga class can also allow you to tune in to your body and your baby, and provides a great setting for nurturing relaxation.
As much as we want to strengthen the pelvic floor, we also want to deepen our capacity to release those muscles.
Fifth change: WALK WALK WALK
Take movement breaks, walk short distances instead of driving, and don’t give in to the idea that pregnancy means that you can rest at home with your feet up all the time (unless your doctor tells you to, of course). Walking may be the most important movement that you do. It strengthens our core musculature, our glutes, and our legs, supports circulation, moves the lymphatic system, and creates healthy cellular loads. As you work towards optimal pelvic alignment and greater symmetry, you will find that walking becomes more effortless too.
Research also indicates that "for women with normal pregnancies, physical activity is accompanied with shorter labour and decreased incidence of operative delivery." The key is to engage in "submaximal weight-bearing activity" which includes walking, hiking, using a treadmill, or stair stepping.
Follow-up: Katy Bowman's Nutritious Movement for a Healthy Pelvis just came out and if you want the most biomechanical value for your money, I highly recommend it.