The truth about recovery

Oh dear, recovery.  Why do we always feel so uninformed regarding pregnancy/labor/birth recovery?? I thought I was informed having had classes on women's health, but I was so surprised at what recovery entailed with my first birth.  Of course, circumstances caused recovery to be worse than expected, but I just felt so clueless during those first few weeks.  Without further ado, let's dive in to the nitty gritty:

You get a massage a few times during your hospital stay

And it's not the peaceful massage on your back that you totally deserve.  It's called a fundal massage and it does not feel great because it is basically a uterus massage on your already-tender abdomen to make sure big clots are making their exit and not preventing healing as your uterus shrinks.

Speaking of shrinking uteruses...

There's also this unspoken fact that contractions continue postpartum. They're not as strong, but they tend to be worse if this baby is a second or third child.  Breastfeeding also causes a release of oxytocin, a naturally occurring hormone (Pitocin mimics this hormone) that causes contractions. I distinctly remember being shocked right after delivering my daughter and feeling those contractions with breastfeeding.

And now about breastfeeding

Ok, ladies, this is how it is- some ladies have tender nipples and other ladies don't. That's it.  Breastfeeding hurt like the dickens for me every time and made me want to say @#!?!*^#$ for the first 2-3 weeks.  It was longer with my son.  The nurses and lactation consultants for my first-time breastfeeding woes with my son kept telling me that "if it hurts, then you're doing it wrong. WRONG WRONG WRONG." So I sucked it up and tried to not cry for the first few weeks (believe me, there were tears shed), and finally, after a few weeks, it gradually improved until it didn't hurt anymore. **I should add that what was painful about it was the initial "latch" ** With my daughter, a wonderful nurse came to talk to me the morning after right after a lactation consultant told me that breastfeeding shouldn't hurt and said, "Honey, I don't care what they say.  I can't imagine breastfeeding NOT hurting- there's a baby constantly sucking on your nipples and you're not used to that. It will be a little painful, just count to 10 and it should be better by then." So there. I counted to 10 every time and she was right, the pain began to subside each time and made the experience much more tolerable. Though, I did get a horrible tension headache from tensing up so much for fear of pain...

You don't bounce back instantly. 

I figured I'd be tired and beat after a long labor.  I thought, hmmm I'll bet I'll feel better within the next week or two. Nope.  As I've learned, recovery can take weeks, maybe even months, and you won't feel like you have your old body back for quite awhile. This varies for every mom.  For me, I've had two experiences so far.  With my son, I didn't feel like I was truly getting better until about 6 weeks postpartum.  This is because of the blood loss, birth canal trauma, two bouts of mastitis, and breastfeeding troubles. I saw notable improvement after 3-4 weeks, but right after 6 weeks, I can remember thinking I got this. I never did feel quite like myself until a year after my daughter was born.  Recovery with my daughter was much better.  I felt better after about a week and fairly well-healed by one month postpartum.

Down below probably doesn't feel great

If you just pushed a baby out, you'll probably have some swelling.  Both hospitals I delivered at provided nice long ice packs and pack of Tucks to line them with and that provided great relief.  Tucks contains witch hazel, which comes from a plant (called... you guessed it, witch hazel...) and is great for pain relief for skin irritations. It's a fairly natural cleanser too.  The swelling can last a day to several days depending on how long you pushed for and any other tissue trauma such as forceps use. You will probably given a little squirt bottle that can be filled with warm soapy water so that you can clean your lady parts after going to the bathroom.  You'll want to take that home.

Blood

Postpartum bleeding (lochia) varies for all women, usually much shorter for c-section moms.  Don't be surprised at the large clots that can pass (unless they're softball-sized or larger.. your provider will want to know). Your uterus is purging all the extra linings and trying to clot and shrink back to the right size. I think mine lasted about one week of heavier bleeding and another week of light/spotting. If you don't recall from my last post, just know that you will receive a couple pairs of extremely stretchy (meaning, they'll fit both a petite lady and plus size lady) panties and sanitary pads that are basically diapers that don't close around your legs.

Bladder Control

I remember having to run to the bathroom when recovering from son's delivery because I was pretty sure I was going to pee in my super stretchy undies I just got. Ha.  Your pelvic floor muscles are just worn out from pushing a baby out, so just keep practicing your Kegels to strengthen them again.  For some ladies, this lasts awhile, others may not even experience it.

You may fear going #2

No one likes to fear a bowel movement, but your nethers may be swollen and you may have had stitches placed for tearing, so the first bowel movement can be scary.  Most postpartum protocols for providers include a stool softener regimen 2-3 times a day.  Don't be afraid.

Hair loss

Perhaps you read about this, perhaps not, but hair loss is common.  I feel like I'm always shedding when my hair is longer than 2 inches, but I did notice an increase in the amount of hair I was pulling out during showers the first few months.  I never did get any bald spots and you likely won't either. Go get a haircut and your nails done a few weeks postpartum and you'll feel like a new woman ;)

Emotions May Run High

Your body is going to go through drastic changes in a extremely short period of time, so chances are, you may being feeling a lot.... feeling ecstatic, feeling blue, feeling angry, feeling nothing short of asylum-crazy at times. There's a lot of anxiety being a parent of a newborn too- are they sleeping? wait, are they breathing?! Oh good. But did they eat enough??! Both times I have felt a surge of these extreme emotions on and off- it lasted the first two months for me. Thankfully, it would usually just be a short amount of time, like a few hours, here and there each week.

** Please also realize that postpartum depression is real and not just the "baby blues" though. While it's normal to feel some depression, it is not normal to feel like you have no control over yourself or thoughts to the point where you fear you may actually cause harm to yourself or another.  This can vary from feeling like your problems will dissolve if you just run away to feeling even suicidal.  Seek professional medical attention if you feel this way.

The fact is your body will be different postpartum.  There is no simpler truth about recovery.  You will feel strong emotions at times through the first year, especially if you breastfeed- breastfeeding affects every mom differently, which includes crazy hormonal shifts that affect your body mentally and physically. It's ok. It's normal. You may feel like crying one day because your husband didn't say the right thing or because dinner wasn't made on time.  Or perhaps you'll be suddenly so flippin' upset that someone said something that felt offensive even though it wasn't. Just remember, ok, crazy hormones are trying to control me right now. But you got this.  You'll get through it, I promise! Try to accept the new normal and appreciate your capabilities.  There may come a day when you feel like your pre-baby self, but for now, focus on all the great things, like a new baby :)

I really enjoyed writing my blog series and can't believe I'm done!   Thanks for reading, I have been surprised by how many times this blog has been viewed in just the past month when I first started! I am planning on continuing the blog in a few weeks sharing birth stories from now on and any other motherhood related items that cross my brain. Good luck with your labors and recovery!

Who will be present during labor and delivery?

Who will be there?

Well, that really depends on you, mom.  Who do you want to be there? This is not the time to do something for someone because they want it- this is ALL about your comfort level.  Basically consider this- who wouldn't you mind seeing yourself butt naked and completely exposing your lady parts too? That changes the mood a little now.

For me, I only wanted my husband there. Him, my trusted OB, and the random medical staff in the hospital.  No offense to my family or close friends, but I really did not feel like I'd be able to concentrate very well if I was trying to push a baby out and worry if the family member or friend were seeing too much of me in a way they never had before.

Let's go through all of the roles who may be involved:

Physician

I had an OB/GYN doctor for my first delivery.  They are a medical doctor who has gone through medical school and a residency program specializing in women's health, including obstetrics and surgery for cesareans.  For my second delivery and current pregnancy, I am seeing a family practice doctor.  I chose a family practice doctor because they would be able to see me for prenatal care, women's health issues, and other illnesses, like the flu.  They would also be able to do pediatric care as well, so my new baby will see the same provider as me.  I like having a family practice doctor for this very reason.  They are also more likely to be present at your delivery instead of being in an office where there is a group of doctors where any one of them may be on-call the day you go into labor.  This varies between offices, of course, but I choose my providers carefully for this reason.  The only issue with a family practice doctor is that they are likely not trained in surgery (though some are), so if you need an unplanned c-section, you'll go with someone you may have never met.

Midwife

There are two kinds of midwives, certified nurse midwife (CNM) and certified midwife (CM).  A CNM is a registered nurse who has completed a graduate-level degree in nurse midwifery.  They are basically nurse practitioners who have specific obstetric education and can diagnose, prescribe medications, and treat you as any other primary care provider.  A CM is a medical professional who did not previously have a nursing education.  They are still required to have a bachelors degree prior to beginning their program and are trained extensively, but because they are relatively new, CMs are not legally allowed to practice in many states.  They are gaining more rights as practitioners though, so soon, they may be just as available as a CNM. A CNM can deliver both at the hospital, birth center, and at home and a CM will mostly only be allowed for home births and some birth centers.

You would think I would have opted for a CNM to support my fellow nurses, but circumstances have just always brought me to seeing a physician.  There are many, many CNMs/CMs who are just as competent at delivering a baby though :)

Doula

I had no idea what a doula (DUAL-luh) was until my second pregnancy.  I had told my chiropractor that I was planning to have an medication-free labor and delivery and she said, "well, you're going to have a doula, right?" A doooo-what? I researched them for awhile before coming across a lovely lady who I ended up having present at my delivery.  So, a doula in my definition is like a hired friend/support person- they can be your partner or they can enhance the support your partner gives you.  They are certified and trained to assist families in having safe and focused labors- I don't think I personally would want one if I was planning on having an epidural, but for a unmedicated labor and birth, they can help you stay focused and provide the support you may need.  My doula took on a few roles- she helped apply counter-pressure to my low back when I needed my husband by my side provide the cues I needed to stay in hypnosis, she took pictures for us, she helped me cheer me on when I needed more support, and she was just so wonderful to have as an extra support person who had "been there, done that" many times already.  She was a birth doula but there doulas trained as postpartum doulas and can be of great assistance for things such as breastfeeding education, infant care, and support for mom in the weeks following delivery- a person who will regularly check in on you to make sure your needs are being met.  Doulas can cost anywhere from $200-$800 (or possibly more!), so having a little disposable income is helpful.  

http://www.dona.org/mothers/ for more information on doulas.

Birth/Midwife Assistant
There is a newer role called a birth assistant or midwife assistant- they are not as common, but more training programs are popping up here and there.  Their role is to assist with the delivery- one step up from a doula, so they have a little more medical training in regards to actual baby delivery. 

Registered Nurse (RN)
For the sake of not having to go into what kinds of licensed nurses there are, I am just going to cover the nurse role as an RN.  Depending on your facility, you will likely have a Labor and Delivery (L&D) nurse and a Mother/Baby nurse.  I have only had good experiences with the nurses that cared for me (except for that one nurse who I swear had no clue what she was doing when trying to show me how to nurse my son...) and am always grateful for the help.  What does the nurse do in either of these roles? So much more than you can see.  First of all, they monitor your health and the baby's- you will be connected to monitors to measure vital signs like blood pressure and heart rate as well as a tocometer, which is often shortened to "toco" (think taco, but with a TOE sound) and monitors contractions and fetal heart tones/tracings (FHT).  Depending on hospital protocol, you may be allowed to be disconnected from all of these things to be able to move around more freely.  With my daughter's birth, my hospital had wireless toco monitors so that they could have continual monitoring without interfering with me too much.  I'll admit, I shook off the pulse oximeter (measures your O2 levels- it's the clip that goes over your finger and lights it up like ET [phone hooome]) and any other cord my nurse attached to me when she came in to chart my vital signs. Nothing more distracting than being tangled in a cord! Your nurse will also be the one who places an IV, does cervical checks to check labor progression when the provider is not present, and basically watches your every move even if you don't see them.  They are the middleman when communicating with you and your provider- both parties heavily rely on the nurse to be effective communicators.  Nurses complete most of the patient charting- this charting goes on your medical record so that insurance (and heaven forbid, lawsuits) can see it and it also holds the nurse accountable for all interventions and patient care. No pressure.

Patient Care Assistant (PCA) or Certified Nurse Aide (CNA)
A PCA and CNA are the same, it just depends on what the hospital calls them- I will just call them CNA in this post. Nurses rely on CNAs to assist in patient care- without them, nothing can be fully done.  A CNA will be responsible for different things depending on the patient- they can monitor vital signs, assist you to and from bed, answer your call light, and communicate with your nurse if the nurse is with another patient.

Lactation Consultant
The booby nurse.  Not always a nurse, but usually.  They specialize in breastfeeding assistance and can be a godsend if you are having breastfeeding troubles.  They will evaluate your baby's ability to nurse and will give you helpful advice and hook you up with different things like a nipple shield and breast pump supplies.

Social Worker
Sometimes a social worker will come in just to make sure your needs will be met when you go home.  They can help with any legal paperwork too like completing social security paperwork and obtaining a birth certificate.  If I recall correctly, bring a checkbook because both these things cost $$.

Phlebotomist
This is the dracula of the hospital.  Just kidding(ish).  They are trained medical professionals who draw your blood for lab testing.  You will likely encounter one at least twice, if not more, during your stay.

Janitor
I probably don't need to include this, but anyway, a janitor will come into your room at some point to clean.

If you want happier staff, bring a treat in during your stay :) I brought a sealed container of cookies from Trader Joes both times- not sure if all nurses are like me and some of my old coworkers, but I rarely trusted homemade treats from patients haha!

Support Person
This can be anyone- your go-to helping hand.  Some women want their significant other, some may just want mom.  Maybe your person is your BFF.  Having someone personal present at the birth is comforting and I highly recommend it.  No matter what method you deliver by, having someone you trust present to share the experience with is great.  I cannot imagine not having my husband there with me! Limit your visitors to those who will only uplift you, not test your patience or break your concentration. As I mentioned in the beginning, consider what your support person will see you doing- moaning, deep breathing, yelling, etc. and possibly dressed in your birthday suit only.

As suggested by my friend, Michelle, she also had present at her birth of her second child:

Birth Photographer
This is a great idea if you want some truly beautiful keepsakes from your experience. A birth photographer can capture the joy of meeting your new baby in a picture. The nice thing is that you have someone who will be able to take a picture of you and your support person and any others involved, instead of having your support person take on the photographer role too.  Cost depends on the area and demand. I did not have a professional photographer at either of my births, but I did consider it! With my son, I didn't take nearly as many pictures as I wanted to and while I got a lot of pictures with my daughter, having some professional pictures would have been nice.

Interpreter
My friend's husband is deaf so she actually had an interpreter present during her son's birth! What a great idea.  Consider hiring/having an interpreter present for either you or your support person if you are birthing somewhere that does not speak your native/primary language.  There is a lot less confusion and potential miscommunications.  Most hospitals in the US are legally required to have an interpreter present for you, the patient, if English is not your primary language, FYI.  Of course, keep in mind that an interpreter may really just be a "language line," which is a phone connected to an interpreter somewhere else.

Hoping you feel enlightened and more prepared about the people you may encounter during your own labor and delivery! I will add in more if I can think of any more roles.

Alternative Birth Methods

There are many methods for childbirth that do not involve medications.  There are also many reasons why someone would choose not to have medication.  I used to be completely against medication-free births because my thought was why the heck would you want that if you have modern medicine? Well, silly me, there are many reasons.  Some reasons other moms have told me are:

• because medication makes them feel funny/out-of-control 
• they have an immense fear of needles
• having control over their body is more comforting than being numb
• to be able to labor and deliver in the position of their choice
• they believe all drugs are harmful (not true, but this isn't coming from me)
• they want to feel more connected to their baby (I also disagree with this one)
• just to feel like a warrior princess (ay ya ya ya ya!! xena!! please tell me I'm not the only one who grew up watching xena...)

For me, it was having more control over my body. Aside from the whole blood pressure fiasco with an epidural, I loved being numb and feeling relaxed while laboring. I could chill, watch a movie, chat- it was great. But tell you what, when I felt the grinding of the forceps deep within me, even my fatigued i've-been-pushing-for-three-plus-hours thoughts couldn't hide oh lawdy, this is gonna be a scary recovery. And it was. So when I was preggers with number two, I researched and researched a method that could get me through contractions and have some kind of peace during labor. And with preparation, I was able to achieve my goal!

Before going too into my own experiences, I want to highlight the most common alternative birthing methods:

Bradley Method

The whole course is focused on learning to "trust your body" because birth is a natural process.  It teaches key relaxation techniques and overall good health habits during and after pregnancy.  Pain management is focused on the body relaxing and embracing any pain as part of the natural process. The class is 12 weeks long and is taught by an instructor, so you would need to be able to attend an actual course.  I'm sure there's a modified version where you can learn from home, but the Bradley Method is a registered trademark and is based on this 12 week course, starting around 5 months pregnant.  The class heavily relies on having your husband or significant other as a coach, so those who are more independent may not like this option.  Link to official course here.

Lamaze

The Lamaze method has been around since the 1950's and from what I'm reading now at this present time, there has been a shift in method to a more general focus of "increasing women's confidence in their ability to give birth."  The method was known for its classic "hee-hee-hoooooo" breathing technique.  Now, they focus on the whole aspect birth- before and after. The method wants you to feel prepared for anything and to have as few interventions, like artificially rupturing membranes or epidurals for example, so that you can let your body do what's most natural. They are supportive of birthing positions other than being on your back.  Pain management is much like the Bradley Method in that it is a natural process of childbirth and learning relaxation techniques can help minimize the pain and help you cope.  The course is usually around 12 hours- the duration really depends on the instructor, so anywhere from 4-8 weeks.  They also have online course opportunities.  See more on the official site here.

Hypnosis

The main focus of using hypnosis for childbirth is having a peaceful, gentle, and painless childbirth.  I know, it sounds kooky as soon as I said painless, but for many women, it is painless.  In general, self-hypnosis techniques are taught in these kinds of classes/books and by utilizing these techniques, a peaceful and fearless childbirth can be achieved. The main emphasis is total relaxation and using hypnosis to change your perception of pain.  One of the main ways to achieve this is reducing the negativity around your regarding birth. Every woman who has given birth has some kind of significant experience and sometimes it is less than ideal, so naturally they want to share and warn other expecting moms of their issues.  Well, if you are particularly sensitive, this kind of information can instill a little fear regarding childbirth and make it challenging to have total relaxation. Using hypnosis can be as structured as you'd like or be more flexible and self-taught with the guidance of a book.  From what I've gathered, there are two main classes to utilizing hypnosis for childbirth:

• Hypnobabies (what I used)
• The Mongan Method

Hypnobabies is both an instructor-led course or home-study course. The class is set up to be completed at a minimum of 6 weeks or longer.  There are 6 sections and many women take 2 weeks per section, totaling 12 weeks. The home-study course is a set of CDs with hypnosis scripts on them , narrated by the Hypnobabies founder, Kerry Tuschhoff.  There is also a workbook that structures the class and has additional reading to study on your own.  Attending a live class just goes over the workbook and scripts on the CD and is more ideal for people who are less self-motivated for a home-study course. Link to official course here.

The Mongan Method, by Marie Mongan, is similar to Hypnobabies except that it focuses more on an instructor led class.  Otherwise, much of the techniques are similar in teaching self-hypnosis.  There are not CDs or set hypnosis scripts, so it relies more on the student to master these techniques on their own. Marie Mongan has written a book that can be used as a basis for a home-study course, but it is not as structured as her course.  The actual course is 5 classes long, about 2-3 hours each, so the duration of the overall course is set by the certified instructor.   Link to official course here.

Other- there are many ways to learn self-hypnosis.  Google is filled with endless possibilities. Self-hypnosis is nothing new as people with allergies or anxiety have been using the techniques for at least the last 15-20 years with dental and minor surgical procedures. I would be weary of buying a course other than the two listed unless you have read testimonies of other moms' experiences who you know and trust.

Water Birth

A water birth is not necessarily a method, more of a position in birth, really.  You can use any method and have a water birth.  The whole point of a water birth is that it is supposedly an easier transition for baby to go from womb to warm bathtub water instead of cold air- makes sense to me! Moms also may prefer having a water birth because they feel lighter and less pressure on their whole body if they can float a little, lessening childbirth pains.  Water births can be anywhere- many hospitals that are supportive of alternative birth methods are beginning to include birthing tubs as an option to labor in and even give birth in! Some women who choose to have a homebirth will get a blow-up pool and set it up in their living room. Water births are illegal in some states, so check before planning your dream birth. http://www.waterbirth.org/ has a lot of helpful information regarding water births.

DIY

I say do-it-yourself because there are women who choose not to follow any of these methods and do so successfully.  If you think you have enough willpower and self-motivation to go without a course of any kind, then just make sure you research interventions before D-Day so that you can give your truly educated informed consent before receiving any interventions.  A few books that either I have read or have heard good things about are:

• Ina May's Guide to Childbirth- Ina May Gaskin is a nurse midwife who's like the ultimate natural birth guru. She is totally hippy and has a lot of good insights.
• The Birth Partner- by Penny Simkin. It is a guide for your supportive partner/doula during childbirth
• Hypnobirthing- by Marie Mongan.  I mentioned her earlier- her book is a great intro to hypnosis for childbirth and also shares key techniques for relaxation.
• Natural Hospital Birth- by Cynthia Gabriel. This is an empowering book but I would just keep in mind that although it suggest to always stand your ground, it is a good idea to ask educated questions regarding an intervention that is suggested (ex. so why do I need to have an IV? or what happens if I don't have my membranes ruptured right now?)

Now that you are aware of some options for alternative birthing methods, here are your three main options for places to birth at (and while I want to say these are your only options, you can always find a YouTube clip for something like a "natural birth in the woods" or "childbirth in nature with community group." It's true.) -

Home Birth

Some women dread the idea of being in a hospital full of sterile items and medical professionals or perhaps home is the place they are most comfortable at for everything, childbirth included.  Whatever the reason, this is a popular choice among many moms choosing alternative birth methods.  Generally, you have a midwife who will come to your home and you labor where you are most comfortable at. Some women deliver on their bed, others in the living room.  As mentioned earlier, a water birth can be set up in your home too. I'm sure this will rub some people the wrong way, but I am not an advocate of home births.  Emergencies are uncommon, but if they occur, I certainly would not want to be at home.  Also, I am lazy and I would not want to clean up... birthing goo.

Birth Center

A birth center is now a more common option.  Many are set up near a hospital and are like a bed and breakfast set up practically, but with necessary medical equipment.  You have the comforts of a homey-feel yet you don't need to worry about anything in your actual home.  I have heard of many positive experiences regarding stand-alone birth centers. Some hospitals are beginning to have birth centers within them- kind of like a hospital within a hospital.  I love this concept.  I had my daughter at a birth center within a main hospital and the staff were supportive of my decisions and I got to labor/deliver and recover in the same room, which was wonderful.

Hospital

There seems to be a shift in hospitals now with their L&D units- I see a lot more mom support now with alternative medicine and less intervention pushes.  There is also a lot of breastfeeding advocacy and the concept of skin-to-skin contact (learn more about Kangaroo Care here). A hospital is a safe place to be at to deliver.  What it all really comes down to is if your provider you choose is supportive of your childbirth wishes and plans because if they aren't, the hospital staff are less likely to be.  I always look for a provider who is on the same page as me because after my first experience, I realized that besides preparation, I depend a lot on my provider too to support me.

I hope this information can help you make an informed decision about what route you may want to take regarding your birth experience!

As I mentioned earlier, I did use Hypnobabies.  If you want to read about my birth experience, you can check it out on my family blog. 

Birthing Positions

Initially, I was going to include more about vaginal births in this one, but I found that I had a lot of material regarding birth positions, so I will cover vaginal births in my next post.

We are all familiar with the typical Hollywood birthing scene- ya know, where the mom is on her back and her feet are in stirrups:

A lot of times they are screaming, sweating, and appear to be in a LOT of pain. Well, there may be some of that if you choose to birth this way, but I have found that many women, including myself, don't really feel a ton of pain in this position because it is likely the only position you are allowed to be in with an epidural.  I will add that I'm sure there are some women who probably had a doctor say they could stand up with an epidural, because there's always exceptions, but really, sitting or laying down is safest when you're numb from waist down. 

Sitting semi-upright with your feet/legs in a mid-air squat (assisted by stirrups, your birthing partner, or nurses) is probably the most common position and it is out of convenience- mom gets to rest, doctor gets a very clear picture. Here's me after a few hours with my epidural during the birth of my son:

Pain-free gets a thumbs up.  Getting ready to push a baby out soon!

Many women have successful births in this position, but for those like me, it wasn't so much the birth that was rough (though there were several complications with that), it was definitely the recovery.  Because I had to be in this position, I wasn't really able to help my son with gravity and he was basically stuck for the 3+ hours I pushed for, which then led to a number of interventions.  I felt quite broken after delivery and recovery was worse because of how long it took for me to heal. With my daughter, I was able to move around more- walking, sitting in different positions, hanging out in the water for bit, and bouncing on an exercise ball.

So this leads me to share with you about other birthing positions that are available.  Some women go completely medication-free, others find that they would rather labor without medications first to help facilitate the position and then get some pain relief (as long as they didn't wait too long). I like this infographic both for the positions and the fact that the colors are aesthetically-pleasing:

Let's discuss these positions and how they can help:

Squatting- you can squat with a partner from behind, using furniture in the room, or some hospitals even have "squat bars" that provide stable support. Gravity is your friend here! This position really opens up your pelvis by aligning your birth canal with the pelvis.  Contractions are potentially more productive in this position too.  However, this position can be extremely tiring.  If you're like me, your legs may begin to feel jelly-like during labor so take fatigue into consideration. 

Sitting- chairs, beds, straddling chairs, on yoga balls (birthing balls. whatevs, they're just yoga balls), and the toilet (yes, seriously!) are all places that are good laboring seats.  This position is nice because you can rock your pelvis side to side or forward and back, utilizing gravity still.  This is a good resting position, but also note that when sitting, there can be more pressure on your coccyx (tailbone) and perineum.  I don't want to say that increases the likelihood of tearing or tailbone injury because honestly, those are both risks of vaginal birth no matter the position. Depending on how you are sitting, this can be difficult for your providers to check progress and sometimes can be less than ideal for pushing the baby out (no babies allowed in the toilet).

Kneeling- you can kneel with assistance like a yoga ball, a couple of pillows, on your partner's knees, or against the head of the bed (that's what I did with my daughter).  You can also just be on your hands and knees.  This position is really great for anyone who has back-labor because the pressure is lessened against your low back and contractions have been reported to be a little less painful this way. This is also a good position for somebody to apply counter-pressure against your low back for back-labor.  Kneeling is also another good resting position. This can again be a tricky for your providers if you are kneeling on the ground or sitting on your feet or if you're like me, I couldn't really see what was going on once my daughter was out and it was kind of pain to turn around and still have an umbilical cord attached to me.

Side-Lying- this is another good resting position, especially between contractions, and can also work for mothers who have an epidural if your provider allows it.  However, itt doesn't use gravity like any of the other positions so that is something to consider.  You would need assistance in holding your leg open while pushing though otherwise this would probably feel like the worst pilates move you've ever done.

Standing/Walking- the combination of gravity and being able to move around by swaying while standing or just walking around the room is something that helps facilitate birth for many women.  One way to birth in this position is to hug your partner around the neck (try not to strangle them) and then the provider can catch the baby. Leaning against the wall or supporting yourself on some sturdy furniture are also good options.  This can be a tiring position though if you are pushing for awhile or if your labor has already been long.  

a little more up close and personal than I prefer to share, but this is a good example of what laboring while kneeling looks like and my man applying counter-pressure on my low back (correct, he is not pushing my butt).

Every woman finds something that works best for them.  Like I said earlier, just because you get an epidural doesn't mean you won't have a comfortable birth! The best way to prepare is to just research your options, make a birth plan, and be flexible (flexible with your circumstances, though physical flexibility is always a plus).

Coming up next: Expectations of a Normal Vaginal Birth

*images from health-and-parenting.com and scene from Baby Mama