05.19.22 8 min read

Preparing For Labor and Delivery – Advice From a Midwife

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Pregnancy brings so many valid emotions–joy, fear, anticipation, and excitement among them. It’s normal to feel nervous at the end of pregnancy while waiting for labor to begin. 

Fortunately, there are a few things that you can do during pregnancy to help prepare your mind and body.

Balance your nutrition

The Institute of Medicine recommends the following ranges of weight gain during pregnancy, based on maternal pre-pregnancy BMI (1):

  • BMI less than 18.5:  28-40 lbs
  • BMI  18.5-24.9: 25-35 lbs 
  • BMI 25-29.9: 15-25 lbs
  • BMI 30 or greater: 11-20 lbs

Weight gains that are both lower and higher than recommendations have been associated with adverse pregnancy outcomes, including fetal growth issues and preterm birth (2, 3).  

In particular, gaining too much weight during pregnancy increases the risk of having a large-for-gestational-age baby, which is associated with higher rates of cesarean section, delivery complications, newborn complications, and childhood obesity (3, 4). 

While a variety of foods can be enjoyed in moderation during pregnancy, there is no need to “eat for two.” Daily calorie needs do not change in the first trimester, and energy requirements increase by just 350-450 kcal/day during the second and third trimesters (5). This can be accomplished by adding in one or two additional snacks, like an apple with 1 ounce of sliced cheddar cheese or a cup of Greek yogurt with berries. 

Protein, iron, and folic acid needs increase during pregnancy,  so it is more important than ever to choose nutrient-dense options for meals and snacks (5). For example, a handful of walnuts is a great source of protein, folic acid, and omega-3 fatty acids. 

A registered dietician (RD) can help you make personalized dietary changes that are in alignment with your health goals. 

Strengthen your body

Regular exercise is a vital component of a healthy lifestyle, and may be especially beneficial during pregnancy. The U.S. Department of Health and Human Services Physical Activity Guidelines for Americans recommends 150 minutes of moderate-intensity exercise per week (6). 

Though more research is needed, some studies have found that exercise in pregnancy is associated with: 

  • Decreased pregnancy weight gain and associated complications, including gestational diabetes and preeclampsia (7-10)
  • Decreased length of active labor (11, 12)
  • Increased rate of vaginal delivery and decreased cesarean section (13, 14)

While exercise has important benefits, it is important to ensure that your form is correct. Levels of the hormone relaxin are increased during pregnancy, resulting in loosening of the joints and soft tissues of your body. This can make pregnant people more susceptible to injuries (15).

The lower back and pelvic floor are common areas of stress, discomfort, and injury during pregnancy. A pelvic floor physical therapist is a specialist that can provide targeted exercises to strengthen your core and pelvic floor, which may:

  • Reduce time spent pushing (16)
  • Reduce risk of severe vaginal tears (16)
  • Prevent/treat urinary and bowel incontinence (17)

Calm your mind 

Beyond the physical work, labor requires mental preparation. Some people find that breathing exercises and mindfulness strategies, such as hypnobirthing, help prepare them to cope with the challenges that labor brings (18).

In particular, mindfulness-based childbirth preparation can help to reduce fear about birth, reduce use of pain medication during labor, and reduce risk of postpartum depression (19, 20). 

It is equally important to prepare for the postpartum experience. Postpartum depression and postpartum anxiety are real and common disorders. Some studies estimate that as many as 10-20% of new mothers experience postpartum depression and anxiety (21, 22). 

There are many risk factors for postpartum mood disorders (23), including:

  • Personal history of anxiety or depression
  • Complications during pregnancy, labor, or delivery
  • Young age
  • Lower socioeconomic status
  • Minimal social support 
  • Inadequate nutrition

Mental health therapy is an effective treatment for reducing postpartum mood disorder symptoms, and may even help to prevent postpartum depression (24, 25). People at risk of postpartum mood disorders and people who want to be proactive about prevention may find it helpful to establish counseling with a mental health therapist during pregnancy.

Several complementary therapies including yoga, acupuncture, and music therapy have also demonstrated benefits among people with depression, though more research is needed among pregnant and postpartum people (26-28). These practices are considered safe while pregnant and breastfeeding, unless otherwise directed by your healthcare provider. 

Medication is sometimes required for the treatment of anxiety and/or depression. Many medications are considered safe for use during pregnancy and breastfeeding. It is important to talk to your healthcare provider about the right option for you.

The bottom line

Though it may seem daunting, there are several steps that you can take to help create a healthy prenatal and postpartum experience. And Zaya is here to help!

Create your own personalized care plan to ensure that you are meeting your physical, mental, and emotional needs. 


Zaya can help you find and book in-network lactation consultants, dietitians, physical therapists, mental health therapists, acupuncturists, and more. Get started today.


References

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  2. Rogozińska E, Zamora J, Marlin N, Betrán AP, Astrup A, Bogaerts A, Cecatti JG, Dodd JM, Facchinetti F, Geiker NRW, Haakstad LAH, Hauner H, Jensen DM, Kinnunen TI, Mol BWJ, Owens J, Phelan S, Renault KM, Salvesen KÅ, Shub A, Surita FG, Stafne SN, Teede H, van Poppel MNM, Vinter CA, Khan KS, Thangaratinam S; International Weight Management in Pregnancy (i-WIP) Collaborative Group. Gestational weight gain outside the Institute of Medicine recommendations and adverse pregnancy outcomes: analysis using individual participant data from randomised trials. BMC Pregnancy Childbirth. 2019 Sep 2;19(1):322. doi: 10.1186/s12884-019-2472-7. PMID: 31477075; PMCID: PMC6719382.
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