Understanding Laboring Down: A Natural Approach to Childbirth
Hello Mamas,
Are you looking for ways to efficiently shorten the pushing phase of childbirth? Do you wish to deepen your understanding of birth physiology and make informed decisions about your labor process? If so, let me introduce you to a practice I am deeply passionate about: laboring down. This method deserves attention as it empowers mothers to let their babies move naturally into the birth canal at their own pace before starting active pushing.
This approach is especially beneficial if you have an epidural. Epidurals can alter the natural dynamics of childbirth—often diminishing the sensation of pushing, extending delivery time since gravity is less effective, and restricting movement. This can challenge the correct positioning of the baby in the pelvis. Moreover, without the natural cues from your body about the baby's descent, the birth process might become more directed by medical staff, rather than being led by your own body’s instincts.
Now, let me walk you through everything you need to know!
💫 Why Consider Laboring Down?
Laboring down can significantly reduce the time spent pushing, conserve your energy, protect your perineum, and even promote your baby's health during birth!
Regain Control and Physiology
When you choose to labor down with an epidural, you allow your body to use the time to naturally adjust and prepare for the active pushing phase. This process helps align the baby properly in the pelvis, compensating for the lack of gravity and movement due to the epidural.
Feel the Natural Urge to Push:
By allowing the baby’s head to descend naturally and gradually, you might reach a point where you feel the urge to push even with an epidural. This can be a crucial aspect of laboring down because it signifies that your body is ready to deliver, and you can actively participate in the process rather than relying solely on the medical team's guidance.
Save Your Energy:
Laboring down allows you to conserve strength for when you really need it—during the final, intensive stages of delivery. This approach is particularly useful after the exhausting efforts of early labor, as it minimizes the immediate need for intense pushing, which can be more challenging with an epidural.
Better for Your Baby:
Allowing the baby to gradually and naturally move through the birth canal can ease their transition into the world, making it less stressful and more comfortable. It's a kinder introduction to life outside the womb. Babies born after laboring down are generally healthier and often require less assistance from pediatric teams for breathing and adapting to their new environment.
Staying Active and Engaged:
It's a common misconception that laboring down means lying passively on your back. Actually, it’s quite the opposite. I encourage you to move around and regularly try different positions to help open your pelvis and assist the baby's descent. Squatting, hands and knees position with some support, or lying on your side with the upper leg bent on your chest can be particularly helpful. Yes, even with an epidural! with the help of your nurse or your doula, you can play around with some pillows as well as with the hospital bed to find the best support you need for your legs. This active participation is crucial to help gravity in doing its job, helping your baby find the best path through the birth canal.
Addressing the Concerns: Trust In Your Midwife
You might have heard about a Canadian study suggesting increased risks like hemorrhage and infection with laboring down. While it's important to consider all research, this particular study doesn’t entirely align with what we’ve observed in Europe, where laboring down is a common and celebrated practice. Here, it's seen as both effective and safe under the right circumstances.
As midwives, we are trained to support natural birth processes and make informed decisions about the best practices during labor. We know the physiology of birth perfectly, and we use our judgment to decide if laboring down is right for you, especially considering any complications like fetal distress or maternal fever.
Protect Your Perineum:
The gentle, controlled descent of the baby during laboring down allows your perineum to stretch gradually, significantly reducing the risk of tearing or the need for an episiotomy. This can lead to a smoother recovery and less postpartum discomfort. Consider this: forceful pushing for hours can severely strain your perineum, leading to long-term issues like muscle fatigue. Prolonged pushing increases the risk of complications such as urinary incontinence, weakened pelvic muscles, and even organ prolapse later in life.
🌷What is perineum and why we should take care of it?
The perineum is the area of tissue between the anus and the vulva in women, and between the anus and the scrotum in men. It's a critical area that includes muscles and tissues that support the pelvic organs and play key roles in bodily functions. Here are the main functions of the perineum in women:
Support for Pelvic Organs:
The perineum contains muscles that are part of the pelvic floor. These muscles help support the bladder, uterus, and bowel, holding these organs in place and aiding in their proper function.
Sexual Function:
The perineal area contains a concentration of nerve endings and blood vessels, contributing to sexual arousal and pleasure.
Childbirth:
During childbirth, the perineum is the area that needs to stretch to allow the baby to be born. The flexibility and strength of the perineal muscles can significantly affect childbirth, influencing the likelihood of tearing or the need for an episiotomy (a surgical cut made at the opening of the vagina during childbirth).
Continence:
The perineum is crucial for continence control. The muscles in this area help control the external anal sphincter and the urethral sphincter, aiding in the regulation of bowel and bladder movements. Strong and healthy perineal muscles contribute to effective control over these bodily functions, preventing incontinence.
🌸 European pelvic floor rehabilitation: a model to follow
In Europe, perineal care is taken very seriously. Every single woman is encouraged to undergo pelvic floor rehabilitation with a specialist, whether you had a vaginal delivery or a C-section, whether you have symptoms or not —usually a midwife who understands the full physiology of pregnancy, childbirth, and the importance of postpartum perineal care. Starting about six weeks after birth, this rehabilitation helps strengthen the pelvic floor to prevent future issues such as urinary leakage and prolapse.
In contrast, in the US, there's a significant public health concern regarding incontinence, yet there’s a lack of emphasis on proactive pelvic floor care. This oversight often means that women are only treated after problems become apparent, rather than preventing them in the first place. Many French women I meet here in the US express difficulties in finding adequate care. Prevention is key, and it is far more effective to address potential issues while you're still young, ensuring a healthier later life. And just to note: the typical three hours of rehabilitation often prescribed here is simply not sufficient. In France, we usually see women for five to ten sessions, with additional ones as needed. It's about ongoing care, not just a one-time fix.
✨Work with me to strengthen your perineum!✨
In my office, I offer a comprehensive approach to pelvic floor rehabilitation. More than just occasional exercises, I focus on integrating daily care practices that strengthen and maintain the health of your perineum. I teach you how to care for your pelvic floor every single day, turning these methods into preventative life skills that enhance and protect your pelvic health over the long term.
And rest assured, we won’t be doing a single Kegel exercise! That’s not my approach. Instead, I guide you through understanding how your pelvic floor functions within your body, and how it interacts with everyday postures, exercises, and breathing techniques. This isn’t just about temporary fixes; it's about giving you lifelong skills that will significantly improve your quality of life. You'll be grateful for these tools every day!
As a French midwife, doula, and acupuncturist, I strongly believe in the body’s physiology and natural skills and I would be honored to give you the chance of a healthy pregnancy, labor, and postpartum.
If you want to know more about laboring down and wish to get guidance on the big day, or if you want to take care of your perineum, book a 30 min free consultation with me here.
