Posterior Position: Practical Steps for Prevention and Remedy

Art by Katie Atkinson @spiritysol

A baby in a posterior position is facing your abdomen, and baby’s back is towards your back. Some babies are born easily in the posterior position with baby facing mama’s face “sunny side up.” This is especially if Mama:

• Has given birth before

• Is carrying a baby of average or smaller size

• Has an adequate sized pelvis

• Is committed, relaxed and prepared

• Is able to be upright, move and change positions at will

• Has the ability to eat and drink freely

• Is supported by providers who are patient, calm and trained to help baby turn

Art by Katie Atkinson @spiritysol

Other babies in posterior position can be more challenging, creating problems like not going into labor, water breaking prematurely before labor starts, slower more difficult labor progress, exhaustion, and labor felt mostly as back pain that can be harder to cope with. All of these factors increase the risk of complications, interventions and cesarean if baby can not be safely born vaginally. 

Epidurals increase the incidence of posterior babies, as well. But sometimes in prolonged labor, when Mama can no longer cope, the compassionate use of an epidural can help her give birth vaginally. 

The modern sedentary lifestyle of slouching in chairs over smart phones and computers, sitting back in sofas and car seats with associated poor posture, stress and tension in our bodies contributes to the rise in babies presenting in the posterior position. Many of us are no longer as active as our ancestors and indigenous cultures around the globe. We are not often leaning forward doing manual work, which helps baby’s heavier back come forward into the anterior position, unless we are doing activities like gardening.  

Art by Katie Atkinson @spiritysol

Ideally and actually most often, the baby will be in an anterior position facing your spine at term, or turns anterior during labor for childbirth. It is important to know when your baby moves into the optimal anterior position, so you can encourage the baby to stay there, which usually means an easier and shorter labor. 

You can learn on your own what position your baby is in. But if you are unsure, ask your practitioner for help figuring it out. Then try to pay attention to your baby’s position, without getting needlessly obsessed about it. This is easier to do when your baby moves or when momentarily lying on your back. It may take a lot of concentration to understand what is what at first, but soon you will get the hang of it.

When your baby is posterior, your tummy may look flatter and feel more squashy, and you may feel arms and legs and kicks all over the front towards the middle of your tummy. The area around your belly button may dip to a concave, saucer-like shape, and you may also experience long and painful practice contractions with a more severe lower backache as your baby tries to turn around to the anterior position to engage down into the pelvis.

When your baby is anterior, the back feels hard and smooth and rounded on one side of your tummy, and you will usually feel kicks under the side of your ribs. Your belly button will normally poke out and feel firm.

Pay attention to your posture and positioning at the time when your baby may be starting to descend into your pelvis, which is during the last 6 weeks of your first pregnancy, and the last 2-3 weeks of your subsequent pregnancies. The goal is to make room for your baby to assume the optimal position for birthing. 

The baby’s back is the heaviest side of its body, and will thus gravitate towards the lowest side of your abdomen. So, if your tummy is lower than your back (such as sitting on a chair leaning forward), the baby’s back will tend to swing anterior towards your tummy.

If your back is lower than your tummy (such as reclining back in an armchair with your feet up), then the baby’s back may swing towards your back into a posterior position. With this in mind, when you are 34 weeks onward, avoid any position where you are spending time leaning backwards with your knees higher than your pelvis.

Ideally, ditch the chairs. If you do need to sit on one, make sure your knees are lower than your pelvis, and your trunk is tilted slightly forward. If you need to work at a desk, consider a standing one at least some of the time, resting an alternating foot on a step stool.

Watch TV, read and lounge while kneeling on the floor, over a beanbag, birth ball, cushions, or sitting backwards on a straight backed dining room or kitchen chair facing and leaning on its back. 

Practice yoga to be in shape for the lunges and varied positions used to help your baby come down and out. Use yoga positions like bound angle (badha konasana) sitting with your back upright with soles of your feet together, or on your hands and knees while curving your back up like a cat followed by dropping your spine down in an arch and/or wiggling your hips from side to side. Get out your yoga mat and support your body with props like blankets, bolsters or blocks  as needed. 

Avoid crossing your legs, as it reduces the space in front of your pelvis and opens up the back. Sit on a wedge cushion in the car so your pelvis is tilted forward, and keep the seat back upright.

Avoid deep squatting until baby is anterior and well down in your pelvis or when needed in labor. Deep squatting opens up your pelvis and encourages the baby to move down, so refrain from it until your baby is in the anterior position. You can squat on a low stool or yoga blocks instead, keeping your spine upright.

Rest and sleep on your side, with two pillows under your bent right knee, which should be jackknifed up towards your chest, and keep your left leg straight out.

Swim with your belly downwards, doing the front crawl and breaststroke. The leg movements with the breaststroke in particular are great for opening your pelvis and encouraging your baby into an optimal anterior position.

If Your Baby Is Posterior

Continue the above mentioned positions, and add the following exercises for 20 to 30 minutes each, 3 times daily while watching something inspirational, romantic or that makes you laugh, or while listening to music:

Maintain a knee-chest position, with your buttocks sticking up in the air to tip the baby  back out of the pelvis so there is more room to turn around to the anterior position.

• Sway your hips back and forth and do the pelvic rock up and down while on your hands and knees.

• Crawl around the floor on your hands and knees, or hands and feet like an elephant.

• Scrub your floors or do some gardening.

• Swim belly down, kicking with straight legs only. Avoid frog leg movements.

• Lie on a slant board (using an ironing board or see-saw), with your head down and your legs up or lay with your pelvis and legs on the top stair landing or sofa and rest on your hands or forearms on a lower stair so you are at a similar incline. Jiggle your pelvis as you do this.

• Try resting and sleeping on your tummy using lots of pillows and cushions for support.

• Sit on a kneeler-rocker, which is a kneeling stool that sits you in an upright position with your knees lower than your chest, and has a rocker underneath for movement that encourages your baby to rotate. There are several types. See what is best for you. 

When baby turns to the anterior position, you can encourage descent further into your pelvis by walking around upright, gently massaging the baby’s buttocks downward, deep squatting and swimming, this time using lots of breaststroke frog leg kicking.

If you have lax abdominal muscles from several babies or lack of toning exercises, use a supportive maternity binder to keep baby in place. Bellefit makes a fine one, as pictured below. You can check them out and purchase here.

If Going Into Labor With a Posterior Baby

Starting in early labor, try the following movements involving altering the level of your hips, which help wiggle the baby down through your pelvis:

• Walk up and down stairs, sideways if you need to.

• Rock and dance from side to side.

• March or tread in place.

• Step on and off a step stool.

• Climb in and out of the birth pool.

• Lay on your side, so the part of your belly where your baby’s back is, can lean forward almost over the sofa or bed, with your upper knee resting on a lower chair.

• Consider having your midwives help to rotate the baby using a variety of external techniques, or if needed, by manually lifting your baby out of your pelvis during a contraction.

During the pushing stage of labor:

• Kneel on all fours, with the other leg up in a lunge. Switch legs periodically. You can do this standing, alternating one leg up on a chair moving towards and away from it. 

• Maintain a supported high squat in a birthing stool or hanging from a dangling squatting rope or your partner, with your bottom at least 18 inches off the floor.

• You can rest on your side with one leg straight out and the other leg bent up towards your chest, supported with pillows.

• Avoid lying back, semi-reclining, sitting or semi-sitting. 

For more information online, visit Spinning Babies, Association of Radical Midwives, or the GentlleBirth archives for Suboptimal Fetal Positions.

Check out my number one international best selling book Natural Birth Secrets and my Love Your Birth course, an online version of how I have helped thousands in my local practice.

Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned nurse midwife of over two decades, who has seen everything! It is now recommended by midwives, physicians, health care professionals around the globe, and doulas take it for their certification training.

As always, if you need more personalized guidance, schedule a consultation with me. 

Postpartum Bleeding: Holistic Prevention Strategies

It is normal to have light bleeding in labor as your cervix dilates and breaks its tiny blood vessels. And as baby emerges from the birth canal there can some local tearing that can cause bleeding. Expect to experience the most bleeding at delivery and postpartum. Most of this bleeding is from where the placenta was located in your uterus. 

At normal vaginal birth and immediate postpartum, it is common to lose up to a half liter of blood. After cesarean birth, one liter of blood loss is the average. After birth, your uterus needs to contract around the major blood vessels that supplied the placenta to close them off and prevent excessive bleeding. 

The first few days, bleeding can be like a heavy period. Then, it tapers to a moderate period, after which it becomes lighter and changes color over several weeks from shades of red, then pink to brown. The body is healing the former placental site, shedding the internal scab there, and extra tissue and blood that was lining your uterus during pregnancy. 

Postpartum hemorrhage usually occurs immediately, or up to the first 24 hours post birth, and remains a major cause of maternal death in the US and around the world. It must be taken seriously. Currently, there is substantial evidence in support of what is termed ‘active management of the third stage of labor,’ to reduce the risk of severe excess postpartum bleeding. It includes the use of:

•  The synthetic hormone oxytocin (referred to as Pitocin in the US) via intravenous or intramuscular injection

• Early cord clamping with waiting 1-3 minutes until baby gets at least most of the cord blood

• Controlled traction on the cord along with counter pressure on the uterus to effect placenta delivery within the first 5-30 minutes after birth

• Uterine massage to make sure it is firmly contracted

• Assessments every 15 minutes for the first two hours. 

The above process, or a similar version, is done routinely in most hospitals, and can certainly be done in out of hospital birth settings. However, the studies that determined these procedures, were based on hospital births in mostly resource poor but also well developed countries. Like all studies, they have their limitations and flaws, some were even considered to be of poor quality according to the esteemed Cochrane Review. Also these interventions are not without side effects and concerns. The American College of Nurse-Midwives support the use of active management of third stage of labor in low resource settings, according to their position statement, although they do admit its benefits are not as clear in the low risk healthy population, and encourage the provider to have a risk benefit discussion with each pregnant family so they can make an informed decision about it. 

Most homebirth and birth center moms and providers are passionate about physiologic birthing, minimal interventions and holistic modalities, do not routinely want an injection of medication, and are more interested in natural alternatives. They trust the incredible wisdom of the normal birthing process, which has worked for thousands of years or we would not have survived as a species. They share a common belief that if it is not broken, don’t fix it, wary of medication and interventions unless absolutely necessary and benefits outweigh risks. They tend to like the alternative, ‘expectant management’ approach, which also entails close observation by the provider, but tends to take longer, allowing for the normal physiologic process to take its course, and for interventions only if needed in select cases. 

After birth, mom and baby are of course carefully assessed, but encouraged to bond skin to skin. There is no rush. Cord clamping is delayed until pulsation has ceased, or after placenta is birthed. Mom and baby are assisted to breastfeed which helps release mama’s own natural oxytocin.

The provider waits and watches for signs that the placenta is naturally separating and then assists mom into an optimal position usually using gravity, and encourages her to use her own bearing down efforts to birth her placenta. The provider may sometimes guide the birthing placenta with gentle traction on the cord, while supporting the uterus, then massages the uterus to make sure it is firm, assesses the bleeding until stable, and assesses and repairs tearing as needed. 

Certainly, if there are certain concerns or risk factors, you may truly benefit from medical prevention and active management.

If there is an actual hemorrhage, make sure your provider is skilled, experienced, and fully equipped to deal with it with at least the commonly used effective medications, IV fluids, suturing material for lacerations needing repair, and hands on care that are usually sufficient to control it successfully. 

However, you can build up a strong blood supply and reduce excess bleeding and its risks with the following suggestions for natural support both in your pregnancy and postpartum.

Prenatal Support

Make sure you get checked and treated for anemia common in pregnancy, that your iron stores (ferritin) are sufficient. 

Eat 3 large servings of wild greens or dark green leafy vegetables every day. They can be made into a salad, lightly sautéed or steamed. Good options are parsley, dandelion, alfalfa, kale, collard greens, comfrey and turnip greens.  For additional support, you can try the following:

NETTLE AND RASPBERRY TEA

Starting in the third trimester, drink 1 cup of this nourishing herbal infusion several times per day. 

1. Combine a handful each of the dried herbs Nettles and Red raspberry leaf with 1 quart boiling water.

2. Steep for at least 4 hours.

3. Strain to a glass mason canning jar.

4. You can add fresh mint leaves, lemon juice, or honey to taste.

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GREEN DRINKS

Drink 1 ounce fresh, frozen, or powdered  wheatgrass juice 1-2 times daily to enrich and build your blood.

Or, try 1 scoop daily of powdered greens in your smoothie, 1-3 Tbsp bottled chlorophyll, or tablets or powders of spirulina and chlorella.

Postpartum

You need to rest in bed, on the couch or an outdoor lounge chair as much as possible for the first 2 weeks to recover.  Make sure you arrange for help in the home during this special time. Limiting activity and increasing rest help the area of open uterine blood vessels where the placenta detached to heal. 

Check the top of your uterus regularly for firmness, and massage it if it feels soft, until it hardens. Postpartum bleeding can be minimized when mothers are taught regular postpartum self massage of the uterus so that it stays firm and contracted around the blood vessels that supplied the placenta. 

Start breastfeeding right away, and every 1 ½ - 3 hours thereafter, especially taking advantage of the times when your baby is awake and alert and eager to suck.  Nursing frequently causes the body to secrete its own natural hormone oxytocin to keep the uterus firm and decrease bleeding.

Urinate frequently to keep the bladder empty so the uterus can contract easier.

You can also take homeopathic caulophyllum 30 or 200 C immediately after delivery, then 3-4 pellets arnica 30C under your tongue every 2-3 hours. Or, try herbal shepherd's purse, 1 dropperful of the tincture three times daily for the first 3-5 days after birth. If you need additional herbal support for heavier or persistent bleeding, you can try a dropperful of Angelica tincture a few times daily. 

Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. Find the best supplements that have gone through my thorough screening process there. Look in the category for postpartum bleeding prevention or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days.

As always, if you need more personal guidance, schedule a consultation with me. 

If bleeding becomes heavier than a heavy period, and you are soaking through two maxi pads an hour for 2 hours, empty your bladder, make sure the top of your uterus is firm and massage it if soft until it becomes hard. If no relief, take 1 tsp shepherd’s purse herbal tincture under your tongue. You can repeat the dose a few times, but if the bleeding becomes heavier, contact your practitioner. 

Do read my Natural Birth Secrets book, to prepare yourself for a healthy, joyful and calm pregnancy and childbirth - NOW OUT IN SECOND EDITION!

For further inspiration, empowerment, and optimal health in pregnancy, birthing and postpartum, please make sure to take my online Love Your Birth course, so you can ROCK your journey wherever and however you plan to give birth.

Photo by Megan Hancock Photography

'Overdue' Baby: What to Do If You’re Past Your Due Date

Although it’s totally normal to have an ‘overdue’ baby, it can be very frustrating. The ideal is to prevent it early on by knowing when you conceived and getting accurate pregnancy dates.

Try to keep busy past your due date by continuing to exercise as tolerated and planning some daily pleasurable activities to keep your morale upbeat and positive.

There is a five week time frame around the estimated due date, when babies are considered term, in which it is normal and most common for moms to go into labor.

In a well-nourished, healthy woman whose pregnancy has been accurately dated, the actual time of delivery often extends 1-2 weeks past the estimated 40-week due date. This is especially true with first-time moms.

Only a small percentage of women give birth on their due date, and most babies are indeed born at the perfect time for them.

A pregnancy is actually “postdates” when it exceeds the 42nd week of gestation. In this case, it’s still best to wait for labor to occur naturally, assuming:

• Your baby is still as active as usual

• The amount of amniotic fluid is adequate

• Your baby has a normal heart rate

• The size of your baby is estimated to be compatible with the characteristics of your pelvis

• You are healthy and there are no other pregnancy complications

Monitoring a Postdate Baby

There is an increased risk of complications associated with postdate pregnancies, mostly related to an aging placenta that ceases to function as well as it did earlier, or to a baby that continues to grow to an exceptionally large size. Therefore, there will be a need to monitor you and your baby more closely after 41 weeks. Rest assured, though, that the majority of postdate babies do just fine.

FETAL MOVEMENT COUNTS

Fetal movement demonstrates adequate nourishment and oxygen from a healthy placenta. A baby will significantly decrease its movement as the condition of the placenta deteriorates. With that in mind, a wonderful way you can monitor the continued well-being of your baby throughout the third trimester is to do daily fetal movement counts. 

Pick a time when your baby is usually most active, often this is after meals, when resting or at night when lying in bed. Make sure you count at least 10 distinct moves in 2 hours. If you notice less, the baby may be sleeping. Try again a little later after drinking 2 large glasses of fruit juice, a cup of coffee and eating a complex carbohydrate and natural sugar meal, such as peanut butter and jelly sandwich on whole grain bread. Lay down after 30-40 minutes and count the number of moves. If baby is not moving after this, or you still feel that the baby is moving less than usual in a 12 hour period, contact your practitioner right away. The baby needs to be evaluated, and if in trouble, will need to be delivered as soon as possible.

IN-OFFICE TESTING

Two tests commonly done in the office to monitor the condition of the placenta and baby’s well-being are the twice weekly NST (non-stress test) and the weekly BPP (biophysical profile sonogram).

The NST uses an external electronic fetal monitor to note the character of the baby’s heart rate and its response to fetal movement. A desired response is a fetal heart rate that varies from beat to beat within the normal range, and increases at least twice when the baby moves, 15 beats per minute for at least 15 seconds within 20 minutes. Out of hospital midwives are asked and can use a fetoscope or doppler to check fetal heart rate and record accelerations manually, but it is less accurate, without a recorded tracing, not the standard of care nor evidence based; it is also not supported by modern medicine, or most of the collaborative obstetricians midwives work with.

The BPP uses ultrasound to examine the fetus and its environment in utero by assessing a variety of parameters including the baby’s movements, muscle tone, the placenta and the amount of amniotic fluid. The ultrasound can also provide estimates on the baby’s growth and weight, but they are only estimates and not always accurate at this late stage of pregnancy. Try to schedule this test during a time the baby is usually active and moving the most. On the day of the test, make sure you are drinking your usual daily 8-10 glasses of water so the baby has plenty of amniotic fluid. 30-40 minutes before the test, make sure to have 2 large glasses of fruit juice and a natural sugar/carbohydrate meal or other foods that usually wake baby up and causes lots of movement. You can even have a cup of coffee or tea just in case the baby is still sleeping after the meal. The test is somewhat dependent on the baby moving, and we would not want a false report of no fetal movement indicative of fetal stress, when the baby was just sleeping healthfully.

Natural Measures to Help Prevent Problems Related to Postdates

These recommendations are especially helpful if you had complications from postdates in prior pregnancies, you are attempting a vaginal birth after a previous cesarean, or you have other complications such as diabetes or high blood pressure and it is not advisable to let the pregnancy extend past term. Research on natural induction methods is sparse, but growing. Sometimes one remedy or a combination of them does the trick, and all is well. Sometimes, no matter what we do, we can not get labor started. Nothing works consistently, including the medications used in hospitals. Ultimately, unless there is a scheduled cesarean birth, when a baby comes into the world is ultimately not in our human control.

KNOW YOUR STATUS

If you are planning a pregnancy, keep an accurate record of your cycle and know the first day of your last menstrual period. Or better yet, the day of conception around the time of ovulation. If there is a question about your dates (if you are breastfeeding, recently miscarried, went off the birth control pill, or have long  or irregular cycles), an early first trimester ultrasound can accurately date your pregnancy. This will prevent a lot of aggravation later on, like unnecessary testing, pressure to deliver and induction based on miscalculated dates.

EAT RIGHT FOR BABY

Maintain a healthy well balanced diet including lots of:

• Organic fresh fruits and vegetables

• Whole grains

• Seeds and seed products like tahina 

• Nuts and nut butters

• Beans

• Organic tofu and tempeh  

• Organic whole eggs

• Turkey or chicken

• Beef, lamb, or wild game

• Wild Alaskan salmon 

• Organic fresh raw whole dairy-ideally goat or sheep

Use healthy fats for cooking, such as organic cold pressed extra virgin olive oil, coconut oil or goat butter. Drink at least 64 ounces of filtered, spring or well water or herbal tea per day, at least 20-30 minutes before meals. Limit intake of fruit juice and refined white flour, sugary products, and refined vegetable oils or partially hydrogenated fat. Aside from being unhealthy and fattening, the refined sugars and starches grow big babies that are harder to push out.

Make sure to eat plenty of dates and pineapples - some swear by them to encourage labor. I am not convinced, but no harm trying.

Prepare Your Mind

Prepare for a deeply positive childbirth experience. It is very important to enter labor and birth with positive feelings, trusting your body and the whole birth process.

It is helpful to write a positive birth vision, what you wish your labor and birth to be like from start to finish, and include the role and involvement of all persons who will be there.

This is something you and your partner can think about and write together. You may write as little or as much as you like, but enjoy thinking about this special time in your life. 

There are a number of methods to help you get ready for the amazing experience to come:

• Childbirth classes

• Hypnosis for birth in adjunct 

• Gentle, Prenatal and Restorative Yoga 

• Breathwork, meditation, and progressive muscle relaxation techniques (yoga nidra)

• Watching positive birth movies

• Listening to inspiring podcasts and birth summits

• Books. Some of my favorites are:

  • Mindful Birthing by Nancy Bardacke

  • Orgasmic Birth by Elizabeth Davis and Debbie Pascale Bonaro

  • Ina May’s Guide to Childbirth by Ina May Gaskin 

  • Baby Catcher by Peggy Vincent 

  • Natural Birth Secrets by me, Anne Margolis! 

Accept and express feelings that might be holding you back, such as anxiety or fear about childbirth or becoming a mother, uncertainty about your changing role as a person or relationship with loved ones, and hesitation about giving up the special attention you’ve enjoyed while being pregnant. Do not hesitate to talk with a close friend, family member, childbirth educator, or therapist, as labor and birth is heavily influenced by your emotions. Often, simply sharing and releasing ambivalent or troubling feelings does wonders to help you open up, let go and give birth. When that does not help, try releasing it from your body with breathwork.

Practice the following thoughts daily while doing slow deep breathing in a quiet meditative space: 

Spend some time saying goodbye to your pregnancy and inviting your baby to come out. Tell yourself that you and your baby are ready for labor and birth to occur. Imagine your uterus contracting. Visualize your cervix softening and opening, and picture your baby descending through the birth canal so you can cradle your beautiful newborn child in your arms. Affirm that you will surrender, let yourself be relaxed and open so that your body will do what it was perfectly designed to do - give birth to a new human being.  

HERBAL SUPPORT

Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. Find the best supplements that have gone through my thorough screening process there. Look in the category for labor stimulation support or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days.

Drink fresh infused Red Raspberry leaf tea regularly. Among its many benefits, it encourages more effective uterine activity and thus an easier birth. It is optimal to make your own by adding a generous handful of the dried herb to 1 quart of water. Let it soak in a glass canning jar for approximately one hour, then strain. You can add honey, fresh mint leaves and/or lemon juice to taste and drink several times per day.

Dr. Christopher’s Birth Prep herbal formulation is designed to cause an increase in toning contractions in late pregnancy and prepare your body for labor and birth. It can be taken during the last 6 weeks of pregnancy under supervision by your provider. The recommended cycle is 1 capsule per day at week 34-36, 2 capsules per day at week 37, 2 capsules twice per day at week 38 onward, until you have your baby.

Make your own wonderful late pregnancy herbal tonic, to be used 37 weeks onward. Combine 1 dropperful each of red raspberry leaf, partridge berry, blue vervain and cramp bark with ¼ dropperful each of wild yam and motherwort in a separate tincture bottle and shake to mix well. Take 1/2 dropperful of the mixture a few times daily. You can double the dose in the last week before your due date. Other reputable herbal brands include Gaia, Wish Garden, Herb Pharm and Eclectic Institute.

You can take Evening Primrose oil capsules, 500 mg daily, as early as 36 weeks to help ripen the cervix. 

At 38 weeks gestation, start inserting 6-8 caps of Evening Primrose oil deep inside your vagina behind the cervix every 8-12 hours if:

• This is your first baby OR

• You have a history of post-term pregnancies

At 41 weeks gestation, start inserting Evening Primrose at the dose above if:

• Your cervix is still not ready for labor as measured by internal exam AND 

• Your bag of waters is intact

You should have a ripe cervix within a few days. At 41 weeks, you can also increase the oral 500 mg dose to three times daily. 

GET IN THE MOOD

As long as your bag of waters is still intact and you do not have a history of premature labor, engage in frequent sexual intercourse, especially after 36 weeks. Semen contains prostaglandins which can help ripen the cervix for labor, and reaching climax can bring on uterine contractions that may stimulate labor if the cervix is ripe and the baby is ready. The same energy that gets baby in, gets baby out, so turn up the sensual and make lots of love.

She is dancing to the music on her phone.

GET MOVING

Likewise, if you do not have a history of preterm labor, engage in regular moderate exercise like brisk walking, cycling, dancing, swimming or low impact aerobics for at least 30 minutes 5 days per week. As you get closer to term, moving around while upright uses gravity to help get the baby in an optimal position for birth, as well as press on the cervix and cause it to ripen and stimulate contractions.

As women get closer to the term, it is common to feel an increased frequency, length and intensity of Braxton Hicks contractions as the uterine muscle warms up for labor. These contractions are felt as occasional lower abdominal menstrual-like cramping in early pregnancy. But, as you get closer to term, you can actually feel your uterus ball up and harden, often from the top on downward before it softens again. They are usually brief, painless and irregular without pattern, increase with activity and resolve with rest. 

If you do not feel such uterine activity beginning at 39 weeks, you can do nipple stimulation every 10 minutes for an hour 3 times per day to stimulate contractions. To do this, roll the end of your nipple between your fingers and compress and pull slightly as a suckling baby would do. Alternately, you can, or use a breast pump, which will come in handy postpartum. 

Natural Ways to Bring on Labor

Only use the below methodologies if you have reached or passed your due date and you have discussed options with your practitioner.

Increase nipple stimulation to every five minutes for 2 hours, 4-5 times per day. It may take several hours, but with a little persistence, this can get labor going. Nipple stimulation causes release of your body’s own oxytocin, the hormone that ripens the cervix and stimulates uterine contractions. Don’t stop until labor is progressing on its own.

Take homeopathic Cimicifuga 30c, 4-5 pellets, alternating with Caulophyllum 30c, 4-5 pellets every hour for 12 hours. Repeat for two days. This gently stimulates your cervix to ripen and labor contractions to begin.

Massage your uterus with Castor oil until you get a contraction, and then repeat every 5 minutes until a labor pattern is established on its own.

If all else fails, you can try drinking Castor oil. This induces labor by stimulating your bowels, so be prepared for the possibility of diarrhea. Take 2 ounces of Castor oil in orange juice every hour for a total of 3 times. Two ounces of vodka, brandy or bourbon can be added to this mixture to loosen you up psychologically if needed. After each drink, go for a walk around your house (staying close to a bathroom!) and then take a hot shower, letting the water flow onto your nipples and persistently massage your belly with some of the Castor oil.

If still no labor, there are other things we can recommend like an enema, gently stretching your cervix open and stripping your membranes (separating the membranes from their attachment to the lower uterine wall), or as a last resort, breaking your water and/or medication if your baby needs to be born without delay.

If you need more personal guidance, schedule a consultation with me. I am happy to help!

Natural Induction Methods: The Evidence

Art by Catie Atkinson @spiritysol

Natural Induction Methods: An Unbiased Look at the Evidence

Natural methods of labor induction have been sought after for millennia by third trimester mothers for a variety of different reasons. In modern times, they're frequently a resort of mamas who might be facing a medical induction if they don't labor naturally soon.

There are myriad purported natural induction methods, but both the efficacy and safety of the methods in question are often under-studied and sometimes dubious. It's important to understand the difference between treatments that are largely safe and those that could negatively impact labor, birth, or your baby's health.

The majority of popular natural labor induction methods revolve around the consumption of plants or plant derivatives, such as castor oil and dates or pinapple, or herbal and homeopathic remedies. In the case of simple fruit consumption, there's little risk to mom beyond a stomach ache caused by an overzealous attempt. This can mislead pregnant women into thinking that all plant-based methods of attempting to naturally induce labor are safe, which is not true. In fact, some more potent plant derivatives have been shown to lead to labor complications.

The other category of natural induction methods involve forms of physical stimulus. Again, these have been attempted throughout the ages with varying degrees of success. Sexual intercourse, which is one of the most colloquially suggested methods of naturally triggering labor, has minimal risk unless a midwife or doctor has noted otherwise. Interestingly, despite its reputation, it has still been shown to be less effective at triggering labor than other forms of physical stimulus. Other stimulation methods include breast massage, acupuncture and acupressure, walking (most effective once actually in labor), uterine massage, and membrane stripping - to name just a few.

When you're attempting a natural labor induction, knowing what works and what doesn't is helpful; knowing what's healthy and what could harm your baby, however, is vital. We The Parents has compiled an infographic detailing nine of the most popular ways mothers attempt natural labor induction. For each method, the scientific evidence is examined. How much research has been done? And what do the results indicate about the efficacy and safety?

While this can help you to make an informed decision, it's also essential to get your treating physician, midwife, nurse practitioner, or other qualified health care provider’s go-ahead before trying any of these methods in order to avoid inadvertently harming yourself or your baby.

As a holistic midwife of just about 25 years, countless mamas have sought my guidance on how to bring on labor with natural modalities. I have experienced much success with a variety of methods - some not even mentioned here, but nothing has been consistent, and as with many natural remedies there is a paucity of research. As long as they are safe and sometimes effective, I will continue to recommend them, knowing that I am helping, and it is ultimately not in our control - babies prefer to come when they are ready. Many of the professional grade, top quality remedies I recommend and use often are available in my holistic online apothecary. Find the best supplements that have gone through my thorough screening process there. Look in the category for labor stimulation support or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days.

Also, even the powerful medicinal methods have significant risks we can not take lightly, as well as benefits when there are serious complications, and do not always work either.

A common reason women want to bring on labor naturally is the concern about being ‘too late’, the postdates testing and threat of hospital induction, along with the cascade of interventions associated with it. A key factor people often do not consider is prevention. When planning a pregnancy, I encourage women to take charge of their fertility, empower themselves with knowledge about their cycles, fertile signs and know when they conceived, so the due date is more accurate than if simply based on first day of last menstrual period alone. Read more about what you can do, covered more in depth in a previous blog. Women who do not know their cycles or the date they got pregnant can also consider an early first trimester sonogram, especially if they have a history of long or irregular cycles, or of being induced previously for carrying post-term babies; but a decision to do that should be an informed one, as there are also pros and cons of ultrasound to consider.

Knowing what you should do can seem daunting. I am here to help if you need more personalized guidance. You can also read my books, to prepare yourself for a healthy, joyful and calm pregnancy and childbirth, and for healing and enhanced well-being. For further inspiration, empowerment, and optimal health in pregnancy, birthing and postpartum, please make sure to click here to take my online Love Your Birth course, so you can ROCK your journey wherever and however you plan to give birth.

I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  

But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by.

I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. 

Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby. For more info on the Bellefit girdle, check out my blog about it here. 

Have a Great Postpartum Recovery (with a little help from Bellefit)!

Singing and Dancing My Way to Natural Birth With Pre-Eclampsia

My heartfelt thanks for reading my story. I'm so blessed and honored that you will post my birth story on your blog and social media.  I hope and pray that this would inspire more women to try birthing naturally and perhaps encourage them also to sing and dance their way through labor! 

I was diagnosed with Pre-Eclampsia with severe features due to the extremely high amount of protein in my urine. My blood pressure remained normal, below 120/80, all throughout my labor, delivery & recovery. This is my 5th pregnancy. My first pregnancy was with twins.  The 1st twin, Annalise, was born naturally (no anesthesia, IV, oxygen, pain meds) in our church's birthing clinic.  The 2nd twin, Therese, was born via CS in a hospital. I was transferred because Therese went transverse when Annalise came out and it was Therese's hand that first came out.  My midwife put her hand back twice before transferring us to the hospital.  

In most hospitals, 24 hour monitoring is only done in the High Risk unit, so when my fluid was low, I had to be monitored for a full 24 hours before I transferred to a regular room.  I went back to the High Risk unit again for the Magnesium sulfate, to counter possible seizure or convulsions, according to my OB.  They also don't allow the natural birthing suite for high-risk cases like mine, because I already underwent Caesarean in a previous pregnancy, even though I've already had 3 VBACs.

Valentine’s Day, Thursday, Feb. 14, 2019, I was looking forward to a lovely dinner that night with my husband of 13 years, Ritche, to celebrate our 15th year of being together, when we received news that my husband’s 98-year old maternal grandmother “Lola Auring,” whom he was very close to, had just passed away peacefully in her sleep.  He regretted not being able to visit her sooner when she was still alive but looked forward to flying out from our home in Metro Manila (Philippines) to their province to be with her for the last time.  

But, first things first… I had to go to St. Luke’s Medical Center in Bonifacio Global City, for my routine 36th week checkup & ultrasound.  My OB did a Biophysical Score of our baby and told me that my fluid was low.  In my mind, I thought, “Okay, I’ll just have to drink up at home then.” But, my OB had another plan... I needed to be admitted to the High Risk Pregnancy Unit and hydrate via IV. I called Ritche and he agreed for me to be confined, thinking we’ll just stay overnight until my fluid goes up in 24 hours.  

So, aside from the IV drip, I tripled my water intake to 3 liters in the morning, 3 liters in the afternoon and 2 liters at night, which equated peeing almost every hour! AND I had to be hooked to several machines so my heart rate, blood pressure, baby’s heart rate and my contractions will be monitored for 24 hours. It was super uncomfortable but I thought, “No problem! As long as baby’s fluid will go up right away.”  We then asked our churchmates and close family & friends to pray with us.  I also prayed that I would be discharged as soon as possible so that Ritche could still travel the next day to be with Lola Auring.

24 hours later, Friday afternoon, my fluid just increased a tiny bit so my OB double checked the protein-creatinine ratio in my urine. While waiting for the results, we got a regular room and waited another 24 hours.  My husband already cancelled his trip and let my mother-in-law, Mama Tess, go ahead to their home in the province.  My UPC ratio was still extremely high, which made me a candidate for severe pre-eclampsia. We couldn’t believe it.  Even my OB couldn’t believe it, either. I’ve always been careful with my diet, preferring veggies & fruits. I always made sure I had regular exercise.  My blood pressure has always been normal.  How could I have pre-eclampsia?   

We’ve been praying for Baby Abe to come out at least on his 38th week so, imagine our surprise when she advised us on Saturday afternoon that we’ll both be safer if he came out as soon as I reach my 37th week, which was the following day, Sunday!  Questions ran through my mind.  We knew 38 weeks is the ideal.  How do I induce labor?  We’ve always just waited for me to labor naturally.  With Agatha, our 5th child, we had to keep her in as long as possible.  With Abe, it seems, we now had to bring him out as soon as possible! We hadn’t even packed our hospital bag! We were just supposed to buy baby boy stuff this week!

I had my Birth Plan printed out for the doctors and nurses and went back to the High Risk unit so that I can be given magnesium sulfate to counter possible seizure/convulsions.  I was also given 4000 mg of Evening Primrose Oil every 4 hours to soften my cervix. It just seemed so foreign and unnatural to me that we had to naturally induce labor.  How do we do that?  

My husband comforted me and reminded me that we have a great and awesome God and that so many people are praying for us.  He had been diligently communicating with and updating our close friends.  My dearest friend Kartika from Singapore visited me twice. My best friend and sister, Lala and her husband, Solomon, came all the way from Carmona, Cavite, to encourage me with their love and presence.  Our dear godparents, Fr. Dino and Sis. Anj, braved the 3-hour traffic to show their support and pray with us. When they mentioned the words “total trust” and “perfect peace” in their prayers, I was inspired by the Holy Spirit to write down the alliterations the Lord revealed to me as they were born in my heart so I can meditate on them:

“Total Trust in Thee”  “Perfect Peace in the Prince of Peace”  “Sweet Surrender to My Savior”  “Calm and Courageous in Christ”  “Blissfully Blessed and Brave to Birth our Baby Boy”  “Relaxed, Rested and Ready”

Most importantly, my mother, Mama Lou, my father-in-law, Papa Adelo, and our 5 beautiful and wonderful children, gave me so much encouragement that I knew that we can bring Baby Abe out in God’s perfect timing.  The Holy Spirit will lead me and guide our baby out.

Monday, after the magnesium sulfate treatment, I had another ultrasound.  Baby’s fluid had significantly increased from 7.89 to 13!  Praise God!  We could really feel the prayers of everyone.  We were ready to induce natural labor.  My OB mentioned that Baby Abe could even be born on Thursday, which was her birthday!  But I thought to myself that I didn’t want to labor that long.  Our churchmates, Dcn. Jojo and Sis. Evelyn, brought homebaked muffins along with much laughter and prayed over us before leaving.

We finally finished my IV (Yay!) and I drank my red raspberry leaf tea, walked about our windowless room, slow danced, bounced on a birthing ball. Contractions were very mild at 3-5 minutes apart, but they weren’t “painful.”  Mama Chato, our midwife who helped me naturally birth our other children, taught us that we must reframe contractions as “good pain” because it helps bring the baby down.  The more you welcome each “good pain” and embrace the sensation, the more relaxed you will be and fear will leave you.  So, everytime I felt a contraction coming, I relaxed my facial muscles, my jaw, my shoulders and let the tightening sensation do its work on my belly. The uterus is a very powerful muscle and I looked forward to the pressure, imagining that every contraction brought Baby Abe closer to being in my arms.

The resident doctor did my first internal examination and said I’m only 2cm dilated.  Well, at least it’s not totally closed, right?  However, at 530pm, I had an unexplainable occurrence of “chills” where I suddenly felt like I was freezing.  I couldn’t stop my teeth from chattering and my body from shaking violently. My mom wrapped me in thick blankets, wore socks on me, rubbed my legs. I called my husband to hurry, as he was getting some documents for our hospital stay. I placed my cold hands in my armpits and prayed that the nurse won’t peek in and report that I’m having some kind of seizure.  The chills passed after 20 minutes.  My husband warmed me with his embrace.  However, I couldn’t sleep a wink that night.  My husband decided we transfer again to a normal room with windows so I could be more comfortable.  I searched online “how to dilate cervix fast” and visualized my cervix opening and prayed constantly to the Lord to give me thoughts of peace and not anxiety.  The baby knows when to be born.

Tuesday, I had a prenatal massage to relax and press those labor-inducing points, drank more red raspberry leaf tea, bounced on the ball and did more than walking, I did some dancing, too!  Contractions were still mild at 3-5 minutes apart. I had another bout of “chills” at 530pm so my mother wrapped me again and I rebuked every thought of convulsion or seizure.  I kept telling myself that this will pass and Baby Abe is safe in my womb. The chills stopped at 6pm. By 8pm, I was so tired from the lack of sleep that I was able to sleep very well, even with the regular rhythm of my belly tightening.  We continued to entrust everything into the Father’s hands. 

The next day, Wednesday, February 20, I was determined to up my natural induction techniques.  My OB was pleased with the progress of my labor but reminded me not to wait until my water broke.  She reminded me to let her residents know when I’m already 4cm dilated, because I gave birth so quickly to our last child, she almost didn’t make it.  

My Mama Lou and I danced belly, hip hop, Zumba to the jiggiest songs I could find (Think “Trolls” soundtrack, “Walking on Sunshine” “Moves Like Jagger” “Waka Waka” you get the picture) and I sang my heart out to our Hillsong & Bethel favorites (Oceans, What a Beautiful Name, O Praise the Name, Open Heaven/River Wild, It Is Well, No Longer Slaves, etc.) when I rested. The doctors and nurses were amazed I could still sing and dance through my contractions.  Haha!  It actually took my mind away from the pressure.  By 530pm, I thought my water was leaking so I called a resident to examine me.  No water, just the EvePrim Oil melting but I was 3-4cm dilated.  Yay! She then asked me to go down to continue laboring in the High Risk unit.   Labor progressed very quickly and I did feel more and more pressure every minute!  

Shout out to the doctors and nurses of St. Luke’s BGC for honoring my Birth Plan as much as possible and I agreed that I will only be hooked to the monitor for 20-30 mins every 2 hours.. No pitocin, no IV, no oxygen and no pain meds.  By 8pm, I was 5cm dilated.  Hooray! That pushed me to do even more dancing, bouncing, marching, swaying & singing during contractions, with my husband playing every song I requested.  The pressure was already immense at this time, and I had a tugging feeling I was very close to transition, although it’s only been a couple of hours.  I was thankful that my husband was just right there to tell me I’m doing great, and my mother was also with us, cheering me on.  Whenever I felt the tremendous pressure, I would say, “Baby’s going down, down, down!  Yes, yes, yes! Go, go, go!” and I knew that they both agreed with me and believed with me.  

I was already speaking in tongues, asking the Holy Spirit to be my Comforter, my Teacher, my Guide.  I envisioned Mama Mary giving birth to our Lord and Savior Jesus Christ.  I remembered all our children who are happily awaiting their baby brother at home. They’re counting on me to give birth to Baby Abe soon.  I wanted to birth this beautiful being in my womb without fear, only love and joy and peace... Feelings of indescribable bliss welled up in my heart for this boy whom Ritche and I had so conceived in love.  I was determined to confidently bring him out in that same love that conceived him. 

At 1030pm, I asked the resident to check my cervix, which had already dilated to 7cm, with a “bursting” effacement.  I had to be strapped again so I lay down waiting for the nurse when, a minute after, the nurse relays the message from the doctor to tell them right away if my water bag ruptures. She hadn’t left the room yet when my water bag burst!  It felt like a water balloon popped out of me. 

I excitedly told everyone, “Baby’s coming out!”

 They wheeled me out our room into the delivery room right away.  I felt the head of Baby Abe crowning.. I thought I couldn’t hold him in anymore.. but I tried to relax, as the doctors were still preparing, I had to be moved from my bed to the delivery bed and my husband, Ritche, was also getting into scrubs. I requested that I be more upright and not lying down.  Our OB was nowhere to be found but already gave instructions to her three resident OBs present in the room.  I already felt like pushing but was holding Baby Abe in.. I was so excited.. I called my husband.. “Daddy!” and told the nurse, “The cellphone!” Haha!  I didn’t want the nurse to miss taking Daddy Ritche’s picture catching Baby Abe.

Finally, it was only a matter of minutes before I told them I had to push Baby’s head out.  The doctors assured me and said they won’t hinder me from pushing.  His head came out and the doctor was wise enough to remind me not to push anymore because he slid out so easily! It’s a birth phenomenon they call the “Fetal Ejection Reflex.” Pushing would have made the baby fly out.. Haha! It was amazing to see my husband “catching” our son!  As with all our other children (except Therese who underwent emergency CS), he did the ceremonial cord cutting after the cord stopped pulsating.  Baby Abe had already pooped meconium but miraculously, he didn’t ingest any and his Apgar score was 9 out of 10.  Thank God!

I delivered the placenta within 5 minutes. And our OB, Dra. Bambalan, arrived moments after to check on me.  Everything looked good.  My blood pressure stayed normal all throughout. I had a 1 mm tear that didn’t need any stitching. 

They were amazed at how easy the birth was and how fresh I still looked even after giving birth.  We all laughed at how my primary concern was to get the cellphone to the nurse and how Baby Abe didn’t want to have the same birthday as Doc.  Everyone in the room was lighthearted and Dr. De Guzman exclaimed that this was one delivery she will never ever forget!

All in all, we stayed in the delivery room for 18 minutes then I was brought out to the Recovery Room for 4 hours to check on Baby Abe and me.  By the end of the recovery period, my BP was still stable, Baby Abe and I had skin to skin contact and he latched on the breast perfectly, but there was just one problem.  The nurse said that they’d have to put a catheter on me if I didn’t urinate soon. No way!  I gently pressed on my bladder and, sure enough, I was able to pee on my own.

The next 48 hours were critical for me and Baby Abe. I recently saw the diagnosis of my OB upon discharge.  It was Pre-eclampsia with Severe Features.  But, thank God, we never manifested any complications.  No headache, nausea, vomiting, seizure, swelling, convulsion, shortness of breath whatsoever.  My blood pressure never elevated all throughout.  Baby’s oxygen levels were stable.  I didn’t go into shock, stroke, had brain damage or any organ failure. I didn’t need any kind of pain medication.  

Within 48 hours of delivery, we went home to our family, carrying our 6thbundle of joy, our second boy, whom we named "Abraham Nickola."  So thankful to all our family, relatives, friends, and churchmates for keeping us in your thoughts and lifting us up in prayer.  I believe that Ritche’s grandmother, Lola Auring, was also looking down from Heaven and interceding for us, along with all the saints and angels. To God be all the glory, honor and praise!  He is a miracle-working God who faithfully keeps all His promises and grants us the desires of our hearts!

By: Chat Jandayan @chatjandayan

Most of the photos were taken by my husband and my mom.

This is why excellent childbirth education is a must, why planning for your birth and the unexpected challenges that can arise, is so important today, and is a major reason why I created my Love Your Birth course. It is a comprehensive online course that teaches women what they need to know about planning and carrying out the birth that they want in all settings - the hospital, birthing center or at home. It’s a course on how to have a holistic, healthy pregnancy for the body, mind, and soul - and is how I have guided thousands of women and their families in my midwifery practice for over 21 years.

It contains a rolodex of my favorite resources with over 200 of the best books, movies and supplies I use personally and professionally with my clients, family & friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting...It includes resources on improving and even ensuring ensuring healthier pregnancy and birth outcomes than the status quo, and preventing and healing from birth trauma so prevalent in the modern world!  

Be prepared to do some research on your own, but knowledge restores your power. I also help you prepare your mindset for such a task, to debunk myths, and to reframe any current ideas or conditioning about pregnancy and birth that can use a change in perspective or that are simply incorrect and do serve you. After finishing the course, the idea is that you are now able to create and have the healthy, beautiful and empowering pregnancy and birth that you want - so you can ROCK your birth, however it unfolds!

It’s wonderful alone, a great refresher or adjunct to any other course!