As people are nearing their due date, or have even gone past it, we often get the question “is there anything I can do to get things going!?” The short answer is yes, and no. The process of starting labor is still relatively not well understood, and is thought of as a multifactorial process with feedback between your body and your baby. There are many factors that go into when labor may start – some things we can control and many we cannot. These factors include the position of your baby, the shape of your pelvis, how “ripe” your cervix is, coordination of uterine contractions, and even your emotional state, just to name a few. So of these factors, what can we control, and how?

• Position of baby/shape of your pelvis: The position of your baby can play a large role when it comes to starting labor, and how long your labor is. The “optimal” position of your baby is having baby be head down, facing your back, with their head evenly in your pelvis. This is called “occiput anterior.” Other positions such as baby facing upward (“sunny side up” or occiput posterior), having baby’s head turned so it is not evenly in your pelvis, or not having baby be “engaged” (as in low enough in the pelvis) can delay on the onset of labor. Oftentimes, helping baby get in ideal position requires pelvic opening/slight changes in the shape of your pelvis to allow for baby’s descent, and many of these suggestions are based in altering that shape

o   Ways to promote optimal position of baby

• Walking
• Sitting on a yoga ball, using it to make hip circles, bouncing, etc.
• Prenatal yoga exercises
• Pelvic tilt exercises
• Swimming
• Chiropractic adjustments or induction massage
• Acupuncture
• SpinningBabies daily activities, or specific activities if you know your baby is occiput posterior (https://spinningbabies.com/)
• Cervical ripening: Your cervix has a long process of opening, thinning out, softening, and moving forward in your pelvis prior to you going into labor. These changed are caused by a release of prostaglandins that changes the structure of your cervix. For information on cervical ripening, see our other blog post on it!

o   Ways to promote cervical ripening

• Membrane sweep (at appointment)
• Intercourse (semen has prostaglandins)
• Evening primrose oil
• Coordination of contractions: Labor is ultimately defined by regular, strong, coordinated contractions. As people are nearing the end of their pregnancy, it is common to have non-painful, irregular “practice contractions”, also known as Braxton-Hicks contractions. People may also experience long periods of regular, even painful contractions that occur at certain times of day, but that go away after rest, hydration, or taking a warm bath. With true labor, there is no going back – once contractions start, they will continue to ramp up, come closer together, and last longer until you hit true, active labor

o   Ways to promote coordinated contractions

• Nipple stimulation – using a breast pump or your hands, provide stimulation for 10-15 minutes, then go for a walk for the remainder of an hour
• Membrane sweep
• Acupuncture
• Induction massage
• Intercourse
• Mother’s cordial (taken daily after 36 wks)
• Red raspberry leaf tea
• Walking
• Experimenting with position changes – standing, lying on your side, sitting on yoga ball, etc.
• Staying calm, present, and working through anxiety: Your mood can play a big role in when labor starts. When we are anxious or in a state of fear, the hormones that are released in response to that stress can actually inhibit the hormones that play a role in labor. This is why it is important to tend to those feelings, and work through them with yourself, your family/friends, and with your birth providers.

o   Ways to cope with anxiety, fear, or anticipation

• Meditation
• Yoga
• Visualization
• HypnoBirthing techniques
• Self care – taking a bath, reading a book, massage, etc
• Exercise
• Mindfulness practice
• Counseling
• Discussing specific fears

With all of these suggestions, they will only work if your body is ready to go into labor. These pieces basically help “push you over the edge” if your body is ready. So ultimately, while we can do whatever we can to help promote labor, at the end of the day there is a lot we have to let go from our control. Every baby has their own journey, and no two people labor the same way. We are all just along for this wild ride, and know that your True Harmony family will be with you every step of the way!