How to mentally prepare for labor
It's easy enough to find resources on physically preparing for the experience of birth: what to pack in your hospital bag, what supplies you'll need for a home birth, exercises you can do in the last few weeks of pregnancy to increase your chances of an easy labor, and more. Those are important topics, and I plan to address them here at some point in the future! But this is a post about the less talked-about aspects of that preparation. This is a post for experienced mothers, first-time moms, survivors of trauma, birth partners, and anyone else seeking to have or facilitate a positive labor experience.
Labor is a profoundly physical event--comparisons to marathons or other intense feats of athleticism are apt here. It demands the full participation of the entire body, and in doing so, it also requires an extraordinary mental and emotional engagement. In Western society, we are all taught on some level to view the mind and the body as separate entities, when they are not. With this sort of mindset, it can be extremely unsettling or even frightening to be thrust so completely into an integrated mind/body state. That is why preparation is so important. Below I've outlined a few steps, questions to ask yourself and/or your partner, and other considerations to help you through this process.
When I think about my/my partner's upcoming labor, how do I feel? Try to experience and process these emotions without judgement. If the answer is "I'm terrified" or "I'm not sure how I feel," that's okay! Consider journaling and/or talking through your emotions with your partner, a trusted friend, your doula, your care provider, or a therapist.
When I envision the process of labor, what do I think my reactions will be at each stage? Especially if your only previous exposure to birth has been through dramatic scenes in the media, which often present an unrealistic and very negative image of labor, this is a great time to read more about childbirth from positive, informative sources. Ina May's Guide to Childbirth by Ina May Gaskin and The Birth Partner by Penny Simkin are two of my favorites. If you've hired a doula, she can help answer some of your questions about the different stages of labor and how you might experience them.
How do I feel about my body? If you generally have a positive relationship with your body, that's great! If your relationship with your body is negative, punitive, or even just ambivalent, pay attention to that. Engaging with the physical process of labor is difficult enough already; people who struggle with negative self image, chronic pain/illness, body dysmorphia, gender dysphoria, and other body-related issues face additional challenges. Dealing with heavy issues like those can be the work of a lifetime, and you shouldn't feel pressured to be suddenly fine with them; the best course of action is to try to cultivate a habit of positive self-talk, to be aware of how such issues might impact your labor, and to seek outside help when necessary.
What am I afraid of? This is a big one, and it's hugely important to address in advance so that you can work through at least some of your fears with a friend, partner, doula, medical care provider, or therapist. Some common fears are:
Inability to cope with the pain. This fear can be present even in people who have chosen to use pain medication
A negative birth outcome (generally speaking, maternal or infant death/injury)
Specific complications, e.g. "I'm afraid that my labor will stall and result in a cesarean like it did last time," "I'm afraid the epidural won't work," or "I'm afraid of tearing"
Survivors of traumatic birth experiences may fear a repeat of what happened to them before
Specific interventions such as Pitocin, surgery, vacuum extraction, etc.
Loss of control; this is particularly relevant to survivors of sexual violence or other abuse
General fear of or discomfort around doctors/hospitals
For partners: fear of seeing the person you love in pain or discomfort, fear of not knowing what to do in the moment
On similar note, what experiences do I carry with me that may impact my labor? Here's a partial list of things to check within yourself. If you have experienced any of the following, it is worth opening up a discussion with your doula and your care provider so that they know how they can best support you during labor.
Estrangement from family, partner, or other ongoing relationship issues
Previous traumatic birth experience
Previous pregnancy or infant loss
Death of a parent, especially a mother or mother figure
Mental health difficulties such as depression and anxiety
If birthing in a hospital, past experiences in a hospital setting (whether positive or negative)
Visualization exercise: What does my ideal labor look like?
Positive visualization both before and during labor has been proven to be extremely helpful. As a starting point, I recommend taking the following steps:
First, sit by yourself in a comfortable place and take a few deep breaths with your eyes closed. Imagine that you are in labor and that you feel happy, relaxed, and secure. If this is too difficult, imagine that you are somewhere where you feel safety and contentment.
Keeping your eyes closed, take a mental "look" around you. Notice your physical surroundings: where are you? Who is present with you? Where is your body in the space? What is happening inside your body? (It's okay if your answers are not realistic or don't make logical sense!) Spend as much time as you need in that place before opening your eyes.
Take some time to write down some of the things that struck you about your visualization. What made you feel most relaxed? What made you feel safe?
Keep this list somewhere you won't lose it. At some point, you may wish to share its contents with your birth partner, doula, and/or care provider.
Birth planning: the emotional element
Labor is unpredictable, which is why I highly recommend writing a birth plan sometime in the months and weeks that precede your birth. The purpose of a birth plan is twofold: first, it can be extremely helpful to your care provider so that they are aware of your preferences during and immediately following labor. Second, it is an invaluable resource for you as you work through and prepare for different possibilities and outcomes. Many people find the act of writing a birth plan to be incredibly reassuring; they know that whatever happens, they have considered the possibility and made every effort to have their wishes honored. A birth plan is also the ideal place for you to synthesize all of the information you have gathered about yourself by asking yourself the above questions. This is where you can advocate for yourself by making decisions that will help you to feel comfortable and safe during labor. For example:
Who, specifically, do I want present at my labor? Is there anyone I would like to exclude from the delivery room for my own safety and/or comfort? Most hospitals and birth centers have policies requiring them to honor these sorts of requests.
What kind of environment do I want to give birth in? Are there any particular smells, sounds, lights, etc. that would make me feel more relaxed?
Do I have specific cultural or religious rituals that I would like to incorporate into my birth experience?
Would gentle massage help me to relax and focus, or would I prefer not to be touched?
What can my birth partner and/or my doula do to help me through this process?
There is no right or wrong way to format your birth plan, although ideally the version that you present to your care provider should be about one page for the sake of easy access and referral. (A future post about the nitty-gritty of writing your birth plan is in the works, so stay tuned!)
Prayer and meditation
If you are a person of faith, or if you are spiritually inclined, I highly encourage you to incorporate that into your preparation. Take some time to pray for yourself, your partner, and your unborn child. Set your positive intentions for the birth. (As an anxiety-ridden person, I half-jokingly refer to this aspect of preparation as "throwing myself on God's mercy." You may call it something different!)
Just as each birth is different, so does each person's path to readiness vary. I encourage you to take away from this post the things that you find most helpful, and to leave behind whatever doesn't speak to you. You may find, as I have, that your preparation takes you beyond yourself into places you couldn't have imagined. Whatever form your journey takes, my wish for you is to discover many unexpected blessings along the way.