It can be tough to convey your thoughts about how you'd like your birth to go, such as what level of intervention you expect and how much painkiller you want, when you're panting through contractions. That's why it's a good idea to write down a birth plan and present it in advance to your midwife or doctor. Just know that once labor begins, you may not be able to follow your wish list exactly.
You probably know that exercise helps keep weight gain in check and fights off depression during pregnancy, but new research shows there's another potential benefit to getting your heart pumping: easier deliveries. A 2008 study from the University of Campinas, in Brazil, found that women who did water aerobics three times a week for 50 minutes required less pain medication during labor. "Pushing takes a lot of work," says Marjorie Greenfield, MD, associate professor of obstetrics and gynecology at University Hospitals Case Medical Center, in Cleveland. "If you're not in good shape, you're going to tire quickly." Any aerobic exercise is good, and you'll get the best results by working out for at least 30 minutes on most days.
The better rested you are, the easier it's going to be to get through labor and delivery. A 2004 study from the University of California at San Francisco School of Nursing found that women who average less than six hours of sleep a night in the third trimester have significantly longer labors and are 4.5 times more likely to need a c-section. If your growing belly is preventing you from getting comfortable, try sleeping with a body pillow, which can offer support to your aching back and legs. Also, don't be afraid to try different sleeping locations, such as a recliner or a comfy couch.
The noise, lights, and interruptions you'll encounter in the hospital aren't exactly conducive to helping you keep calm. That's why doctors generally recommend staying at home in the early stages of labor: Check in with your doctor, of course, but she'll probably say that unless your water has broken or your contractions are closer than five minutes apart or completely debilitating, there's no need to rush to the hospital. Staying home as long as possible may also help you avoid getting things you don't necessarily need, like drugs designed to speed up labor, says Laura Riley, MD, director of labor and delivery at Massachusetts General Hospital, in Boston.
Tina Fey's Baby Mama poked fun at perineal massage, which helps stretch the area between the vagina and rectum. But a June 2007 study from the University of Colorado at Denver found that women who did this were less likely to tear while giving birth. Experts also agree perineal massage may prevent the need for an episiotomy. It's recommended that first-time moms give themselves a five-minute daily massage in the last weeks of pregnancy. If this is your second time around, you don't need the extra stretching.
When the time comes for labor, the best positions are the ones that let gravity help you out. A 2004 study from Nijmegen University, in The Netherlands, showed that sitting or squatting resulted in shortened first and second stages of labor and made pushing easier. The same review found that there is a higher rate of episiotomies and instrument deliveries in the reclined position. It makes perfect sense -- you don't get ketchup out of a bottle by laying it flat.
A 2006 Cochrane Review study revealed that women who used self-hypnosis or relaxation exercises during labor were more satisfied with their pain management. Download a guided meditation onto your iPod or go to a meditation class. While you're in labor, your partner can help you with visualization exercises or deep breathing, which you can learn by taking a childbirth class together. Above all, think positive, and it won't be long before you're holding your baby.
A birthing ball provides back relief and a good way to do pelvic rocking, which may help your baby to descend. If your hospital doesn't already have them available in delivery rooms, ask if you can bring your own (you can usually find one for under $50 at department or sporting goods stores).
