How you sit and use your body can affect the position of your baby in the uterus. While this does not matter so much during early pregnancy, later on it can affect the position that the baby moves into the pelvis in prior to labour starting.

When you regularly sit in a slouching type of position and your pelvis rocks backwards, this can encourage your baby to enter the pelvis in a "posterior" position as their back, the heaviest part of them, is more likely to be positioned against your back. This can make having your baby harder and labour longer, as your baby will need to turn during labour to move down the birth canal (vaginal passage) the right way.

Midwives report there are more posterior babies born now days as compared to 20 or more years ago.

In the past, women used to spend a lot more time being upright and moving around than we tend to do now that we have many modern conveniences and cars to travel around in. They used to scrub floors and spend more time on their hands and knees than we need to now and this allowed more room for the baby to move around in, and encouraged the baby to move into the right position in the pelvis. Their jobs were more labour intensive than a lot of ours are now since the increased use of computers and modern appliances. It is when we spend a lot of time sitting during our day that the baby is encouraged to be in the posterior type of position. Crossing our legs can also cause our pelvis to tilt backwards more and so discourage the baby from moving into the right position. Sitting in the car for long periods of time can also encourage a backwards tilt position of your pelvis, unless you consciously sit upright and with your pelvis slightly tilted forwards.

Midwives suggest using the hands and knees position during your pregnancy, especially in the later stages from 25 weeks onwards, but particularly the last 6 weeks, to encourage your baby to be in the right position for labour. When you are sitting, you should sit "on your sit bones" (see page 6 in 'As Your Shape Changes') rather than letting your pelvis rock backwards so that you sit on your tailbone. This will help your pelvis to be in a forwards leaning position, which encourages your baby to move into the right position.

When you can, sit forwards slightly with your elbows on your knees (like the toilet position suggested on page 33 of 'As Your Shape Changes'), or sit astride a chair. Sitting on the floor in either a cross legged position or with your legs out will also assist your pelvis to be in the right position and will give you the chance to stretch your leg muscles so that you also become more flexible for labour.

Using these positions regularly during your pregnancy will help to give you the best chance of "optimally positioning your baby", prior to labour. If you are reading books and magazines, use this time to be on the floor for a while, either on your hands and knees for as long as comfortable, or sitting on the floor. Lying on your side is a better option when on the lounge, than sitting slumped and really relaxed back into the lounge chair. Also sitting on a low stool where you are in more of a supported squat type of position is also another way of getting your pelvis and back into the right position. If you place your feet flat on the floor this will also give you the opportunity for a calf stretch too, and will help prepare you for having the supported squatting position as an option for during labour.

To prepare for having the modified squatting position as an option to use during labour, it is recommended that you practice this during the last 6 weeks of pregnancy. Sitting on a stool approximately 25 cm high with a cushion on it, with your back against the wall and your legs comfortably apart, can be used to practice this position without going down into a very deep squat.

Sitting on a fitness ball is also a better option than sitting on a chair for long periods, providing you choose one at the right height for you so that your hips and knees are around 90 degrees when you are sitting upright. You can then lean forwards slightly while you are sitting on it, and move it around under you too, to allow you to change position slightly as needed, especially if you need to sit for any length of time. It again gives you the chance to stretch your calf muscles when you place your feet flat against the floor, and your inner thigh muscles if you have your legs comfortably apart. It is much harder to slouch when sitting on a ball. Balls are also available now in many labour wards, and when you are used to using a ball it is easier to use it in different positions during labour. Resting over a ball while on your hands and knees is also another way of being in this position while being supported at the same time. This can even be a good position for practicing relaxation during your pregnancy.

When your labour starts you can continue to use these forwards leaning positions. If you are at home you could try leaning over a bench, kneeling on the floor and resting on the lounge, or being on your hands and knees. These positions will continue to encourage your baby to be or move into the right position during labour. Your partner can easily rub your back in these positions, which is another benefit of using them.

To find out more about "optimally positioning your baby for labour", and to help you understand this more fully, speak to your Midwife. Midwives are also able to advise you of how to try and encourage your baby to move from a posterior or breech position during the later stages of your pregnancy.

Compiled by Dianne Edmonds, Physiotherapist. Reference: "Understanding and Teaching Optimal Foetal Positioning", by Jean Sutton, Midwife and Pauline Scott, Childbirth Educator. Further information provided by Tracy Ashworth, Midwife, Kalgoorlie and Tara Ilich-Gaebler, Midwife, Kalgoorlie.

PREPARING FOR LABOUR

It is said that labour can be one of the most tiring and energetic experiences of a woman's life. Some people even say it is like running a marathon.

Now no one would consider entering a marathon race without considerable preparation and training specifically for it. All areas of a runners life would be focused on preparation for this big event - diet, fluid, particularly water intake, the amount of sleep and rest you get, and also physical training and mental preparation.

All areas of an athlete's life need to be prepared. Now what would happen if we considered labour like this. From the time you know and are ready to believe that you are pregnant, you could be preparing for this big event. Many people do, exercising and taking care of their body, while some spend more time physically preparing the baby room than they do themselves.

So in preparation, if you're not doing it already, what is needed?

Food/Diet

Good fuel for your body will make it function to its peak performance. Runners won't usually just think about what they eat the days before an event. For the months of training prior to a race they will choose good foods that they know will continue to refuel their body before and after every training session throughout the day. If they put bad fuel eg junk food into their body, they can feel the effects. A little bit may be OK, but on a regular basis if they consume the wrong fuel, they wouldn't expect their body to perform at its peak, both in training and during the actual event - the race they are planning to run.

Liquid

Water is important to re-hydrate an athlete before, during and after training and an event. If we use other fluids continuously all the time, we don't get the full benefit of hydration to help our bodies work the best they can. For example, sugary drinks may taste nice and give us short-term energy, but aren't purely for re-hydration when needed. Too much sugar has actually been shown to cause dehydration (if the concentration is too high this can also lead to stomach cramps during an event).

Caffeine products/drinks will also contribute to dehydration, so water should be consumed in addition to caffeine products eg tea, coffee, cola drinks, as they will not supply the needs of re-hydrating your body. Being dehydrated can make you more tired and so you perform better when your body is hydrated well.

During pregnancy, in the time leading up to your labour it is important then to stay well hydrated. Clear urine can help to indicate this. If it is yellow, then you are not as well hydrated as you should be. During labour, if you are able, sips of water regularly can help you to replace the fluid your body is using due to the hard work of labour. You would never see a marathon runner complete a whole event without taking regular drinks throughout. You may have seen the effects of dehydration on athletes eg fatigue, lack of coordination and cramps. These things are not helpful during pregnancy or labour. Consider what and how much you drink to meet your own bodies needs.

The amount of sleep and rest needed.

Athletes are often tuned into their bodies, and can tell when they need more rest or sleep, because of a big training session, or the activities of their daily life. Listening to their body is important, as if they ignore the warning signs and push on regardless, they can often end up more fatigued or sick, tired and run down. Then they are unable to train or perform as needed and they are set back in their training schedule. Listening to your body on a daily basis and responding to its needs and demands can allow you better preparation. Your body knows when you need a rest or more sleep, and when you can function on less. Respect these messages and signs, and listen out for them. The more in tune you are with your body, the better and more prepared you will be for when you go into labour.

Physical Preparation

The amount of training a marathon runner does will affect his or her performance in a race. It will determine how quickly he or she will tire during the race, although the race conditions will also influence this. Fitness levels also determine how quickly a marathon runner will recover after the race - whether it will take weeks or months to recover from such a long event.

Labour can be considered to be more challenging than a marathon run for many women. It can last longer, although you do get a short break between contractions, At least in a marathon, runners know an estimated time of how long it is going to take to complete the event. During labour you are breaking new ground, never having run this particular track before and you start labour having no idea of how long it will take you to the completion of 'the event'.

Nevertheless, physical preparation will help you to endure and navigate the course ahead of you. That is, the fitter you are before and during pregnancy, the more energy you will have for labour. You are more likely to recover more easily if you are fitter too.

The other thing you often hear about is the 'runner's high'. This is where mentally and physically the runner benefits from a release of the hormone 'endorphins', which help to reduce the pain perception they have. All that work their body is doing can be seen as 'painful' and sometimes it would be easier to give up and stop the race than to push through until the end. Endorphins help them to push through and give a feeling of well being. The more trained an runner is, the higher the amount of endorphins released during exercise. This is the same for women during labour, who also release endorphins, which help reduce pain perception and give more of a feeling of wellbeing. Women who are fitter will release more endorphins during exercises in pregnancy and during labour.

Physical preparation is not always easy. Sometimes you have to 'make or discipline' yourself to go out and exercise, when it would be much easier to sit or lie down and rest. Although rest is important, as previously mentioned, there needs to be a balance between it and exercise. For more information on the types of exercise suitable for during pregnancy and how to exercise safely in pregnancy, look at the sections "Exercise" and "More about Exercise".

Stretches - More Physical Preparation

If a marathon runner didn't stretch after training or an event, their muscles, particularly in their legs and upper body, would continue to tighten and become stiffer over time. Flexibility of muscles is important to allow them to work freely and normally.

Flexibility of your muscles before and during labour is important to allow you to move freely as needed, and to get into comfortable positions for labour. Hamstring, quadriceps, adductor and calf stretches are all important both for the runner and the pregnant woman. These are stretches of the back, front and inside thigh muscles, as well as the calf muscles. These can easily be done before exercising (after a warm up), after exercise, or at other times of the day. Sitting cross legged on the floor will help the inside thigh (adductor) muscles become more flexible, as will sitting on the floor with your legs apart and knees straight. This will also stretch your hamstrings. A further inside thigh stretch is to 'diamond sit', with your feet together, instead of crossed. The good thing about these stretches are that you will also be more supple for when your baby is born and you play and spend time with your baby on the floor. To stretch your quadriceps muscle lay on your side and take hold of your foot, pulling it gently towards your bottom. Pull your knee back also, until you feel a gentle stretch at the front of your thigh.

For calf stretches, see the article on calf cramps in pregnancy (in the FAQ section), which explains how to do calf stretches correctly.

Remember to stretch gently while you are pregnant, as you are more flexible than normal due to the hormone relaxin softening your ligaments. This means it is more possible to overstretch if you are not careful.

Stretching after an event does help to reduce the amount of stiffness and tightness felt in the muscles over the next few days. Although this may be the last thing from your mind when you get to meet your baby after labour has finished, these same stretches can be used for the few days after the birth if you do feel sore from some of the positions you used in labour.

Mental Preparation

Often a marathon runner needs to prepare mentally for the event. This can be as simple as setting goals and targets for training sessions, and ticking them off once achieved. For pregnancy this may mean deciding to exercise regularly, for example three times per week for 20-30 minutes per session and recording this on the chart provided in "The Powerful Pregnancy Program".

Visualization of the event is another way marathon runners can prepare for an event. This may involve running through the course in their mind, imagining how they may feel and how they may overcome obstacles such as feeling tired in the race. Determining to push through when they know it is going to be hard work is part of preparation of the mental attitude. If no attention is paid to this before an event, we would not be surprised if that runner found it harder mentally than another who was mentally prepared.

Preparing mentally for labour is of course very different. Again the course is unknown: the intensity level of the contractions, how long labour will take, what the different stages will feel like and what coping and pain relief strategies will benefit.

Preparing, despite this, could mean 'rehearsing' or running through your mind how labour might be for you. Be aware though that this can cause disappointment if your labour is harder or longer than expected or rehearsed, so don't get your heart set on a particular time or expectations of labour.

Relaxation methods may help you to physically relax your body while allowing you the time to think about labour. Thinking about how you feel while doing this can help you deal with what might be to come. Allowing yourself to explore your feelings and responses to your thinking about labour can be as much a part of preparation as preparing the nursery. Making time for this is important, particularly as labour approaches and becomes more of a reality. Mental preparation may help you feel more ready, and hence be more relaxed and less anxious about taking on the challenges ahead. Remember every labour is different, so even if you've already had a baby, spending some time on this process may be useful.

So, you may not be a marathon runner, but you're going to be a mum (or expand the number of children you are a mother to). So take the time available to you to prepare for your labour. The added benefits may be a more enjoyable pregnancy and energy afterwards to enjoy motherhood.

Be prepared. Take up the challenge.

Remember you were designed to have babies and there are many people to help you along the way.

PREPARING FOR DEALING WITH THE CONTRACTIONS OF LABOUR

Labour is called labour because of the amount of physical work it can involve. Think about what contractions are. They are your uterus muscle working really hard to open up your cervix and to then push your baby down the birth canal to be born.

Do you remember a time where you were holding a heavy shopping bag and were unable to put it down? The muscles in your arms had to work very hard to hold the weight of the bag. If someone made you keep holding the bag of shopping, your arm muscles would start to ache and feel 'burning' and uncomfortable.

We could 'liken' this to labour, again, with the muscles of your uterus working very hard to allow your baby to be born. Preparing for working with these contractions may help you to get through them, aiming to reduce the amount of pain you feel and optimize the effectiveness of the contractions so your body can do the work it was designed to do to have your baby.

Breathing out during your contractions can be helpful, rather than holding your breath or 'fighting' them. This can help your labour to progress more easily, rather than inhibiting it by tensing up every time you get a contraction (which will only make contractions more painful, and can also be more tiring).

Practicing using breathing out to help you get through contractions can be helpful. You are more likely to find it useful during labour if you've practiced it during your pregnancy.

It is difficult to imagine what your contractions are going to feel like. There is no way this can be done, or anyone can describe to you how your labour will feel. You can practice using the same principles, using other muscles in your body working hard for a few minutes at a time, to give you something to practice with.

One practice example:

Lay on your side on the floor. Lift your top leg up and hold it in the air. Either keep holding it, or start a slow cycling action with that leg. Keep going, until you can start to feel your leg getting heavy, or the muscles at the side of your leg starting to work.

Then you can focus on breathing out, rather than holding your breath. This will give you something else to think about. As your leg gets heavier and more achy, you may need to breathe out more deliberately or strongly. Try not to change the rate of your breathing too much, simply focus more on the breath out and see if this helps you to push or work through the feelings of your leg muscles working. Relax when you need to and have a rest. If you change sides and repeat on the other side, this will also mean that you are doing a useful pregnancy leg toning exercise.

Next time you repeat this, try and last for a little bit longer. Also think about how the muscle contractions in your leg make you feel. Do you want to give up and drop your leg down as soon as it starts to ache? Is it too hard to continue?

Can you push through a little bit longer and does your breathing help? Use this to see how you respond, and to help you practice on focusing on your breathing out. Does rubbing your leg help? Try focusing on something else to distract you.

As contractions intensify during labour you may need help to focus more. While practicing you may need to draw on everything you have to keep you 'pushing through' and not giving up with your distraction technique or focusing on the breath out. It may be the same for during labour.

Another way to practice:

You can practice a similar thing by squatting with your back to the wall. This will make your bigger thigh muscles work hard and as you stay there you can focus on the breathing in the same way as mentioned above.

Ideas for Mental and Physical Preparation for Labour

Another way of preparation mentally and physically for labour may be riding a bike or walking up and down hills, or using a preset course at a gym for a bike or stair climber course.

While exercising for fitness you could change your course to one with hills or try doing an interval course on the machines at the gym. If you are riding or walking and have hills in your area, while you are going up hill, think about this extra work as the contractions, and when going down, think about this as the rest between contractions. At a gym it may be easier to set the course with regular intervals eg with 1 or 2 minutes space between a hill or harder work lasting for up to 90 seconds, then easier work or downhill in between. If you do this over a 10, 15, 20 or 30 minute period, you will soon see how you need to focus with each 'contraction' and how it feels to have a limited rest in between each one.

Again, although it is not the same as being in labour, it may help you to feel more prepared. You will also be well practiced at using your breathing and pushing through when you need to and so will be more likely to use this more easily when you try to use it during labour.