What is the Pre-birth Protocol?
As an acupuncturist who specializes in women's reproductive health, including pregnancy and postpartum, I get asked often if I attend births. I just as often surprise people to let them know that actually I don't.
It's not because I don't want to, rather, it's because I've found I can be of most use to my patients during the weeks leading up to their birth. With acupuncture, herbal medicine, and moxibustion (a Chinese medical heat therapy,) I have developed a process I call the Pre-birth Protocol - through which I help women to prepare for vaginal or surgical labor, so that when the time comes they are ready and the process moves along smoothly.
The Pre-birth Protocol is a holistic method of preparing the body for labor, but that doesn't mean you have to be a totally crunchy hippie to use it. No matter if you've planned a birth at home, in birth center, or hospital, no matter what you're feelings are about pain medications or pitocin, no matter if you're delivering with a midwife or OBGYN, you can still use the Pre-birth Protocol to help prep for your experience. Here's how.
Prepping the Cervix: Effacement vs. Dilation
We often hear a lot about cervical dilation during labor, which refers to the width of the opening of cervix. Even people who know almost nothing about birth know that dilation has to reach 10 centimeters before pushing can begin.
We hear a lot less about cervical effacement, which is the thinning and shortening of the cervix, also sometimes referred to as cervical "ripening."
Imagine the cervix is a cone-shape, sort of like the tip of your nose. During pregnancy it remains firm and closed. Later on in the third trimester, closer to labor, it begins to soften and flatten, becoming more like the shape of your chin. Eventually it flattens and things out even more, becoming completely soft and thin. At that point, you’re considered “fully” or 100% effaced and the process of dilation, and then labor, can progress.
Generally, especially for first time moms, the cervix can take a few weeks to fully efface, and dilation won't usually occur before effacement is complete. If you're cervix is effacing steadily in the weeks leading up to your due date, it's a good sign that your body is preparing to go into labor. Your doctor or midwife may or may not check how effaced you are with an internal exam once you're a few weeks, or a few days, away from your due date. Some doctors are more conservative about doing internal exams than others.
With the use of acupuncture and moxibustion, circulation to the cervix is increased and cervical effacement is quiet easy to achieve by the due date, meaning dilation can proceed easily.
Prepping the Uterus
The uterus is a strong and resilient organ that grows 6 times its original size to accommodate a growing fetus. It has a big job to do during birth, whether it’s vaginal or surgical, and the job of an acupuncturist and herbalist is to help women both prep their uterus for and help it to recover from birth.
Raspberry leaf tea is one of my best tools for this task, because it does both. It helps the uterine muscles to tone and prepare for labor, and it also helps uterine tissue to repair afterwards.
I have my pregnant patients drink it daily, sometimes all throughout pregnancy, but especially starting at 35 weeks and extending through the postpartum period. It's an generally safe herb with no known contraindications. It's easy on the stomach and actually improves digestion. It tastes similar to black tea, though it's totally caffeine-free.
Prepping the Hips & Pelvis
Especially if you've been experiencing issues with your hips, such as tightness in the tendons or ligaments, sciatica, or joint pain, it can be important to address before a vaginal labor. Your hips are the opening to the birth canal, and they need to remain open and flexible in order for labor to progress smoothly and easily.
Usually relaxin produced in the body before labor helps to make joints and muscles a little more loosey-goosey, but sometimes the hips are chronically tight and refuse to loosen up all that much. Normally tight hips may not cause much of an issue, you might not even notice them, but during labor it can slow the entire process down.
Acupuncture is excellent for increasing circulation, reducing pain, and opening up the hips prior to labor. In some cases I recommend using chiropractic care in conjunction with the Pre-birth Protocol to address issues of the hips and pelvis.
Prepping Hormones: Regulating Cortisol & Oxytocin
Oxytocin is the hormone that gets labor started, it's also the feel-good hormone that is released in our brains when we have sex or fall in love. The release of oxytocin is opposed by the release of cortisol in the body, which is the stress hormone. Cortisol is released when we're totally freaking out, when we experience fear and panic, or when we engage our "fight or flight" system.
When oxytocin goes up, cortisol goes down, and vice versa. Therefore, in order to oxytocin levels to get high enough for labor to get started, cortisol levels have to remain low enough to let the process happen.
The problem is, when many women are approaching their due date, especially if they’re still working or if family is coming into town, stress can be high in those last few weeks before their due date. Stress might even be higher than it usually is. Add in going past your due date and facing an induction, many women start to sweat at the idea, all while they are suppose to be staying calm!
That's where the acupuncture, once again, comes in handy. Acupuncture helps to turn down the "fight or flight" system in the body, reduce cortisol levels, calm the mind, and deeply relax the body. That’s one of the many reasons it’s so effective for helping to prep for labor.
Improving Fetal Position
Your doctor will usually let you know at or before 35 weeks if your baby is in the breech position, meaning they aren't facing head down. Most hospitals and doctors refuse to deliver breech babies vaginally these days, meaning a caesarean becomes necessary, but acupuncture and moxibustion are effective treatment for flipping breech babies. In fact, acupuncture and moxibustion used together have been shown to result in fewer non-cephalic presentations (that's when the baby's not head down) and fewer caesareans, here's the study.
But breech isn't the only concern when it comes to positioning, the direction the baby is facing will also ultimately determine how smoothy labor progresses.
Ideally babies are facing what's called occiput anterior (OA,) meaning the back of their head is facing the front of your body. But even once head down, before their head engages in the pelvis, a baby can and swivel in any position. If they swivel into the occiput posterior (OP) position, meaning the back of their head is facing your back, also sometimes called "sunny side up," that can make labor much more difficult and painful.
Typically when babies are in OP position it increases the length of labor and the amount of back labor a women experiences. Because of the way the baby's neck is swiveling it puts a lot more pressure on the sacrum and tailbone.
This can all be avoided by paying attention and making subtle adjustments to baby's position in the weeks before labor. Just as acupuncture and moxibustion is effective treatment for breech presentation, they are also effective at turning babies into the OA position.
What does the Pre-birth Protocol involve?
Starting at 35 weeks, I recommend patients begin weekly acupuncture treatments and follow instructions for using moxibustion and prescribed herbs at home. If you find out your baby is breech prior to 35 weeks, I recommend beginning treatment as soon as 33 weeks.
Based on the nature of what I do, the specific treatment plan varies from patient to patient depending on their individual needs, but the goal remains the same: to prep the body and position of the fetus for labor so that the birth process and recovery period goes as smoothly as possible.