What to do now for an easier labor: expert advice from a PT

We asked top pelvic floor physical therapist Natalia Avelar, PT, DPT, PRPC, Cert. MDT, what you can do now to prepare for labor. She specializes in helping women through pregnancy, labor, and postpartum. Here’s what she said:

Q: Are there any exercises that can help prepare for labor?

A: Yes. Good hip mobility can help you progress through the later stages of labor more quickly. Here are three simple hip movements to work into your daily routine.

Q: What if I plan to get an epidural?

A: Many people are surprised to hear that changing positions every 30 to 45 minutes can help dilate your cervix and progress your labor, even after an epidural. Since you’ll be numb from roughly your belly button to your upper legs, you’ll have to stay in bed. But this doesn’t mean you have to stay still: With the help of a support person, you can move from lying flat on your back to lying with your legs up and bent. You can also rotate through lying on your back to lying on your right side and then your left. 

Doing hip mobility exercises throughout your pregnancy can make those laboring positions easier and more effective. 

Learn more about research on different birthing positions—with and without epidurals—here. 

Q: Do breathing exercises really help?

A: Yes. A randomized controlled trial showed that doing breathing exercises during pregnancy and labor can lead to decreased labor time and fewer medical interventions. Breathing exercises are also positively associated with the onset of spontaneous vaginal delivery—versus needing an induction or c-section. This is likely because deep, slow breaths can help relax and stretch your pelvic muscles, so they can more easily move aside as your baby goes through the birth canal.

Deep breathing has also been scientifically shown to help manage pain by releasing endorphins and stimulating a sense of calm. Learn the Lamaze breathing techniques that were studied in the randomized controlled trial here.

Q: Does perineal massage actually do anything?

A: Yes. The perineum is made up of tissues and muscles at the bottom of your pelvic area, between your vulva and anus. This area can tear during childbirth. Studies show that massaging your perineum when you’re 35-plus weeks pregnant improves perineal mobility and stretch, reducing your chances of severe tearing. 

See here for additional information on perineal massage and how to perform it.

Q: What if I have a planned C-section or want to prepare for that possibility?

A: There are some simple things you can do to help prepare your body for a C-section. If you can, keep moving throughout your pregnancy. Doing gentle strengthening and flexibility exercises now may make it easier for you to care for yourself and your new baby after surgery. 

• You can find pregnancy-friendly core strengthening movements here and postpartum options here. 
• Doing cat-cow poses and gentle upper body rotations a few times per day can help build spinal mobility and reduce stiffness prior to your C-section.
• Diaphragmatic breathing can help you create strength, flexibility, and mobility for your deep core muscles, including your pelvic floor. It can also help with pain management post-surgery. 

Meet the expert

Natalia Avelar, DPT, PRPC

Pelvic Floor Physical Therapist

Learn more about the research

Abdelhakim, A. M., Eldesouky, E., Elmagd, I. A., Mohammed, A., Farag, E. A., Mohammed, A. E., Haman, K. M., Hussein, A. S., Ali, A. S., Keshta, N. H. A., Hamza, M., Samy, A., & Abdel-Latif, A. A. (2020). Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: A systematic review and meta-analysis of randomized controlled trials. International Urogynecology Journal, 31, 1735-1745.

Chen, Q., Qiu, X., Fu, A., & Han, Y. (2022). Effect of Prenatal Perineal Massage on Postpartum Perineal Injury and Postpartum Complications: A Meta‐Analysis. Computational and Mathematical Methods in Medicine, 2022(1), 3315638.

Dieb, A. S., Shoab, A. Y., Nabil, H., Gabr, A., Abdallah, A. A., Shaban, M. M., & Attia, A. H. (2020). Perineal massage and training reduce perineal trauma in pregnant women older than 35 years: A randomized controlled trial. International Urogynecology Journal, 31, 613-619.

Hemmerich, A., Bandrowska, T., & Dumas, G. A. (2019). The effects of squatting while pregnant on pelvic dimensions: A computational simulation to understand childbirth. Journal of Biomechanics, 87, 64-74.

Karkada, S. R., Noronha, J. A., Bhat, S. K., Bhat, P., & Nayak, B. S. (2022). Effectiveness of antepartum breathing exercises on the outcome of labour: A randomized controlled trial. F1000Research, 11.

Michel, S. C., Rake, A., Treiber, K., Seifert, B., Chaoui, R., Huch, R., Marincek, B., & Kubik-Huch, R. A. (2002). MR obstetric pelvimetry: effect of birthing position on pelvic bony dimensions. American Journal of Roentgenology, 179(4), 1063-1067.

Siccardi, M., Valle, C., & Di Matteo, F. (2021). Dynamic external pelvimetry test in third trimester pregnant women: Shifting positions affect pelvic biomechanics and create more room in obstetric diameters. Cureus, 13(3), e13631.