You don't know what you don't know. And for first time moms, asking questions about the birth process can be very challenging for this exact reason.
That's why I am compiling questions I have my clients ask their providers here for you in this blog. These questions are primarily about the birth process, but if you're shopping for providers early on in the pregnancy they can help shed light on the philosophies of your chosen provider.
If I Get An Epidural, Can I Still Move Around?
Walking is out of the question after receiving an epidural, but you should still be able to change position in bed.
Birthing in an upright position, such as quadruped or child's pose, can help decrease your risk of tearing during birth.
Having an epidural should not automatically remove your ability to move. I had an epidural and pushed for 4-hours in bed, in various different positions!
This is dependent on whether or not you need additional medical interventions, and your provider may require you to lie on your back during pushing if it is medically necessary.
This is a great question to ask your provider. Their answer will tell you quite a bit about their birthing philosophies and may dictate whether or not you choose to continue care with them.
Can My Partner Help With Perineal Massage During Labor?
Massaging the base of the vaginal opening during labor and applying warm compresses, like a moist wash cloth, can also help decrease your risk of tearing.
This can be performed in between contractions by your partner or your provider.
According to a meta-analysis of randomized controlled trials published in 2020, Perineal massage during labor has been shown to significantly decrease your risk of tearing during labor.
Your provider may be uncomfortable allowing your partner to perform massage, but should at minimum acknowledge your desire to involve your partner and decrease your risk of tearing during birth.
Many times it is the midwife that provides this service, so if your provider does not wish your partner to assist, then they should offer to perform this service themselves.
Your provider's answer to this question will reveal quite a bit about their willingness to listen to your requests and interest in including family in the birthing process.
How Do You Tell People To Push During Labor?
Your pelvic floor does not push the baby out. Your uterus pushes the baby out. Your job during labor is to relax your pelvic floor and breathe.
Purple pushing, or holding your breath and bearing down, will actually result in your pelvic floor naturally contracting. Although you may be able to generate force through the abdominal cavity this way, your will also now have to push a baby out through a tight pelvic floor.
The current recommendation by the American Association of Obstetrics and Gynecology for pushing is to not coach the mother on how to push, but to allow her to respond to her own instincts. When women are not coached to push during labor, they tend to not hold their breath and strain, and instead breathe through pushes, which is consistent with normal human anatomy and core activation.
It's possible your provider will offer you a good reason for their preference in pushing style. This is an excellent question to ask your provider, and will shed quite a bit of light on their philosophies around labor.
Conclusion
These questions will get right down to the culture and core of your chosen provider and establishment. The response you get to these questions will speak volumes about your provider's willingness to work with your needs and desires, and compassion capacity for involving family.
I highly recommend asking these questions early on to drill down to the nitty gritty about who you are working with. If it doesn't vibe, give yourself plenty of time to find someone new.
Remember, you have choices in health care. You do not have to work with someone who doesn't share your philosophies on birth.
You got this mama.