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a pregnant women reading a baby book

THE LAST MONTH OF PREGNANCY

the last month of pregnancy blog post a pregnant lady reading a book

“Being pregnant is like running a marathon for 9 months” 
– Herman Pontzer, Duke University.

Over the last 8 months your body has been changing, adapting, growing and nurturing your baby. 

A research paper by Duke University has found that pregnancy puts the body under the same amount of strain as running a marathon every. single. day.

However, unlike athletes who can rest and recover after completing their endurance challenge, your body is gearing up to birth your baby – an epic endurance event in itself!

Much like a professional athlete, preparation is essential. 

Effective preparation increases chances of a birth with minimal intervention and minimal tissue damage. It can help you feel mentally and physically prepared, eliminating excess stress and worry.

In this post I hope to outline what you can do to achieve this, preparing you for birth and supporting you in the last month of pregnancy. If you want to know more make sure you download our super helpful e-book  ‘Birth Preparation Guidelines’.

WHAT DO I NEED TO PREPARE FOR BIRTH?

  1. PHYSICAL: PELVIS – Physically preparing the pelvis
  2. PHYSICAL: PELVIC FLOOR – Physically preparing the pelvic floor
  3. PHYSICAL: PERINEUM – Physically preparing the perineum
  4. PHYSICAL: CERVIX – Physically preparing the cervix
  5. HORMONE PREPARATION – Stress reduction & rest to protect birth hormones & conserve energy
  6. MENTAL PREPARATION – Letting go of fear around giving birth
  7. PREPARING THE TISSUES – Creating an anti-inflammatory environment, improving microbiome and fuelling you for birth
  8. EXERCISE – What to do and not do in your last month

PHYSICALLY – THE PELVIS

In the last month of pregnancy there are some important physical changes that occur as the body prepares for birth.

The uterus turns slightly to the right and, facilitated by relaxin, the hips become slightly asymmetric, with the left hip sometimes moving forward. This is all in preparation for the baby to come down the birth canal.

Now, there are optimal positions for the baby to be in, which gives the highest chance of a birth with minimal intervention. The most optimal position is with the back of the baby’s head on the front left side of the pelvis, as the baby just has to a quick 40* rotation to come down. 

There are certain things we can do to prepare the pelvis and encourage the bubba into this position.

  1. Movements bringing the left leg forward: a passive external rotation of the femur and gently driving forward.
  2. Asymmetric movements with the pelvis: circles and figure-of-eights with the hips. favouring the left side. Click here to watch a sequence demonstrating these movements.
  3. Avoiding a ‘bucket seat position’ which can encourage the baby to go back-to-back. So try to avoid slumping into the couch or long drives in the car.
  4. Movement in general is encouraged, particularly circling of the hips either whilst standing or on an exercise ball.
  5. Try, as much as possible, to sleep on your left side.
  6. Visit an osteo or chiro to check that the pelvis is mobile – this is particularly important if you have ever had a hip injury of any kind.

PHYSICALLY – THE PELVIC FLOOR

Let’s think of your pelvic floor muscles like a woven basket that supports your baby and holds up your vital organs. These muscles need to be strong to support your growing bump, but also have the ability to fully release when it comes to birth.

It’s recommended to do pelvic floor exercises for the duration of your pregnancy to keep them strong and to keep you mentally connected. However if you haven’t been able to so far, the last month is a great place to start.

Place a hand on your heart and a hand on your belly and take a deep breath into the base of your lungs. Try and expand 360 as you inhale. Then exhale fully to the end of the breath. Then take your awareness to your perineum area and as you next inhale visualise a lift, then when you exhale a full release. Repeat this a few times. You can use deep sounds if this helps you feel this lift and release.

Here is a guided meditation to help with the release.

PHYSICALLY – THE PERINEUM 

Around 90% of women will tear during childbirth, with a 3% risk of a more severe tear in the first delivery. Although there can be no guarantee that you won’t sustain a tear, there are a few things that you can do to try and minimise and reduce severity:

  • Antenatal perineal massage from 35 weeks
  • Try and integrate Eutonia, bringing awareness to the area using objects, from 35 weeks.
  • Use a device like an Epi- no, 2-3 times a weeks from 37 weeks to help gradually stretch the perineum.
  • Warm compress on the area at the 2nd stage of labour
  • A slow delivery of the baby’s head to allow the perineum to gently stretch.

If you do sustain a tear or a scratch it’s recommended you start perineal scar massage when the area has healed (usually 6-12 weeks).

PHYSICALLY – THE CERVIX

In the final few weeks of pregnancy, daily deep intercourse helps to prepare the cervix for birth. Sperm contains prostaglandins that help the cervix become softer and thinned out. 

So here’s some advice to have daily sex in the last few weeks of pregnancy, although this might be the furthest thing from your mind!

HORMONE PRODUCTION: REST & STRESS REDUCTION

In so many cases mums-to-be are working right up to their due-date, maybe even running around after their other kids on top of a million other things.

Stop. Take a breath. Accept help and rest. We want to try and enter birth with:

1. Optimal rest. We want optimal rest so that we have the energy and strength for birth.

2. Limited stress. We want limited stress so we can create an environment that facilitates the release of oxytocin.

Oxytocin, sometimes called the ‘love hormone’, kickstarts the birth by starting contractions, and its release is directly hindered by stress, or cortisol, being released.

The following are good ways to limit stress and optimise rest in your last month, which in turn helps you with hormone preparation.

  • Go to bed at the same time every day, ideally before 11. Hormones are secreted in cyclical fashion, so following a cyclical lifestyle – i.e. going to bed at the same time – helps the birthing hormones.
  • Get tactile. Oxytocin is released through touch, so being kissed, caressed and loved by the ones closest to you creates a happy hormone environment.
  • Create a calm space at home. Find a place at home where you can sit in solitude or meditate for a few minutes every day.
  • Favour rest over social events.
  • Reduce working hours, where possible. Limit busy commuter time.
  • Accept help. Ask your partner to do the shopping, if you have other kids ask family to help or accept their offers to babysit.
  • Try and have naps whenever you can or need to.
  • Organise everything related to birth and your birth plan so you’re not stressed about being under prepared.

MENTAL PREPARATION: POSITIVE BIRTHING

Your brain can really control your birth. If you’re afraid, this will really affect your whole birth. Fear affects the birthing hormones and your emotional state, impacting and lengthening labour.

I want you to feel confident and ready. Allow yourself to surrender to the process and accepting that you’re about to live an intense and incredible journey that you and your baby are more than prepared and ready to experience. 

The following suggestions can hopefully help you do just that:

  • Connect with your baby and explain birth to baby. It’s not just you but the baby going through the birth too.
  • Visualising the birth will help you mentally prepare for what can be a magical experience.
  • Don’t entertain horror stories. Really try and limit negativity around you.
  • Watch beautiful birth videos. They can surprisingly really help you prepare.
  • Seek the company of other women who had great experiences.
  • Verbalise and process fears related to the birth. This is something that’s great to do with your partner. Verbalising fears can make them vanish!
  • Read and write down affirmations such as:

I put all fear aside as I prepare for the birth of my baby.

I am relaxed and happy that my baby is finally coming to me.

I am focussed on a smooth and easy birth.

I trust my body to know what it is designed to do.

My mind and body are relaxed.

PREPARING YOUR TISSUES & SYSTEMS

Nutrition is important throughout the whole of pregnancy. However if you haven’t been able to eat healthily for whatever reason, in the earlier months of your pregnancy, it is really important that you start eating well in the final month, because:

  • It’s during this time that the microbiome starts to transfer from mum to baby.
  • You are preparing for the biggest event.
  • Your body needs to recover and heal after birth.
  •  A nutrient dense and anti-inflammatory diet is important in preparing microbiome for fetal transfer, and in order to prepare a healing environment for post birth:
  • Eat gluten-free wherever possible as gluten is pro-inflammatory
  • Eat an abundance of fresh fruits and veg, organic where possible.
  • Add more starchy carbs, preferably from veg and gluten free (sweet potato, fruit, buckwheat, brown rice, root vegetables) – now that you are carb loading!
  • Add good fats (coconut milk/oil, avocados, nuts, seeds, fish) – these are good for tissue and collagen quality.
  • Eat foods high in iron (green veggies, walnuts, almonds, meat) – you bleed during and after labour so we need good iron stores to help aid recovery.
  • Take probiotics – microbes get transferred to your baby via vaginal birth so this will help set up their immune system.
  • If possible, start thinking about batch cooking nutritiously dense meals and freezing them in preparation for when the baby is here and you’ll be otherwise occupied!
  • Re-evaluate iron supplement needs with your care provider, as iron supplement ingestion can make birthing more difficult by inhibiting prostaglandins which ripen the cervix in preparation for birth. Favour the aforementioned natural iron sources.
  • Hydration – water helps with tissue quality. Raspberry leaf tea can help stimulate contractions too.

FUN FACT: A curious study found that eating 4 dates a day in the last month of pregnancy are more likely to start birth with contractions rather than waters breaking. It also increases the chance of your bubba being born in the amniotic sac. This is preferable as birth is less painful with waters intact.

EXERCISE

  • Don’t change your routine, keep moving as you were before but at a lower intensity.
  • Try to move daily and preferably outdoors.
  • Prioritise pelvic mobility and birth preparation exercises.

Women at low-risk pregnancy are encouraged to do at least 150 minutes of moderate physical activity per week or 20-30 minutes per day (ACOG, 2015)

OTHER THINGS YOU CAN DO TO PREPARE FOR BIRTH

  • Limit the toxins around the baby and house. A study showed that newborns, at birth, have unacceptable levels of toxins in their blood – 287 contaminants, some that are known cancer causes.
  • Watch weight gain. There are certain times in our life where we can create new fat cells; when we’re adolescents is one. Some studies show that another life cycle is in the last month of pregnancy. So we want to watch excessive weight gain in this phase. Plus we don’t want the bubba to get too big!

As always, please do get in touch hello@planet-mama.co.uk with any questions or queries if you need some support during or after your pregnancy journey. Lettie, Founder of Planet Mama x