Ripe & Ready

Third Trimester

With so many social expectations around the “due-date”, it is hard to be a pregnant woman and not feel like there is a clock that starts ringing ferociously on that magic day. We know that our due-dates are the best guess for a birthday that can take place several weeks before or after. There seems to be a fine line between letting nature take its course, and being proactive so that our bodies are as prepared for the birth as possible. Numerous strategies can support your body’s innate ability to give birth naturally and possibly decrease your chances of going far past your due date. We have tried to outline the strategies we have found to be the most effective in nurturing and ripening your mind and body for labour.  Awaiting baby after your due date has passed may be stressful, especially if you are considering electing a medical induction at some point, which carries a degree of risk as well as benefit, and may not look like the birth you had envisioned for yourself. 

For the most part, when you will start labour is determined by a complex interplay of maternal and fetal hormones that starts in early pregnancy. Another factor is the fetal position in late pregnancy which in turn can be influenced by various other factors including maternal energy, pelvic alignment, and lifestyle habits. Of course, there is also much to be said for the mind/body connection – we know that women rarely start labour if they are sick, and the same can be true if they have overwhelming fear or anxiety.

The third trimester, is the time when the cervix especially starts to ripen. Continue with everything from the Second Trimester that you have started. If you haven’t signed up for Prenatal Classes or hired a Doula, it’s not too late.

Third Trimester

Optimal Fetal Positioning strategies

Once babies are head down, if they are anteriorly positioned, i.e. their face is towards the mother’s back (which presents a smaller diameter into the pelvis), they will be able to sink deeply into the pelvis and onto the cervix. This promotes cervical ripening, as well as minimizes back pain in late pregnancy and during labour.

In order to promote anterior positions:

  • Float or swim with the belly down

  • Garden

  • Practice yoga

  • Use forward leaning positions when relaxing or at work: sit on a birth ball, kneeler-rocker or chair facing the back

  • Sleep sidelying (preferably left side), not on the back – but only if this is comfortable and doesn’t result in less sleep!

In order to avoid promoting posterior fetal positions:

  • Avoid reclining in armchairs, sitting in bucket car seats, or anything where the knees are higher than the pelvis

  • Avoid crossing the legs, which reduces the space at the front of the pelvis and opens it up at the back

  • Avoid sitting with feet elevated

  • Avoid deep squatting, which open up the pelvis and encourages the baby to move down, if the baby is known to be posterior

Homeopathics

30c Pulsatilla daily from 33-36 wks, for optimal positioning

Homeopathics are sugar pellets which are impregnated with highly diluted substances or the “energy” of plants.  There are no associated side effects with taking homeopathics.  For maximum effectiveness, the pellets should be dissolved under the tongue, and should be taken at least 15 minutes before or after eating or drinking.

Acupuncture

Acupuncture, along with its other benefits, can be used to promote optimal fetal positioning and hormonal balance, as well as induce labour when needed.

Sex

Orgasm strengthens the uterine muscles and ripens the cervix. For women with male partners: semen contains prostaglandins, which are hormones that act to ripen the cervix.

Birth plan

Having a birth plan, whether formalized in writing or verbalized with your birth team, will increase your sense of trust and control, allowing you to let go into labour. 36+ weeks

Self care

Eat, drink, take naps. Don’t exhaust yourself by the end of the day in case labour starts in the middle of the night

Optimal Fetal Positioning exercises

15+ minutes a day in a “polar bear position”, i.e. with your knees and chest on the floor. Use pillows to make yourself more comfortable while you meditate, read, watch TV, etc. Also effective for reducing back pain in late pregnancy.

  • Use various exercises done on all fours to promote anterior rotation, including side-to-side swaying or pelvic rocking.

  • Scrub floors by hand on your hands and knees

  • Walk up stairs sideways two at a time

Evening Primrose Oil (EPO)

EPO contains prostaglandin precursors – as well as essential fatty acids – which help ripen and soften the cervix. It is also used to help prevent postpartum depression.

  • Take 1000 mg orally in the morning

  • Insert 1000 mg intravaginally at bedtime, as close to your cervix as you can reach

  • 200c Pulsatilla at 36 weeks. Repeat dose 10 days later.

  • Birth Prep Prenatal Regimen:

Homeopathics (see above re: how to take homeopathics)

Take 5 pellets of 12c Arnica once a day for 3 days.

Then take 5 pellets 12c Cimicifuga once a day for 3 days,

Then take 5 pellets 12c Caulophyllum once a day for 3 days.

Start the cycle again with Arnica.  Repeat until birth.

Herbs

Local herb/health food stores supply tea blends and/or tinctures known as “partus preparers” to support and prepare the uterus during the final stretch before labour and birth.  It is only advisable to take one at a time, thus it is best to elect one or the other.

Some partus preparers contain Blue Cohosh (Caulophyullm thalictriodes).  It is best to avoid this herb until more research is available regarding its safety in pregnancy.  Homeopathic Caulophyllum, however, is considered safe in pregnancy.

Ø  Tea

Below is an example of a tasty, nurturing blend that you can make yourself, or have a herbalist mix for you:

3 parts

Partridgeberry

Drink 1-3 cups daily as a hot tea (let steep for at least 15 minutes), or blend with a juice for a cool beverage.

2 parts

Red Raspberry leaf

1 part

Alfalfa

1 part

Lemon Balm

1 part

Nettle

Ø  Tincture

A tincture is a liquid preparation that uses alcohol and water to extract the constituents of herbs.  The following is a blend inspired by the Eclectic physicians (medical herbalists of the 1900s) which contains herbs that may be considered unpleasant to drink in tea form, but have valuable properties that aid in preparing the uterus for labour and birth and in tincture form can be taken in smaller quantity. This blend can be formulated at local herb stores upon request

3 parts

Partridgeberry

  • Put a small amount (approx. ¼ cup) boiled water into a cup.

  • Add ½ tsp of tincture.

  • Allow preparation to sit 15 minutes to evaporate alcohol.

  • Take the blend of tincture/water with meals (i.e. ½ tsp. tincture in water 3/day).

  • Follow with a dried apricot chaser if you dislike the taste.

2 parts

Black Haw

1 part

Black Cohosh

Essential Oils

  • Have a Labour Blend made for you by an aromatherapist. Massage this into your belly daily from 36 weeks while practicing relaxation or just before bed. Once you are in labour, applying the oils to your belly will bring your senses right to that relaxed place.

  • Add 3 drops of Frankincense essential oil to your bath, along with 3 drops of Lavender, and 1-2 cups Epsom Salts. Frankincense tones the uterus for childbirth, promotes relaxation, and eases feelings of fear or stress

Belly Lifting

Use this technique during Braxton-Hicks contractions in the last weeks of pregnancy. It can also be used in labor. The theory is to change the pressure vector on the baby’s body and head, thus helping baby to better flex and/or rotate its head.

Stand with knees bent. As the contraction starts, brings your hands around your belly and pull up on the bum of baby, thus lifting your belly.

40+ weeks

Stretch & Sweep

Sounds like spring cleaning, but actually refers to a procedure whereby your midwife inserts 2 fingers into your vagina with the intention of reaching your cervix. If the cervix is open, she will stretch your cervix; this action will help release prostaglandins, an essential hormone for labour. While this procedure is not related to a higher risk of infection or your water breaking prematurely, it has been shown to be associated with an earlier labour, especially if repeated over a number of days. Let your midwife know if you are interested.

Time/Patience

Ultimately, your baby will come at the most appropriate time. Even the most aggressive ripening or induction techniques will not bring on labour if it is not your time yet!

SUMMARY

  • Growing Belly Tea

  • Prenatal classes

  • Doula

  • Birth plan

  • 30c Pulsatilla daily from 33-36 wks

  • Massage

  • Chiropractic

  • Acupuncture

  • Lavender essential oil & Epsom salts

After 36 weeks:

  • Sex

  • Evening Primrose Oil 1000mg orally in the morning, 1000mg vaginally at bedtime

  • Homeopathic 200c Pulsatilla at 36 weeks. Repeat dose 10 days later.

  • Homeopathic 12c Arnica, 12c Cimicifuga, 12c Caulophyllum

  • Tea OR Tincture

  • Essential oil blend: Lavender, Frankincense OR Fennel

  • Labour blend aromatherapy

  • Polar Bear position daily

  • Belly lifting technique

  • Stretch & sweep

The complementary therapies listed here are considered safe in pregnancy (based on the resources available) if used as described.  The midwives at Ten Moons have varying experience/education regarding the use of complementary therapies in pregnancy, however we are not naturopaths. We have put forth this document based on our respective personal experiences with using/recommending the above therapies, as well as current resources regarding the use of complimentary therapies in pregnancy.  For more information, please refer to resources available in our lending library, or speak with a naturopath, herbalist, homeopath or aromatherapist.