How to Prepare for Childbirth: Midwife-Approved Guide to Labor and Birth Options
This midwife-approved childbirth guide helps you prepare for birth by walking you through evidence-based ways to ready your body, mind, and support team for labor and delivery.
Preparation for birth is about more than packing a bag. It’s about understanding your options, building confidence, and finding support that aligns with your goals for labor and birth. As a certified nurse-midwife, I’ve guided hundreds of families through this journey, and I know firsthand how important it is to feel supported and empowered.
What should you expect in labor & delivery?
How to Prepare for Childbirth Your Way
1. Choose a supportive provider.
Find someone who respects your preferences, avoids unnecessary interventions, and is open to different labor positions and coping methods.
2. Pick a setting that fits your birth goals.
Hospitals, birth centers, and home births all have benefits and considerations. If you’re aiming for an unmedicated birth in a hospital, ask about natural childbirth accommodations and C-section rates. For home or birth center options, be aware of the plan in case risk factors arise or labor becomes complicated (For example, you experience symptoms of preterm birth).
Resources: AWHONN Intrapartum Care
3. Stay active during pregnancy.
Exercise boosts stamina, flexibility, and confidence—important for labor. You don’t need to run marathons. Walking, swimming, and prenatal yoga are excellent ways to stay strong.
4. Consider a doula.
Doulas are associated with lower rates of medical interventions and higher chances of unmedicated childbirth. They can guide natural pain relief methods, suggest optimal positions, and provide continuous support.
Resources: https://www.dona.org/what-is-a-doula-2/
5. Hydrate, move, and trust your body.
Support, hydration, and position changes reduce the risk of prolonged labor or complications, especially if you’re aiming for an unmedicated birth.
6. Be prepared to understand the process of labor and birth and rock it.
Check out our detailed breakdown of what to expect in labor & delivery>>>
Alternative and Manual Stimulation Methods
These methods require discussion, education, and approval from a qualified health care provider. Safety and timing matter, and not every option is appropriate for every pregnancy.
Professional guidance required
Chiropractic care
Some chiropractors use the Webster technique to address pelvic alignment. The goal is to create optimal space for the baby to descend, not to induce labor.
Acupuncture
Acupuncture involves placing very fine needles at specific points, such as Spleen 6 or Bladder 60. These points are believed to support relaxation and uterine activity. Treatment should only be provided by a licensed practitioner experienced in pregnancy care.
Acupressure
Acupressure uses firm, steady pressure on the same points used in acupuncture. Studies show that it promotes a more favorable cervix. Instruction from a trained provider is important to ensure correct technique and timing (e.g., avoid spleen 6 as it may cause contractions).
Foley bulb
A Foley catheter with a small balloon may be placed in the cervix and inflated to apply gentle pressure. This mechanical method can encourage cervical dilation and is performed by a medical provider in a clinical setting.
Herbal and supplemental support
These approaches are often discussed in midwifery and holistic care settings. Evidence and safety vary, and they should be used only under guidance from a knowledgeable provider.
Evening primrose oil
Evening primrose oil contains gamma linolenic acid, which the body can convert into prostaglandins. It is thought to help soften and thin the cervix. It may be taken orally or inserted vaginally near term, depending on provider guidance. You may want to forgo this, as some studies showed a possible link to prolonged rupture of membranes. The data also shows EPO may help ripen the cervix, but its impact on the baby’s transition immediately after birth is still being studied, so provider supervision is key.
Red raspberry leaf tea
Red raspberry leaf tea is believed to be a uterine tonic that supports uterine muscle tone and efficiency, but it is not intended to start labor. It is most commonly used in the third trimester. Contrary to popular belief, this study found that RRL did not shorten the first stage of labor. However, it did show two clinically significant benefits: a shortening of the second stage of labor (by about 10 minutes) and a lower rate of forceps deliveries (19.3% vs. 30.4%
Midwife tinctures or naturopathic supplements
These products vary widely and may include herbs such as blue cohosh or black cohosh. Because dosing and effects differ, they require careful supervision from a trained practitioner.
Dates
The evidence shows that eating 6–7 dates per day starting at 36 weeks can increase the likelihood of spontaneous labor, improve cervical ripeness, and reduce the need for interventions like oxytocin (Pitocin).
High caution and discouraged methods
These methods carry a higher risk of unpleasant side effects or misuse without strict guidance.
Castor oil
Castor oil is a strong laxative that irritates the bowels, which may indirectly stimulate the uterus. Many providers discourage its use because it often causes severe nausea, vomiting, and diarrhea, which can lead to dehydration and exhaustion before labor begins.
Clary sage essential oil
Clary sage is considered a uterine stimulant. It should never be used before 37 weeks. If used, it must be properly diluted in a carrier oil for massage or used in diffusion. Ingestion is unsafe, and misuse can cause painful or irregular contractions.
Lifestyle and natural methods
Sex
Prostaglandins in semen may help with cervical ripening, and orgasm can stimulate mild uterine contractions.
Walking or stair climbing
Movement and gravity can encourage the baby to move lower into the pelvis, increasing pressure on the cervix.
Nipple stimulation
Nipple stimulation can release natural oxytocin, which may trigger contractions. Because it can cause strong or frequent contractions, it should be done only under clear guidance from a health care provider.
Pain Relief Options
Unmedicated childbirth remains a popular choice. In a poll of 34 readers between 2016–2019:
- 50% had an unmedicated birth
- 12% used opiate pain meds (Nubain, Stadol, Morphine)
- 24% had an epidural
- 15% had a C-section
What is epidural anesthesia?
An epidural provides regional anesthesia, numbing your lower abdomen. A CRNA or anesthesiologist inserts a catheter into your spine, often with a local numbing injection. While it reduces pain, it can limit movement and sensation in your legs. Nurses help with positioning and emptying your bladder (often with a catheter). Medications usually combine local anesthetics (bupivacaine or lidocaine) with opioids like fentanyl. Side effects can include low blood pressure or changes in the baby’s heart rate, but these are temporary and manageable.
Still a Nurse—Just in a New Role
Thinking about leaving the bedside but staying true to your calling? Grab the free guide: 15 Remote and Nontraditional Jobs for Nurses.
What do I need to know before I get an epidural?
To have an epidural, you will get an intravenous (IV) catheter inserted and IV fluids. You will need to have your recent blood count checked to ensure your platelet count is adequate (typically preferred to be above 100k or 100,000 per microliter of blood), but may vary by facility policy. Checking your platelet count will help reduce the risk of clotting or bleeding.
The anesthesiologist or nurse anesthetist is the professional who inserts your epidural. You can sit or sometimes lie on your side during the placement. A nurse will monitor your vital signs during the process.
You will push your back out like an angry cat. Cleaning your back with a cold antiseptic solution reduces your chances of infection. After that, you may feel a pinch or a bee sting as they inject local anesthesia (a numbing solution).
The anesthesiologist or CRNA waits until your back is numb and then inserts a needle through the skin of your back into the epidural space. They place a small catheter, which remains in place while you receive the medication. The needle is taken out, but the catheter constantly provides medication.
All done! The anesthesia team will secure the catheter in place. While removing it may feel like back waxing, many patients would gladly endure a little tape ripping for pain relief.
I’m a midwife and talk to pregnant people every day. While the process can be scary, contractions usually distract you during placement. Sometimes, the medication can cause your blood pressure or the baby’s heart rate to drop. You will know this occurs if you feel dizzy or lightheaded. This is temporary because the medication called phenylephrine can reverse the effects.
Get a free OB SOAP note template here.
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Other Pain Relief Options
Medications often come after deep breathing, massage, movement, or warm water fail to manage pain. Pain medication in childbirth includes opiate pain medication and nitrous oxide.
- Opiates: Given through IV or injection, opiates reduce pain but don’t block it completely. Side effects include nausea, dizziness, and itching. If given soon before birth, it can cause respiratory depression in your baby.
- Nitrous oxide: You breathe into the nitrous mask by yourself and inhale during contractions. Nitrous helps you relax by reducing anxiety and pain perception. The effects wear off within minutes, and side effects are minimal.
Cesarean Section: Operative Delivery
C-sections are surgical procedures to deliver the baby through an incision (opening) in the belly and uterus. There are several reasons to perform a C-section, including scheduled, urgent, or emergent procedures.
- Scheduled: Those with prior C-sections, placenta complications, or certain medical conditions may plan to schedule their surgical birth. If you have a C-section, a vaginal birth after cesarean (VBAC) may be an option with a qualified provider.
- Urgent: When labor or fetal conditions worsen, but immediate danger isn’t present. Typically, the surgery must start (incision) within 30 minutes after making the decision for C-section. You may hear the phrase, “30 mins from decision to incision.”
- Emergent: This procedure should be performed immediately and is indicated when maternal or fetal life is at risk.
Reasons You May Need a C-Section
If you have certain pregnancy complications, you and your provider may decide to give birth by C-section. These scheduled complications include:
Placenta previa occurs when the placenta is near or over the cervix.
Vasa previa is when the blood vessels that the placenta and umbilical cord should protect are left open and vulnerable and cross the cervix.
Herpes simplex virus (HSV) outbreaks occur immediately before or during labor. (Outbreaks earlier during pregnancy do not require a cesarean section unless they appear close to labor and childbirth.)
Frequently Asked Questions (FAQs)
Malpresentation occurs when the baby is not in the head-down position. Types include breech (bottom-first), transverse (sideways), or shoulder presentation.
External Cephalic Version (ECV): Your healthcare provider attempts to manually turn the baby from the outside.
Breech birth with a skilled provider: Rare, but possible in certain settings.
Vaginal breech birth depends on your provider’s skill, baby size, and presentation type. Frank breech (legs up toward the head) is the most challenging.
It depends on your baby’s size, presentation, and your provider’s skill. Frank breech (legs up toward the head) is most challenging. Finding a qualified breach OB provider can be challenging, so start early.
First, the doctor will use an ultrasound to look at the baby’s position and see if the baby remains malpositioned. Next, you may get an epidural to be more comfortable. Finally, the doctor will use their hands on the outside of your abdomen to try to move your baby. If the ECV fails or you opt not to have one, your options are to schedule a C-section or seek a provider who will perform a breech birth.
Resource: ACOG ECV Guidelines & FAQs
VBAC candidates may need to meet specific criteria, such as body mass index (BMI), length of time between pregnancies, and the type of incision from your first surgery.
Having a VBAC typically requires having an anesthesia provider and obstetrician, in case of an emergency.
You’ve read the guide. Now here’s what this knowledge means — especially if you’re a nurse.
For Nurses & Midwives: When Birth Knowledge Shapes What Comes Next
You have seen the power of an unmedicated or physiologic birth. Not because it is the “right” way to give birth, but because the person giving birth feels heard, supported, and in control.
Those moments tend to stay with us. The provider who protected someone’s space. The doula who made a difference just by being present. The quiet confidence in the room when someone trusted their body and the team around them.
If you are stepping away from the bedside, that knowledge does not disappear. In many cases, it is what points you toward your next role.
Still a Nurse—Just in a New Role
Thinking about leaving the bedside but staying true to your calling? Grab the free guide: 15 Remote and Nontraditional Jobs for Nurses.
What you already know
You understand how much a supportive provider and birth setting matter, how options like staying mobile during labor or avoiding unnecessary interventions can change someone’s experience.
You know how physical and emotional health shapes birth. Hydration, movement, mental tools, and feeling safe all play a role. You probably already talk with patients about doulas and support people. Birth does not always follow the plan, and having permission to change course is part of autonomy, not failure.
This is not just information. These are real skills.
Your nursing identity does not end when your role changes; the work just looks different.
Where that experience can take you
If you are feeling burned out, stepping back from shifts, or looking for something more flexible, your experience with physiologic birth can translate into many roles, including:
- Teaching childbirth education, online or in person
- Supporting families as a doula or birth companion
- Working as a nurse coach or holistic pregnancy guide
- Writing birth and health content that is accurate and grounded in real care
- Advocating for your organization, profession, or community
Preparation is Empowerment
Knowing your options, having supportive people and settings, and staying physically and mentally ready can make childbirth a more confident and fulfilling experience. Sometimes birth doesn’t go according to plan, and that’s okay. Feeling supported and informed is what matters most.
I’d love to hear from you. Did your birth go according to plan, or did your baby have their own strategy? Share your story in the comments!
Evidence-Based Resource Corner
- AWHONN Intrapartum Care Resources
- AWHONN Birth Equity & Respectful Maternity Care Toolkit
- ACOG Labor Induction Guidelines & FAQs
- ACOG ECV Guidelines & FAQs
