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Effective preparation - physical, emotional and intellectual - can have a huge impact on birth outcomes. It can significantly increasing the likelihood of a normal birth and a healthy baby, and it can greatly enhance the satisfaction of the mother. Good preparation helps to prepare for the unexpected and can thus enable a woman to adjust herself and her expectations if circumstances change.

Part of the preparation you need to make with her concerns the physiological changes that will happen during labour. She needs to understand how these are measured, as well as her role in monitoring her well-being. She also needs to know what action may be required if there is any deviation from the normal.Many women are now choosing ‘alternative’ ways of preparing themselves for labour, such as yoga. These offer the ability to maintain physical and mental wellbeing though pregnancy. Yoga is ideal for increasing physical strength and flexibility, and for cultivating the kind of ‘withdrawing into oneself’ that can be so helpful in dealing with the discomfort of labour.But in addition to preparing herself for labour, it is also necessary to make plans for what what she wants to do. Run through the various options and help her to formulate a birth plan, ensuring that it is clearly documented. Does she intend to give birth in a squatting position? Might she want to use a birthing pool for pain relief?

Discuss with her the best preparation methods for achieveing her desierd outcomes. For instance, a woman who chooses a squatting birth will need to be aware of the physical demands this might make, and ‘get in training’ by practising being in that sort of position – perhaps while she is watching her favourite soap on TV, sitting on a couple of large telephone directories, or a small footstool if she has one.

By working with her to help her prepare, the foundations for her confidence and empowerment are laid and it becomes possible to see a normal labour and birth as something achievable.

Tips and tricks

• Find out what she expects from her labour - ask her on your first visit what her previous experience has been and what she is expecting this time. What was her own mothers’ experience of birth like? Has she ever been with or seen a friend, sister or other in labour?

• Explore her ways of coping – get her to think about her ways of handling fear, pain and anxiety. Prepare her for the possibility that her feelings may become overwhelming during transition, and help her to develop some techniques for dealing with this.

• Encourage her to exercise her body and mind appropriately - her physical and mental flexibility, stamina and relaxation will have a huge bearing on the likelihood of her giving birth normally.

Further reading

Balaskas J (1983) Active Birth Unwin Paperbacks, London

Dick-Read G (1984) Childbirth without fear Harper & Row, UK

Gould D (2000) Normal labour: a concept analysis Journal of Advanced Nursing 31 (2): 418-427

Muller-Staffelstein T (1996) Preparation for childbirth - preparation for life: a challenge for primary prevention. International Journal of Prenatal and Perinatal Psychology and Medicine 8: 73-79 September supplement