How to Prepare Your Body for Labor: Strength, Breathing and Positions

Short answer: you can't control how labor unfolds, but you can prepare your body and your mind. The evidence points to a few things that help: staying active through pregnancy (ACOG recommends at least 150 minutes of moderate activity a week for most pregnancies), building strength and mobility for upright labor positions, practicing breathing and relaxation, perineal massage from about 35 weeks, and having continuous support during labor, such as a doula. Always check with your OB or midwife about what's right for your pregnancy.

I'm Asia Rideout, a birth doula, student midwife and pregnancy strength coach in Alexandria, VA. I help moms get ready for birth in the gym and at the bedside.

1. Stay active through pregnancy

For healthy, uncomplicated pregnancies, ACOG recommends at least 150 minutes of moderate-intensity aerobic activity a week, such as brisk walking, swimming or cycling, plus strength training. That can be 30 minutes, five days a week, or shorter sessions spread through the day. Regular exercise in pregnancy is linked to lower risks of gestational diabetes and preeclampsia and can help with back pain, sleep and mood.

2. Build strength for labor positions

Labor asks a lot of your legs, hips and back, especially if you want to move, squat, kneel or stay upright. Useful exercises include:

• Squats (to a box or bench): for squatting and getting up and down

• Hip hinges and glute bridges: for back and hip strength

• Split squats or step-ups: for single-leg strength and balance

• Carries and rows: for posture and upper-back endurance

• Hands-and-knees and side-lying work: positions you may use in labor

Read Is It Safe to Lift Weights While Pregnant? for how to adjust by trimester.

3. Practice upright and mobile positions

A Cochrane review of 25 trials (Lawrence et al., 2013) found that women who were upright or moving during the first stage of labor had a first stage roughly an hour shorter on average than women lying down, and were less likely to have an epidural. Practice now so these positions feel familiar: walking, leaning on a counter or partner, sitting on a birth ball, kneeling and hands-and-knees.

4. Practice breathing and relaxation

Slow, steady breathing helps you stay calm, manage contractions and relax your pelvic floor. Try this daily:

• Breathe in through your nose for about 4 counts, letting your ribs and belly expand.

• Breathe out slowly for 6–8 counts through soft lips, letting your jaw, shoulders and pelvic floor relax.

Pair breathing with positions and comfort measures like counter pressure, hip squeezes and massage, and practice with your partner.

5. Consider perineal massage from about 35 weeks

A Cochrane review (Beckmann & Stock, 2013) found that perineal massage done by the mother or her partner, as little as once or twice a week from about 35 weeks, reduced the chance of perineal trauma needing stitches (mainly episiotomies) and ongoing perineal pain. The benefit was clearest for women having their first vaginal birth. Ask your provider whether it's right for you and how to do it.

6. Line up continuous support

A Cochrane review of 26 trials with more than 15,000 women (Bohren et al., 2017) found that continuous one-on-one support during labor was linked to more spontaneous vaginal births, fewer cesareans, less use of pain medication, shorter labors and more positive birth experiences. Support can come from a partner, a family member or a trained doula. Read Is a Doula Worth It?

7. Learn what to expect

Knowledge helps reduce fear. Take a childbirth education class, tour your hospital or birth center, and write a flexible birth plan with your preferences for pain relief, positions, interventions and your baby's first hours.

Frequently asked questions

Does exercise make labor shorter or easier?
Research on exercise and labor outcomes is mixed, but staying active has many benefits for you and your baby, and strength and endurance help you use active labor positions.

Should I do Kegels to prepare for birth?
Pelvic floor training in pregnancy can help prevent leaking, but learning to fully relax your pelvic floor is just as important for birth. A pelvic floor PT can check both.

When should I stop exercising in pregnancy?
Many women stay active right up to birth, adjusting as needed. Stop and call your provider if you have bleeding, fluid leaking, regular painful contractions, dizziness, chest pain, calf pain or swelling, or other warning signs.

Get ready for birth with MotherMade Strong

• 1:1 prenatal training with a coach who is also a birth doula, programmed trimester by trimester (programs)

• Birth doula support with prenatal visits, a birth plan session, comfort measures and partner coaching (doula support)

Both start with a free conversation at One Way Performance, 5400 Eisenhower Ave, Suite A, Alexandria, VA.

Book your free assessment or consultation

Related: MotherMade Strong Resources

Sources: ACOG, "Exercise During Pregnancy" patient FAQ; ACOG Committee Opinion No. 804 (2020); Lawrence A et al., "Maternal positions and mobility during first stage labour," Cochrane Database of Systematic Reviews (2013); Beckmann MM, Stock OM, "Antenatal perineal massage for reducing perineal trauma," Cochrane Database of Systematic Reviews (2013); Bohren MA et al., "Continuous support for women during childbirth," Cochrane Database of Systematic Reviews (2017).

This article is general education, not medical advice. Please talk with your OB or midwife about your pregnancy and birth plans.

Written by Asia Rideout, Certified Personal Trainer, Certified Pregnancy & Postpartum Athleticism Coach, birth doula and student midwife, founder of MotherMade Strong in Alexandria, VA.