Lean on me

The birth of your baby will be one of the most demanding and rewarding events of your life — and you’re the father! How well prepared are you for this big challenge? Take a deep breath — you’ll be doing that a lot once labour begins — and read on, as fathers and experts share their advice on supporting the woman you love as she brings your baby into the world.

Preparing for a birth begins with learning everything you can about the process. Chris and Jenn Gibson of Mississauga, Ont., started with prenatal classes. Chris’s advice? “Be responsible and open-minded about how you prepare. Learn something useful.” Chris asked a friend what he recommended and was advised to learn hypnosis. The Gibsons took four classes and then practised the relaxation and visualization techniques before daughter Sariah was born.

Books, magazines, the Internet and videos are all good ways to get informed. Penny Simkin, an American childbirth educator and doula for over 30 years and author of The Birth Partner, encourages couples in her classes to watch a videotaped birth several times to prepare them for the intensity of labour.

Develop your birth plan together. Make sure you understand what kind of birth your partner hopes to have: What are her thoughts regarding pain medication? Are there comfort measures she’d like to try during labour? After a disappointing first birth, Montreal parents Kareen and Reggie Aristide made very different choices the second time. Reggie listened to what Kareen wanted and agreed to support a home birth with midwives. Today they are the proud parents of four-year-old Abraham, Gabriel, two, and four-month-old twins Israel and Naylissah.

And how do you want to experience your baby’s arrival? Do you plan to cut the umbilical cord? When will you first touch your baby?

Spend some time considering your own feelings about the birth. Supporting the woman you love through labour can be emotionally tough. It’s natural to have some fears of your own. Prenatal classes may provide an opportunity to explore them, or you might want to talk privately with your prenatal instructor or midwife.

If you’re apprehensive about supporting your wife solo, consider some extra help. Simkin is a strong proponent of the doula. “The partner can still be the primary support while the doula guides and helps him to do his job better,” she explains. Or ask a friend to be on standby in case labour is unusually long and you need a break.
Though most women have their hospital bag packed well in advance, it’s easy to overlook the labour partner’s needs. When the Gibsons arrived at the hospital, Chris remembers, “I was starving. I hadn’t eaten since lunch. At 10 p.m. I called my mother and she drove 50 minutes to bring me Swiss Chalet takeout.” They had also run out of drinks as Chris hadn’t realized that it wouldn’t only be Jenn who was thirsty. In the end they consumed a total of six litres of water and juice during six hours of labour. So plan in advance what you’ll bring and pack what you can now. Add perishables like sandwiches, energy bars, and crackers and cheese before you leave for hospital. Most women won’t want you to leave their side to go for food.

When you’re packing, include other items you plan to use, for example, a heating pad, CDs and player, a camera, some cash and phone numbers of people you’ll want to call. It’s a good idea to bring along a sweater and a change of clothes and toiletries. You might not want to leave the hospital once the baby is born!

Find your pace
So when labour gets started, what’s a good partner to do? Connie Banack, a childbirth educator and doula in Edmonton, advises that you run a bath and encourage the labouring woman to drink a glass of water. She says lying in the tub and being well hydrated often stops false labour. If labour continues, the bath’s a great place to relax between contractions. Rest is important too. Nap together. She may even fall asleep between contractions, and you may get to doze as well.

Encourage your partner to eat a high-carbohydrate snack or meal — toast or pasta — for energy. She should also drink about a glass of water, juice, tea or sports drink every hour.

Put your labour tools to use: a birth ball, hot-water bottle or heating pad, and cold pack. Suggest she spend some time sitting and rocking on an inflated birth ball (also known as an exercise ball). Heat applied to her low abdomen or back with a hot-water bottle may relieve some discomfort. If her lower back is sore, press on it while she is on her knees and leaning over the birth ball. Cold packs may also alleviate low back pain. In the hospital, you can improvise by using warm towels or putting ice chips in a bag or surgical glove.

Encourage your partner to use her breath to focus and relax as the contractions become more challenging. “Help her to keep her breath slow and deep,” Banack advises. And, of course, appear calm, regardless of what you may be feeling inside.

Dig Deep
You’ll know your partner is in active labour once her contractions are regularly one minute long and coming every five minutes or less. She’ll appear more internally focused and less inclined to talk between contractions.

Maintaining this internal focus is very important to coping well. Minimize the things she has to think about. Protect her from caregivers asking questions of her during contractions. Simkin adds, “Never ask or offer her something during a contraction. Between contractions, just present the food or drink and see if she takes it.” (Chances are once she’s in active labour, she’ll no longer be interested in eating.)

Put her needs first. Reggie Aristide confesses that during his oldest son Abraham’s birth, “I talked too much. I thought about myself and just wanted to leave and eat.” Now he emphasizes patience and putting his partner first. “I’m there to do what she wants.”

So what did Reggie do for Kareen at later births? “He didn’t leave my side. He was there emotionally,” Kareen recalls. She remembers his encouraging words and holding his hand. Reggie learned the strength of her grip during intense contractions and now knows to remove his ring before labour gets active!

He asked Kareen between contractions what else he could do for her. And while he knows now not to talk too much (Kareen says, “If you don’t know what to say, don’t say anything”), Reggie picked up some helpful phrases from listening to their midwives. At the birth of their twins, he told her how wonderful and strong she was, reminded Kareen that she was designed to give birth, and told her, “You can do this.”

Chris says that he had to do a lot more than he expected. “The contractions were coming like clockwork so I prepared her about 20 seconds in advance for each one, reminding her to get ready with her breathing. During the contractions, I pressed really hard on pressure points on the bottom of her feet and on her hands.” When a woman is in active labour, these may be the only areas she wants touched.

Simkin believes that breathing will get most women into active labour, but will not be enough to carry them all the way through. “If she plans to cope without pain medication, she will need to do something rhythmic to keep her going. It may be an unplanned and almost instinctive act,” Simkin tells us. She gives us some examples: rhythmic sounds such as moans or chants; physical movements such as rocking, swaying, rubbing her thigh or pounding a pillow; or mental rhythm from repeating in her head a verse, prayer or affirmation. The partner may encourage this rhythm by stroking her arm, head or back, talking in rhythm or nodding his head. Chris and Jenn had learned about rhythm and about positive suggestions in their childbirth classes. “I reminded her to breathe in and out, to breathe in peace, and to breathe out pain and anxiety. And I said the same things over and over again.”

Simkin advises, “If she doesn’t have rhythm, she needs help finding it. The partner must step in and get her to follow him.” Simkin calls this the “take charge routine.” For Chris that meant, “I got her attention. I made her look at me and I breathed with her.”

Be prepared for some surprising behaviour as well. Jenn and Chris found themselves in a room without air conditioning on a warm day in September. Jenn, who insists she normally dresses modestly, dealt with the heat by stripping off her clothes and sitting on the cool floor. Chris accepted Jenn’s choice to be naked and even followed her around when she got up so he could lay a clean pad beneath her before she sat down again. Banack reminds partners that women react to the moment and may give very quick instructions. “She may swear or be critical, but don’t take her responses personally.”

Just how should you communicate with doctors, nurses and midwives? Simkin says, “Be diplomatic. Always keep the staff on your side. You are going to need them.”

What if a medical intervention such as an IV or breaking the waters is recommended? While your partner continues to cope with her labour, ask the caregiver this simple question suggested by Simkin: “How urgent is it that we do this procedure?” Any intervention requires your partner’s consent, and you can help her decide by asking for more information.

The Final Lap
For most women, pushing requires huge physical effort. It often takes a couple of hours. Keep her going by offering a drink or ice chips between contractions, cooling her with washcloths and supporting her physically. You may be holding a leg, supporting her head or helping her squat. And as the baby’s head appears, your excitement will encourage her further.

When Jenn was ready to push, says Chris, “the nurse had to tell Jenn how to push.” Jenn remembers that the encouragement from Chris and their nurse-midwife sounded like a rally. And once Jenn got the hang of it, Chris describes her as “the princess of power.” She soon brought their daughter, Sariah, into the world.

When Kareen was ready to push out her twins, she squatted on the birth stool, and Reggie sat behind her so she could lean against him. Banack notes that some women push best when the room is quiet, with just her partner whispering encouragement, helping her to find her strength and focus.

Changing Course
No matter how well you prepare, some births just don’t go the way you planned. For Toronto parents Cathy and Andrew Ullmann, their planned vaginal birth became a Caesarean when an ultrasound showed their baby would be over 10 pounds. Despite the unexpected turn, Andrew simply glows when he speaks of the birth of Noah, and the role he played.

Andrew knew it was hard for Cathy to give up participating in the birth so he did everything to involve her. He asked the doctor if the screen could be lowered so Cathy could see her baby emerge. When this request was denied, he tried another approach and asked if he could take photos of their baby being born to show Cathy later. In hindsight, Andrew says this was exactly the right strategy. “Asking for something way too much first, helped get something else we wanted.” And because Noah was so big (12 pounds, eight ounces) his entry into the world was slow, so Cathy had about half a dozen photos to look at later. “The only proof that Noah actually came out of me,” she calls them.

Once the baby was born, Andrew provided running commentary because Cathy was unable to see him. “I told her where he was, what he looked like — he had tons of hair — and how much he weighed. And after he was checked over, I brought him to her.”

How did it feel to be present for his wife’s surgery? Andrew considers himself squeamish: “If you told me before that I would watch, I would have said no way.” When Andrew was about to stand to take photos of the birth, he noticed his heart beating fast and wondered if he should sit back down. Then he realized that this was a familiar feeling of excitement, like the stage fright that he gets when he conducts his music students in performance. And he stood up to record the birth for his wife.

So are you and your partner up to the challenge of birth? Of course you are, just like Jenn and Chris, Kareen and Reggie, Cathy and Andrew and all the other couples who have come before you. Reggie encourages couples to keep in mind that birth is more than an intense challenge. “The birth of your child is also a beautiful moment. It’s a miracle, shared by you and your partner. Remember this.” And know that this day will be one of the most important and memorable experiences of your life.

Dad’s Labour Kit
Labour, especially with a first baby, can be long, and supporting a woman through to delivery is hard work. So if you’re a father-to-be, it’s worth thinking ahead about what you might need during your partner’s labour. Here’s a checklist of items from our online birthing organizer, to consider for your own hospital bag:

• comfortable clothing and footwear, perhaps a change of shirt and a sweater
• grooming supplies: toothbrush, facecloth, deodorant, shaver
• food and drinks (but save your favourite onion and salmon sandwich for another time)
• a game or CDs and player you both enjoy for slow times
• phone list
• camera, film and batteries
• swimsuit if your partner might spend part of her labour in a bath or shower
• blanket and pillow
• massage oil if your partner might want you to rub her back during labour.

Resources
Book The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth by Penny Simkin, 2nd edition, Harvard Common Press 2001.

Video Rhythm, Relaxation, Ritual, The 3 Rs of Childbirth, Penny Simkin Inc. 2003. Order from parentbooks.ca