Preparing YOUR support people for their role in YOUR Labour

Preparing your support people for their role

Firstly, of utmost importance is the need to ask yourself (as a woman about to give birth) for what reason you would like a particular person present at the birth of your baby. Secondly, make sure your support person/people are clear on what it is you are expecting from them. Drawing up a list of things you would like them to do is really important so everyone is clear. If you intend to have your partner with you, be really clear on what role you want them to play and exactly what you do and do not want them to do. This will prevent any unnecessary conflict when you are in labour. Which can and does occur from time to time! If a woman thinks her partner is going to be a mess and not cope at all, or a partner does not want to be at the birth, employing a Doula – a professional birth support person maybe a consideration.

Your support person/people should read and try to understand the following points if they are to be of any use to you whilst you are in labour.

1. Intuition- listen to your gut instinct as a support person about what the woman in labour is experiencing and suggest only things that are realistic to the moment, ie; suggesting a change in position, place or environment, a shower, a back rub. Don’t offer drugs because you think it looks like they are dying from the pain. Remember you don’t have the privilege as a support person of having all of the wonderful hormones on board, so sit back and relax and support this woman in the best way you can! Nine times out of ten it will be right thing to suggest.

2. Be prepared for the unexpected! Sometimes as a support person you will think it is all plane sailing when suddenly a woman gets blown off course. You may need to change course also. Or it maybe over and done with very quickly, far faster than anyone imagined.

3. You will need to give 110%. A labouring woman demands your total mental, physical and emotional support, which can be incredibly stressful, exhausting as well as rewarding!
(If you are not feeling up to it, call in a Doula!)

4. Be prepared to be awake all night and possibly still going all through the next day. You may become a shift worker for a woman in labour. The other point to note is it is very hard to leave a woman in labour once you have been involved because of the support you have given. Try to stay for the long haul if you have committed yourself.

5. Ask yourself how you feel about massage, as it is quite possible that you will be doing it for hours on end. Most women in labour love massage, especially on the lower back. Note also that when massage has been initiated it is very hard for a woman not to be massaged from then on during contractions. This is due to the gate theory!

6. Being assertive when necessary. Protecting the woman from family members or staff that do not honor a woman’s need for privacy or peace and quiet. It is very hard for a woman to have contractions while a midwife is chatting to someone, and you may need to suggest that they be quiet.

7. Talk the lingo. It really helps to have an understanding of the terminology that the hospital staff uses. If you don’t understand ask them to explain what they mean to you as you may need to relay back to your partner, the labouring woman what is going on.

8. Learn what to say when, how to say it in a supporting way, and in which tone to say it in. Don’t ask lots of questions or talk about rubbish as this can snap a woman out of labour. Know when you need to just be a silent strength in the room with perhaps just peace and quiet!

9. Know how to find your soft gentle tone in your voice to talk in. Really encourage the low sounds as it helps women to push down vaginally and go to that primal space where women can open up and give birth!

10. Understand the power of slow controlled breathing and hypnosis, visualizations, deep meditation and relaxation to help a woman to open up and connect with her body. Help a woman to find the rhythm of breathing in for the count of four through the nose and out for the count of six through the mouth, or sleep sigh resting in between the contractions. As the support person try not to tall or ask questions during the contractions particularly or chat away in between contractions.

Some factors to be aware of as a birth support person
• Serendipity
During the first part of labour a woman maybe very chatty and excited about the whole idea of being in labour and having a baby. With this can come the opportunity to have a really good laugh and joke about all types of things. This can help a woman surrender early and go into labour more quickly as she is relaxed and happy. Laughter also lowers the blood pressure, which can also help tremendously.

• Offer one choice of drink, birth position, or type of food to eat, don’t give her lots of choices or ask that she make decisions
Try not to get into asking lots of questions of a woman in labour as this forces her to get out of the birth space and out of the primal part of the brain. If you feel a drink is what is needed, just hold it up to her and she will either take it or shake her head to say “No”.

• Beware of telling a labouring woman to relax
Some women in labour can relax in between their contractions while others feel the intensity of a contraction and the movement/pressure through the pelvis and lower back even when not contracting (usually during posterior birth) nothing can be more aggravating than being told to relax when you can’t.
• Performance Anxiety
When a woman is consciously being watch or asked repeatedly about contractions whilst in labour she can become self-conscious and start to feel very uncomfortable about the whole situation. This may occur if family members turn up un-announced and think birth is for general exhibition or if a midwife or obstetrician stays in the room just watching.

• Avoid clock watching
Time has no relevance in labour. The reason the partners are asked to time the contraction is to give them something to do! After a while this can be stopped and a more productive and hands on approach can be used. If you find yourself in a hospital room with a clock on the wall take it off the wall and hide it where it can’t be seen or cover it over with a cloth. Have all support people take off their watches also as this stops any attempt to tune into what the time is. Clock watching or continuously looking at your watch can be very distracting to a woman in labour. Remember that time has no relevance in labour, especially to a labouring woman. The only time that time is important, is when a baby is born.

• Dilation time has no rules
So many women believe that because it took their body 2 hours to get to 1 cm of dilation, it is going to take them another 18 hour to get to 10 cm. This is so ‘Not true”. Try to understand this about a labouring woman. The body can for some women dilate and open within one hour if it really wanted to. In some women it does! For most women first time around the body can take a little longer to open. Often first time around the 0-4cm takes the longest time then women are off and running. However, having said this of course there is always an exception to the rule, both faster and slower, there really are no rules!

• Keeping voices down
This will help a woman to feel at peace with her surroundings and relaxed keeping her in the labour space.

• Out of pure love often pain relief will be offered or suggested by the support person/s or partner
It is not uncommon for a labouring woman’s un-experienced support person/s or partner to suggest pain relief to her. This is because sometimes it is so incredibly hard for them to see someone they love experiencing so much (pain) intensity and they want to turn it off and stop it. It is so important that this is discussed completely by all parties concerned before the lanour/birth – day. I suggest that you make it quite clear on your birth plan and suggest verbally to your care provider that if you want pain relief you will ask for it! And state “No matter what I say or do, do not ask me if I want it, I will ask you”.

• Try to involve your partner as much as possible but if he feels he will not make the grade, invite someone you trust and work together as a team!
One of the comments I have received in the form of feedback from couples is how they really loved having someone else in the birthing room as support. Someone they could trust and be supported, and educated by. Partners particularly often expressed sheer relief in the fact I was there as a professional, educated and experienced birth support person, as they felt it took the pressure off them so they could relax more during the labour and the birth. They also felt they could handle seeing their partner in labour and felt empowered to help them as best they could, following my lead in remaining very calm and positive at all times. This helped the partner in relating to what natural birth really looks like and to remain patient about the imminent birth as sometimes it does take a bit of time before the actual birth of the baby.

Try to educate and empower yourself (the pregnant woman) your partner and support people to assist you in asking questions, if and should intervention be considered as an option by your medically trained staff.
The following information is based on a woman and her partner being empowered enough to ask the following questions with regard to the labour and birth when medical intervention is suggested. The reason I feel a woman and her partner need to ask these questions of their care provider, is because, if you don’t question immediately what is being suggested it may be too late, and women/couples may regret making an ill informed choice when pressured, and put on the spot. Every woman/couple have a right to make an informed choice or decision after all facts are correctly given in advance to assist them to see and understand the whole picture.

The five minute time out rule
I suggest to women/couples that every time something is offered or suggested that five minutes time be requested in private for (just the labouring woman and support people/person, no care providers present) to examine all the available options and discuss what needs to be considered, should a change in action need to take place. This insures that an informed decision is made without the pressure of staff watching and listening. This is totally within your right to do so.

Questions a birthing partner, support person and laboring women should ask

The following is what you need to ask the medical staff should you have to make a decision about something or not agree with what is being suggested to you:-

• “Remember, Doctor that you agreed we would not induce, or rush this birth unless there is something wrong. Is something wrong”?

• “I ask that you honor our birth and be patient with what is occurring and not try to rush this labor, as I trust this labour is unfolding as it should”.

• “What is the medical indication here”?
• “I would really like a second opinion on this please”

• “What harm is there if we wait an hour or so”?
“We’d like to do that so we/I am not feeling pressured into making any rash

• “Whoa, what’s happening here”?
“Is my wife in danger”?
“Is this baby in danger”?
“Then we would like to stay with our birth preferences for a
while longer and see how things progress then”

• “What other options are there that we could consider first?”
“How would what your suggesting effect my wife’s labor”?
“ What effect could this have on the baby”?

• “Why do you feel this is necessary at this point”?

• “What indications do you see that tells you we should do this”?

• “My partner and I would really appreciate five minutes alone to discuss all of our options so that we may make an informed decision, without pressure from you”