How to Handle Seeing your Partner in Pain

No one wants to see their partner in pain. Unfortunately, pain is a part of birth and she probably will be in some pain at some point, even if she’s planning to get an epidural as soon as possible.

So here are some things you can do to make seeing your partner in pain a little easier.

• Remind yourself that labor pain is a part of the process. According to Dr. William Camann in his book Easy Labor, “Labor pain is a unique type of pain, since it’s not associated with injury but a normal process.” Labor pain is different from a headache, sprained ankle or even menstrual cramps. It has peaks and it has breaks when she should be feeling no pain whatsoever. And for the majority of labor, she will have more break time than pain time. In addition, no matter how hard it gets, contractions usually last no longer than 90 seconds. Focus on the break time, not the contractions.
  


• Help her deal with the pain. Yes you can help! Review your comfort techniques. Help her breathe and have her close her eyes or look into your eyes. Know that you can help decrease her pain with music, cool compresses, massages and even the shower. Simply being present will be a huge comfort to your partner decreasing the amount of pain she's experiencing.



• Remember that it’s not you in pain. Many very well meaning coaches struggle when their partner wants to go unmedicated; they struggle witnessing her in pain and suggest she get some pain relief. Try to resist doing this. Think about how angry she will be with you after the birth if she feels like YOU forced her to get pain medicine she didn’t need.
  
  
• She needs you to be strong. If you start panicking, she’ll panic. This is the one time you must be a rock she can lean on, a rock she can depend on no matter what happens. The stronger you are, the stronger she’ll be and the less pain she’ll feel. Try to hold off on any emotional outbursts until the baby’s born or she gets some medication (if that’s what she wants).

How Poker is Like Birth

So I’m a poker player, mostly Texas Hold ‘Em. And I love a lot of things about poker from the thrill of bluffing, to the fun of trying to guess what someone else is holding, to the excitement of taking someone else’s money. But the thing I love and hate the most about poker is how unpredictable it is, just like how unpredictable birth is.

With Texas Hold ‘Em it’s possible to do everything right, get flopped 3 queens, play the table perfectly so that no one knows what you have—they just suspect you have something (or you’re bluffing). Finally, you do the All In bet, pretty sure you’ve won.

And you lose to the girl with the flush.

So how does this relate to birth? Well, you and your partner could do everything right. You could attend your childbirth classes, talk about your plans for the birth, practice the breathing and position changes. You could hire a doula and your partner could take a prenatal yoga class. You could read everything you could get your hands on about birth and be as sure as can be that this birth is going to go well.

And then the birth is long, difficult and ends in cesarean, leaving you and your partner wondering what you did wrong.

The truth is, you did nothing wrong. Birth is just unpredictable, just like poker.

Now I’m not saying we stop preparing for births or we stop working hard to prepare for birth just because it’s unpredictable. I prepare for poker games just like you guys need to prepare for birth; I make sure I’m not too tired or hungry before I play and in my free time I read books about poker and watch the World Series of Poker. I know the probabilities of getting a straight or getting four 7s because it makes me a better player. While playing, I make sure I don’t drink too many beers and if I start to get tired or my concentration wanes, I switch to caffeine. I experiment with different styles and different methods of playing poker. But I acknowledge that I can be the best player at the table (not that I am) and still lose because the cards themselves are unpredictable.

Birth is unpredictable too. We don’t know what it’s going to be like for you and your partner. I’ve had mothers tell me it was horrible and I’ve had mothers tell me it wasn’t as bad as they thought it was going to be. I’ve known people who have barely made it to the hospital in time and people who have multiple day labors. I’ve known couples who plan to have dad wait out in the waiting room until after the baby is born and he changes his mind half-way through the labor and wants to catch the baby. And I’ve known dads planning to catch the baby and then faint when it comes time for it.

Just like with poker you have to be flexible when it comes to birth. Just because you have three queens doesn’t mean you can’t be beat. And just because your goal is to go unmedicated and you’ve done all this prep work doesn’t mean it’s going to happen. You have to be able to change your plans at a moment’s notice both in poker and in birth or you handicap yourself.

Dealing with the Hospital Staff

Once you get to the hospital, it won’t be you and partner anymore. Now you have to deal with strangers, the staff of the hospital, medical experts who have jobs to do. While the nurses/doctors/midwives are there to help you and your partner, their primary job is the medical side of birth. And these people at the hospital can make a huge difference in how smoothly or how disastrously your birth can go. So you need to know how to deal with them.

• Introduce yourself
  Try to shake hands or at least acknowledge each person who walks into the labor room. If it’s possible, tell them your name, your partner’s name and ask them for theirs. This seems simple, but during the intensity of labor it maybe harder than you’d think.

• Use people’s names
  Find out the names of your nurses and doctors. When you speak to them make sure you use their names. If you’re bad with names you’re in luck; the staff at hospitals will always wear name badges.

• Be nice
  No matter what’s going on with the birth or how you’re being treated, make sure you stay nice. Smile whenever possible and add pleases and thank yous when asking for things.

• Make jokes
  Jokes make us more human and less like another random stranger that the staff is helping. Even if your jokes are horrible, try dropping a few to see if you can get some smiles out of the staff. Worst case, you end up keeping your partner’s mind off the contractions (because your jokes suck and she’s telling you knock it off).

• Get to know them
  If you have down time, ask the staff questions about themselves. Find out if they have kids, pets or an interesting hobby. If they make a comment about the music you’re listening to, find out about their musical interests. Ask if they’ve seen popular movies or TV shows and ask their opinion. Like making jokes, this makes you and your partner more personable and more likely to get the staff’s help with extras. However, keep this getting to know them session light. Steer away from discussions about religion, politics or parenting views.

• Utilize their knowledge by asking for help
  It does no one any good if you go into a birth ready to “do battle” for your wishes. Instead, ask the nurses and other staff for help. Let them know what your goals are with a birth plan and tap into their knowledge. If your partner wants to go unmedicated, let the nurse know that you would love any help she could offer. If your partner wants to breastfeed immediately after birth, let your nurse know you’re going to need their help. Your nurse is a fountain of knowledge and if you ask for it, she’ll be willing to share it with you.

• Ask for clarification
  If you don’t understand what the staff is trying to tell you, make sure they know that. Chances are you’ll be emotional, tired and possibly hungry during the birth. And your partner is going to be feeling the same things, only be dealing with contractions too. This can make comprehension of birthing and medical terms a lot harder. Make sure you understand what’s going on and you can explain it to your partner if needs be.

• Ask them to leave when making decision
  If the staff comes into the room because they want to do an intervention and you want to discuss the intervention with your partner, ask the staff to leave. This will help you make the decision without feeling pressured from the staff. Just be nice about asking. If the staff won’t leave, a doula I know suggests saying that you’re going to pray and would like some privacy to do that.

• Vent out of hearing
  If you don’t like your nurse or you’re frustrated about what’s going on, don’t complain about it in the hearing of the staff. It may offend them and then they won’t be as helpful to you and your partner.

• Ask for new nurses
  If you don’t like your nurse or you think there’s a birthing philosophy difference (i.e. you want to go unmedicated but you feel your nurse is pushing an epidural on your partner) feel free to ask for a new nurse. Just go out to the nurse’s station at your birthing facility and ask to talk to the charge nurse or the nurse manager. Then simply ask for a new nurse. And don’t worry about offending your nurse—chances are the conflict is two-sided and your nurse will be happy to get a different patient.

• Consider bribing
  See the post below this one for more information about bribing.
  
  

Bribing your Nurse

In one of my classes (you know who you are!) we had an interesting discussion about bribing the nurses to get them on your side and help you get what you want. So here are some tips about that.

• Bring plenty of whatever bribes you choose. Your primary nurse may have to go to attend another patient or her shift may end before you deliver. In addition, your primary nurse may have a nursing student who would also want a goody.

• Bring food. Baked goods like cookies or doughnuts are easy to buy and hand out. Depending on your labor, you could run into a grocery store on your way to the hospital. But some people who are watching their diet won’t want food, especially sweets. You could try bringing dried or fresh fruits if you want something a little healthier.

• Bring girly things. Most nurses, especially in labor and delivery units are women so small bottles of lotion, nail polishes or even room sprays may be appreciated. On the downside, you may end up with a male nurse and some people are allergic to the scents to various products.

• Choose small gifts. Go to a dollar store and check out the bins of notepads, massagers, and frames. Almost everyone will find something they like from these. On the downside, this is a little more expensive option.

• Buy 5 dollar gift cards. An expensive option, but one that may work the best are small denomination gift cards to places like Borders or Starbucks.

• Treat your nurses with respect. While all these are great ways to get your nurses on your side, probably the best way is treat your nurses politely. Try to avoid ordering them around or yelling at them. They’re doing the best they can too.

Kicking Someone Out of the Hospital Room

Your partner wanted to be surrounded by all of your friends and family for this birth. But now that they’re here, all these people are driving you and your partner crazy. So how do you ask them to leave without causing World War III?

• Use a Code Word
  Come up with a look or a word or a phrase for her to use to tell you to start removing extra people from the room. This is a safe way to let you know she needs help without her offending anyone.

• Be Polite, But Direct
  Simply ask people to leave. Explain to them that things are getting intense and your partner needs to focus on her contractions. Be careful though since this can make family and friends angry with you, especially if they were planning on being there with the two of you.

• Guide People Out
  Some people don’t get the hint and you will actually have to walk them out to the waiting room.

• Promise Updates
  If your friends and family are at the hospital, they love you, they love your partner and they already adore this baby. It's only natural for them to be excited and nervous. Promise them you'll let them know what's going on so they can be a part of the event too. Just don't let them knock on your door for updates, or they’ll drive both of you crazy.

• Ask Them to go Home
  If it looks like it’ll be a while before the birth, tell your friends and family that you’ll call them when you get close to the end.

• Give People Something to do
  If you’re truly having problems getting rid of people, send them on food or store errands. This works well if they don’t know the area and you can send them to stores a few miles away.

• Make Your Nurse the Bad Guy
  Have your nurse kick the excess people out if you don't want to do it. The nurse can site hospital procedure, policies and rules to help get the people out of the room. However, be careful though because again, this can make people angry, especially if they figure out the request came from you.

Tip: Decide as a couple not to call people until after the baby is born or when the birth is close. Just tell your friends and family you were too busy to call thus eliminating the need to potentially kick people out of the room.

What to do if Prelabor Lasts for Weeks

It’s not uncommon for women to ease into labor. Most women start experiencing Braxton-Hicks or prelabor contractions around 7-8 months along. These are non-painful, unrhythmic contractions that don’t cause a lot of cervical change. But as her due date starts getting closer these Braxton-hicks contractions start transitioning to true labor contractions. She’ll gradually cycle off the Braxton-hicks contractions and into true labor contractions. And this transition may take weeks. This may be very confusing for both of you, resulting in many trips to the hospital.

So here’s what to do if she’s having a lot of contractions, but isn’t in true labor yet.

• Talk to her care provider. Find out when the hospital wants to see you and stick to it. If the hospital says come in when contractions are 3 to 5 minutes apart, lasting 60 seconds and been that way for 1-2 hours then they want you to wait until contractions are like that. Don’t jump the gun and come in too early because they’ll probably send you home. And no one likes being sent home.

• Keep her mind off the contractions. If these contractions aren’t uncomfortable they probably aren’t the real thing. Keep her busy with meals out, games, visitors, shopping trips and fun activities like picnics and movies. When she can’t stay busy anymore and has to focus on the contractions to get through them, it’s a signal these are real contractions.

• Have sex. Unless your doctor has told you otherwise, feel free to have plenty of sex. It’ll be the last time for a while, so enjoy it; you can’t harm the baby. Need another reason? Sex produces a hormone called oxytocin that causes contractions! In addition, semen contains prostaglandins (hormones) that can ripen the cervix. And if she’s not in the mood for intercourse, that’s fine too. There are other things you both can do that provide nearly the same effects as intercourse.

• Don’t obsess about timing the contractions. It’s not that big of a deal. She will let you know when contractions are getting stronger and closer together.

• Wait for the frown. Each time she experiences a cycle of contractions she’ll probably think this is the real thing. But when the contractions change to true labor contractions she’ll probably frown and comment how these contractions feel different than the other ones she was experiencing. When that happens, you’ll probably find those contractions are the real deal and they’ll get stronger, longer and closer together.

• Encourage her to relax. Relaxation may make the contractions go away, or it may make them into true labor contractions. Pamper her as much as is humanly possible, while making sure you’re not too worn out during this process.

• Schedule fun activities. Encourage her to schedule something fun to do every single day for a week past her due date. That way she’ll wake up in the morning excited because she’s got something fun scheduled that day. And she’ll be okay (or at least a little better) if the baby doesn’t come that day.

• Rest. Make sure you’re resting and taking care of yourself as much as possible. If you wear yourself out stressing in the few weeks before labor begins, you won’t be as much help to your partner.

• Enjoy this time. While you’ve been waiting months to meet your baby, you’ll look back wishing you had a few more days without baby. Enjoy being able to watch a movie all the way through, have a conversation with your partner and sleeping entirely through the night—because those days are almost done.

Helping a Woman Have an Unmedicated Birth

So your partner wants to go unmedicated—she wants to avoid an epidural. And she’s counting on you to help her do it. So how do you help?

• Avoid the unnecessary. You know the basics by now. Try to avoid inductions, try to avoid pitocin and try to avoid letting medical professionals break her water, since it may make labor stronger, testing her resolve to go without the epidural. However, keep in mind that sometimes you just can’t avoid things like pitocin; in some cases these tools are absolutely necessary.

• Talk about your options. So she wants to avoid an epidural. What are her thoughts about narcotics? Would she want a narcotic shot over an epidural or does she want to avoid that too?

• Think about scenarios. What are you going to do if it’s a super long labor or if it looks like she’s heading for a cesarean? How about if she starts panicking? What about if the nurse/doctor start pushing an epidural on her? What if they don’t let her get out of bed/walk the halls/ be in the shower? How are you going to help her now?

• Practice. If you want your labor to go as smoothly as possible, you have to practice your breathing and positions, or you won’t remember how to help her. It only takes a few minutes a couple times a week.

• Become educated. You have to be the one in charge of keeping her comfortable—not her. You must know many ways to help her during the process.

• Come up with a gimmick. You need something to say to her if she asks for the epidural. I told my husband to talk me out of the epidural if I asked for it. I told him to remind me that I didn’t want a urinary catheter and I wanted to be up and moving as soon after my birth as possible. When I did ask for the epidural (and I did) he reminded me of why I didn’t want it. And after he reminded me, I was back and commited to going unmedicated.

• Watch out for the test. I tested my husband, asking for an epidural before I really NEEDED one; I wanted to know what he would do. What can I say? It was my hormones turning me into a mega-witch (not one of my best moments). Some women will do this during labor. Watch out for it.

• Figure out what to do during transition. Remember, transition is the phase of labor right before pushing and is the hardest, but shortest part of labor. This is the point many women ask for an epidural because they hit a wall. However, if you can get her through transition, she probably doesn’t need an epidural. Talk it over and decide what to do if she asks for an epidural in transition.

• Choose a code word. Some women will labor asking for an epidural, but not really want one (welcome to the fun world of women!). In this case, a code word meaning “I actually do want the epidural” can be helpful.

• Step it up if she asks for the epidural. If she’s asking for an epidural, she needs more help. And you have to figure out a way to help her.

• Be prepared for it to test your resolve too. It’s hard to watch someone you love in pain, especially if they’re very vocal about it. It may seem easier on both of you if she just gives in and gets the epidural. Many coaches (out of love) will start suggesting the epidural. And if you suggest it, she’ll probably take you up on it. Make sure you’re committed to her going unmedicated too.

Go Ahead and Move!!!

In one of my classes, I was watching a couple during their labor rehearsal--during the part of the class when couples combine the breathing and positions and pretend they're actually in labor. The woman was holding a piece of ice during the "contractions" and working hard to figure out the best way to deal with the pain from the ice. She started rocking back and forth a little. And her coach told her to stop rocking and stay still. After the "contraction" she put her ice down and told her coach that the rocking was helping. And for many people a little movement is a great way to deal with contractions.

Many women find swaying, rocking, pounding, patting, lunging and rocking helpful during labor. The movement releases the energy of contractions and prevents many women from tensing up during the contractions.

But there was a bigger problem in this situation. A woman found a great way to deal with her contractions and her coach told her it was wrong. While coaches always have the best of intentions, it's easy to tell people what they're doing is wrong, especially if it looks a little weird. She may be doing something we'd never do, that seems like it would make the contractions worse. But if it's working for her, it shouldn't be messed with. If you're unsure whether something she's doing is helping, simply ask her between contractions.

How to Use the Room

You and your partner have been practicing positions for weeks and know which ones you want to use. But now that you’re in your labor room, you’re struggling to use the room. You also don’t know where the TV is, where extra towels are or where the call button for the nurse is. Here are some tips for using your birthing facility room.

• Page the nurse if you can’t get hot water in the shower, can’t get the toilet to flush or can’t find something. It’s part of her job to help you.

• Open up the cupboards. If it’s not locked, peek inside to see what’s in there. Grab towels, sheets, blankets and washcloths. If you’re not sure what something is though, don’t touch or try to play with it. You may accidently set off an alarm.

• Find out how to unhook the fetal monitor. If mom has to be on the fetal monitor you don’t want to have to take it completely off each time she has to run to the bathroom. Ask the nurse to show you how to unhook the wires and how to hook them back in (it’s very easy). Promise your nurse you’ll only unhook mom after getting your nurse’s approval.

• Figure out how to use the bed (and no, not in that way—we’re trying to get the baby out, not put another in there). Your partner’s bed can be raised up so mom can lean onto a birthing ball and put her cheek onto it. The back of the bed can lean up so she can kneel, facing the back of the bed and get a massage. Many hospital beds can be made into a chair for mom’s comfort.

• Use the hospital table that fits over the bed for various positions. These can be raised and locked into place for mom to lean on and get a back rub. Just make sure you lock the wheels or place a washcloth against them so the table doesn’t move.

• Look for a small stool in your room. The stool is great if mom wants to slow dance but you’re an uncomfortable height for her. The stool is also great for shorter moms while they’re hopping into and out of bed or while she's sitting in a chair and getting a foot rub. You can even use the stool for sitting on next to mom if you don't want to sit on the floor (just put a cushion on it).

• Lay blankets and sheets on the ground for mom to lie on if she wants to lie on the floor. Use lots of support to make mom as comfortable as possible.

• Learn how to page the nurse, how to work a CD player, the TV and any other electronics in your room. That way you don’t fool around with it for a while, potentially breaking things or changing settings, before finally realizing you don’t know what you’re doing and need the nurse to fix everything.

• Use pillows and blankets to make chairs and rocking chairs as comfortable as possible.

Taking Pictures/Video During the Birth

One of the things you’ll have to do to prepare for this birth is figure out how you want to take pictures or do video during the birth. Most people want pictures during the birth or immediately after the baby’s born. And the role of photographer (along with everything else) often falls to you.

• Make sure you know how your camera works, how to load memory cards, put in batteries and so on before she goes into labor. You should also make sure any memory cards are empty before she goes into labor. You may find it easier to have a special, unused memory card just for the big day.

• Take pictures all through the process. Snap a couple of pictures when she’s at home and take a picture of the people who are on the rest of the support team.

• Avoid neglecting mom to take pictures. Consider taking pictures secondary to making your partner as comfortable as possible.

• Just snap away. Don’t worry abut taking perfect pictures. If the pictures have a baby in them, they’re fine. If you don’t like the pictures you can always delete them from the memory card before anyone else sees them.

• Talk to mom beforehand to find out what pictures or video she wants. She may want PG-rated pictures (ie: no pictures of the baby crowning) or she may be fine with the R-rated pictures. If you want a shot of the baby being born, but don’t want a shot of your partner’s perineum, try filming up by mom’s head rather than over the doctor’s shoulder. If she’s going to breastfeed, you should also find out if she wants pictures with her breasts in them.

• Consider having a person whose job is to provide secondary support and take pictures. That way you can take care of your partner and still get lots of pictures. And this way, you’ll end up in some of the pictures too.

• Talk to your birthing facility to find out if they let you take pictures during the process. Some hospitals will allow pictures and video as long as everything is going okay. Others will allow still pictures, but no videos of the actual birth. Still others won’t allow any pictures of the actual birth or the moments following it. You should also find out the policy for c-section births. Video is usually not allowed and many hospitals won’t allow any still cameras into the operating room. Find out if the event of a c-section, when you can take pictures of the baby and your partner.

The Car Ride to the Hospital

Many coaches wonder how to handle the car ride to the hospital. Chances are, unless her water’s broken and contractions haven’t started, she’s going to be having some pretty strong contractions in the car. So here’s how to handle the drive.

• Never run through red lights or drive too fast. If you’re worried you’re not going to make it to the hospital before the baby comes, pull over and call 911. Alternately you can just go to the closest hospital.

• Keep your eye on the road. If mom starts groaning or making noise during contractions, avoid trying to help her too much. Your job is to get both of you safely to the hospital.

• Plan on mom being in the back seat. Make her as comfortable as possible. Give her cool compresses and water she can sip on, if she wants to. If she has back labor, give her a heating pad that’s air activated.

• Have her sit on a towel in case her water breaks in the car. She also may need a puke bucket—many women throw up during labor.

• Consider having someone else in the car who can help mom or do the driving so you can help mom. This may make the drive to the hospital a little safer.
  

How to Help Her get an Epidural

She wants her epidural and she wanted it ten minutes ago. Here’s how to support her while she’s getting her epidural.

• Keep her calm while you’re waiting for anesthesia. Depending on the facility, women may have to wait a little while for an anesthesiologist to be there. Get her through those contractions with breathing, focusing and positions and remind her help’s on the way.

• Help her as she’s getting the epidural. Epidurals are usually administered with moms curled into a C shape, with their back sticking out toward the anesthesiologist. Most anesthesiologists recommend moms curl into someone so she stays completely still and yet still feels supported while getting the epidural. Have the nurse show you how to help mom curl up. She’ll have to stay still for about 10-15 minutes while she’s getting her epidural, through a few contractions and she’ll need your help to do it. If she can’t curl into you, stay close, help her breathe and help her focus.

• Make sure moms understand what’s going on, she has all her questions answered and isn’t scared about the procedure. Most anesthesiologists will talk both of you through the procedure, letting you know what they’re doing at all times.

• Don’t watch the procedure, unless you really want to. The epidural is complex procedure involving needles, medicine and thin plastic tubing placed into your partner’s back. Even if you think you’ll be okay, avoid looking if you’re lightheaded from exhaustion or hunger.

How to Keep Calm

I posted this tip for one of my dads who is very anxious about his partner's upcoming birth.

It’s time to head to the hospital. Your partner’s doing fine, breathing through the contraction and coping really well. But you’re starting to freak out. Here are some things you can do to help you stay calm through the process.

Breathe. Remember that slow paced breathing you learned in class? In through the nose, out through the mouth, focusing on your breathing. It’s not just for her; it’s for you too. Breathe with her through the contractions and you’ll stay calmer.

Ask someone else to be there. If you know there’s another support person, her sister, mom, best friend or even a doula, you may feel calmer. You won’t have to remember everything and the other support person can give you breaks.

Take breaks. If you’re really having a hard time handling things, leave the room for a minute. If there’s no other support person, ask the nurse to come in and sit with your partner. Pace the halls, call a friend or head down to the cafeteria so you can come back calmer.

Watch for negative thoughts. If you constantly have worries about your partner or about the baby, or the slightest comment from the nurse or the doctor makes you visualize the worst case scenario, stop thinking those thoughts! Take a deep breath and force your mind to think about something happier. Each time your thoughts go back to that worse case scenario, stop your thoughts. Thinking about the worst thing that can happen isn’t going to help her, it’ll stress and exhaust you.

Ask lots of questions. If you don’t understand why something is being done ask for an explanation. Understanding things may help you keep calm and you can explain things better to your partner.

Tips from the Experts

This tip comes from one of my dad's who coached his partner through a very difficult birth that ended in a ceserean due to preeclampsia.

"I asked all of the questions (benefits, risks etc.) and remembered all of the information the dr's told us to explain to [my partner] and I hit the button for the epidural when [she] needed it. I also stayed in the chair right next to [her] side the whole night and morning and I got her anything she asked for right away when she needed it like her ipod and fresh cool washclothes."

Thanks for this great tip!

The Power of your Voice

I’ve been at births full of chaos. Everyone is talking or yelling at mom, trying to get to her listen to what they’re trying to say. At this point, she usually panics and all the voices merge to one big roar of noise. But one voice can usually break through the chaos. Yours!

Women usually listen to their partner’s voice above everyone else’s. They’ll listen to it above the doctor they’ve only met a few times, and the nurse who was a stranger up until a few hours ago. If her eyes are getting big and everyone’s yelling, get as close to her as possible, look her in the eyes and echo what the nurses or doctors are saying. Make sure you speak calmly, maintain eye contact and she’ll listen.

Tips of the Week

These come from coaches who have just been in the trenches.

One dad commented that the he…he…he…ho breathing really helped his wife through labor. He also said getting close to her face and making her look him in the eyes really helped too. Just so everyone’s aware, sometimes it takes a little while to get an epidural—it took this mom 2 hours. So that was 2 hours that she really, really needed her coach’s support. And it sounds like he did a great job!

A new grandmother who was the coach for her daughter’s birth commented that encouragement was the most important thing she did. This birth was a long and difficult one. The grandmother also said it’s important to be prepared for all potential variations of the birth, like a cesarean. She highly recommends coaches talk to the moms before birth about various “what if” scenarios, just in case they happen.

What to do if She Panics?

Certain aspects of labor can lead a laboring woman to panic. She may panic due the force of contractions or due to concerns about the baby or emotional issues. She also may panic if she’s facing an intervention she didn’t want, like a cesarean. If she does start panicking, part of your job as her coach is to help her.

• Take a deep breath. You can’t help her if you’re freaking out yourself.

• Get her attention. Say her name, snap your fingers, clap your hands, get into her face, grab her shoulders, but get her attention.

• Speak calmly and slowly. Make eye contact with her and tell her what she needs to do. Sometimes all they need is someone telling them they’re safe and they’re doing well. If the doctors or nurses want her to do something, slowly repeat their instructions. Moms often do better hearing instructions from coaches than from doctors or nurses. She’s more used to your voice and is likely to respond better to you.

• Have her breathe. Make her focus on her breathing. Tell her how to breathe, such as “Breathe in, Breathe out,”, until she gets herself under control. If you know your partner is more anal, try counting or he…he…he…ho breathing. However, if she’s not panicking never tell her how to breathe--it may lead to panic.

• Remind her the contractions are short. If she’s panicking due the force of contractions, try to let her know when the contraction is peaking (i.e. at its worst) and when it’s getting better. Sometimes giving her specifics (three more breaths and it’ll get better) helps too.

• Remember, sometimes you have to be forceful with moms that panic. Telling her to calm down, stop crying or just listen may be all she needs to focus on you and calm down.

• Reassure her. After the contraction's over, remind her she’s feeling no pain, you are helping her to relax and together the two of you will deal with the next contraction. Remind her that she CAN do this and that you’re there for her.

Bottom Line: Before birth, talk to her about what to do if she does panic.

What To Do if She Yells at You?

One of the big things I hear from coaches is that they hope she doesn’t yell too much at them. Most women don’t yell at their coaches, but there are always exceptions. So here’s how to deal if she does start yelling at you.

• Take a deep breath before you respond. When yelled at, your first response may be to yell back. But this is the worst thing you can do. Take a deep breath so you can think about your response.
  
  
• Don’t take it personally. She’s doing the best she can. She knows you’re doing the best you can too, but you’re an easy target.
  
  
• Step it up. Maybe she has a point. Maybe you’re not helping her enough. Maybe you need to figure something else out for the next contraction. Pull out your cheat sheet and offer another position or comfort technique.
  
  
• Find out if you did something wrong. Often women in labor will snap because you’re massaging her wrong or you’re not helping her enough. Ask her if she liked what you were doing, or offer suggestions for doing something different. Avoid asking open ended questions such as “Tell me what to do,” or “What should I do”. She can’t answer them.
  
  
• Let her go off on you. She may be yelling at you to express her discomfort, to express fears or because she’s angry at the situation. Sometimes yelling makes us feel better—think about how much better you feel when you yell when you stub your toe. Sometimes being a wall she can yell at actually helps her a great deal.
  
  
• Pat yourself on the back if you’re getting frustrated. Remind yourself you’re helping her by being in the room.
  
  
• Take a break. There’s only so much abuse we can take before we snap. Ask another support person to help you out, or get the nurse so you can go out into the hall and count to ten.

Creating a Cheat Seat for Labor and Birth

Many partners ask me if they can use a cheat sheet during labor. And why wouldn’t you?

• Keep it simple. If you’re creating your own cheat sheet, have it be something you can stuff in a pocket. Take a small notebook and put pictures and notes to yourself you can flip through. Or modify the handouts you’re given in your childbirth classes so you can find the information you need quickly.

• Tailor it to the laboring woman. If you know she doesn’t like massages and doesn’t like being touched, don’t put massage techniques on your cheat sheet. Ideally, you’ve taken the Match Game with me or have talked to your partner about what comfort techniques she wants from you in labor.

• Feel free to put drawings or cut outs of positions of on it. Here’s a good site with positions for labor.

• Include notes to yourself so you don’t forget things. Good examples include:
  

1. After a position change, contractions often hurt worse. Try a new position for 2 or 3 contractions before quitting.
2. Keep moms cool with water and cool compresses
3. Protect the space with music and dim lights
4. Remind her (and you) to breathe
5. Never underestimate the power of a hug

Bottom line: It’s your cheat sheet. Tailor it to both of you!

Comfort Techniques List

So what is she going to like during labor? The easy answer is she’ll like the things she likes during life to deal with stress and pain. If she likes taking long showers, she’ll like showers during labor. If she likes walking when she’s stressed, walking may be extremely helpful during labor. Here’s a list of other comfort techniques she may like. Have her pick out a few for you to put on your cheat sheet. Don't plan on just using one comfort technique. Have a bunch you can rotate through.

Don’t feel limited by this list either—feel free to use whatever comfort techniques you want.

Hydrotherapy (water)

• Shower (make sure your birthing facility has showers you can use)
• Bath (make sure your birthing facility has bath tubs or birthing pools)

Sounds

• Music
• Moaning/Chanting/Singing
• Humming
• Prayers

Visual

• Dim lights
• Focal Points
• Closing eyes

Touch

• Hand massage
• Foot massage
• Back massage
• Belly massage
• Cool compresses
• Heating Pads
• Ice packs

Breathing

• Slow breathing (in and out, focusing on breathing)
• Panting (fast breathing)
• Paced breathing (he…he…he…ho…)

Movement

• Walking
• Slow dancing/Swaying
• Birthing Balls
• Positions (bring pictures of the ones she wants to use)

Misc.

• Visualization/Meditations
• You! (Never underestimate the power of a partner’s presence)

Leave any other ideas in the comment section!

Creation of a Distraction Bag

This tip comes from one of my dads who created a distraction bag for his partner. He went out and bought a whole bunch of things specific to his partner. He filled the distraction bag with a couple of new CDs, a new novel by her favorite author, a few magazines and a few puzzle books. His partner loved it. Remember, even if she doesn’t use that stuff during labor, you scored major points with her by getting her a present that’s tailored to her needs.

Supporting a Woman with an Epidural

Just because she got an epidural doesn’t mean your work is over. She still needs a great deal of help from you as she labors.

• Never leave her alone (unless she says otherwise). Just because her pain is gone, doesn’t mean she’s not going through the emotions of labor. If you need to make a phone call or grab something to eat, see if the nurse can sit with her for a few minutes.

• Offer her sips of water. Her mouth still gets dry with or without the epidural and small sips of water keeps her comfortable.

• Let her rest. If it’s been a long labor up to this point, she may want to try to sleep. Help her get comfortable with pillows and positions. Turn down the lights and/or offer her something to place over her eyes.

• Help her change positions frequently. One of the biggest complaints about the epidural is that it causes back pain. While it may, chances are the back and hip pain after birth is caused by staying the same position for too long. It’s highly recommended women with epidurals change positions about every 30 minutes. This also helps maintain pain relief from the epidural and may help wiggle the baby through the pelvis.

• She may still need your help. Depending on the kind of epidural you got, it can take a few contractions to kick in. In addition, the epidural works great in about 85% of women. This leaves about 15% of women not getting the pain relief they want. Even though she got the epidural, she may still help with breathing, massage and focusing. Remember, if the epidural’s not working how you want it to, talk to your nurse and anesthesia.

• She’ll need your help with pushing. While she's pushing the baby out, you may need to hold her legs, help her count, offer encouragement and keep her cool with water and compresses.
  

What to Pack for the Support Team

Just like moms, coaches need their own list of packed items to help them with the birth experience.

• Snacks. Snacks should be none smelly and easy to carry. They should provide a good protein and a good carbohydrate boost at the same time. Good snacks include power and protein bars, non-smelly sandwiches, smoothies and power drinks. Some coaches will live off of coffee and soda during the birth, while others will find this makes them jittery. Use your best judgment when it comes to caffeine.
  


• Change of clothes. Not only is it refreshing to change a shirt or pants if it’s a long birth, but birth can be messy. Some coaches benefit from changing clothes halfway through the process.
  


• Bathing suit. Many women live in the shower during their labor and they like coaches to be in the shower with them if possible. Bringing your own bathing suit means you won’t get wet and you won’t be going naked in labor and delivery.
  


• Stuff for down time. While it may sound hard to believe, if she gets an epidural, you’ll have lots of sitting around time. Bring a book, magazine or a crossword puzzle so you have stuff to do. Check with your birthing facility to see if they allow laptops. Perhaps your birthing facility has internet abilities.
  


• Jacket or a sweatshirt. If the birth is long or is in the middle of the night, many coaches get cold. Be prepared by layering your clothes.
  


• Medications. If you’re on a prescription, don’t forget to pack it. Allergy and headache medicine is also a benefit and prevents you from gritting your teeth and bearing a headache/allergy attack, or hunting down an open pharmacy.
  


• Cash. It’s a good idea to have a few extra dollars either for the cafeteria, vending machines or for parking.
  


• Feminine products. While most coaches these days are male, some are female. If you’re of child bearing age, it’s not uncommon during labor for you to start your period. It has to do with the hormones during birth.
  

Pack your own things in a bag separate from the laboring woman’s so you can find your stuff quickly.

Supporting Yourself

It’s not enough to plan to support a laboring woman. You have to have a plan to support yourself, because after this baby comes out, you’ve got your partner and a baby to take care of.

• Consider having another coach there. This is a great way to ensure the laboring woman has all the help she needs and you’re not so worn down you can’t enjoy the experience. Your other coach can also learn all of the comfort techniques and positions so if you forget something, it’s not the end of the world. Your back-up coach can be a friend, family member or a doula. A doula is a professional coach whose job it is to physically and emotionally support the two of you.

• Wear comfortable clothes. If you’re worried you’re going to show up to the birth in your business attire, pack a spare change of clothes in your labor bag. Try to wear sweat or yoga pants and a t-shirt, if possible. You’ll also want a jacket or a sweatshirt since hospitals are cold places. You want these clothes to be clothes you can hold a laboring woman comfortably in, and sleep in if needs be. Don’t forget the shoes either. Good shoes include sneakers or clogs.

• Eat. If you’re completely exhausted, try getting a bite to eat. Eating can give you an energy boost, helping you deal with exhaustion. It’ll also keep your blood sugar from getting too low, may prevent crankiness and may prevent fainting at the big moment.
  Good foods for coaches include smoothies, power bars, yogurt, non-smelly sandwiches and fruit. Make sure it’s something you can take a bite out of and put down. It also should be something that ideally gives you a good protein and good carb boost, without being hard to digest or too smelly.

• Watch your positions. You may be getting so caught up in the moment, you’re missing your body’s signal that tells you what you’re doing is uncomfortable. You also may think she’s in so much pain, why should you complain about a little knee or back pain? But pain in you can sap your energy and make you cranky. Use chairs and pillows to make yourself comfortable as you support a laboring women. Put pillows under your knees and at your lower back if you need to. If she’s not using the birthing ball, consider sitting on it yourself. Taking care of yourself will help make the experience more enjoyable and keep your energy levels up.

• Take a break. It may seem impossible, but sometimes during long labors, coaches need breaks. They need to run to the bathroom or get out of the room for a minute to take a deep breath and readjust their emotions. This can also help with your energy levels. Try to time the breaks between contractions or ask a nurse to come in and support your partner for a few minutes.
  

Big Changes

This blog will be going through some major changes in the next few weeks. I'm redoing it to give coaches and support teams what they need to support a laboring woman. I want coaches to be the best coach they can be. Not only is it better for the birth experience, but some research says it may help relationships between couples in the long term too.

Keep checking back; there's going to be some big changes.

Coaches/Support Team's Duties

During Contractions

• Breathe with her. This is very helpful for most women, but for some, this drives them crazy. In addition, never tell moms how to breathe. She’s getting oxygen to the baby and she needs to breathe in a way that feels good to her. If you’re doing the patterned breathing (he…he…he…ho…), hopefully you’ve practiced so you two are in synch.

• Massage her. Most moms enjoy a hand, foot, and head or back rub during contractions. It distracts her and keeps the tension from overwhelming her. Some women don’t like this though—so make sure you’ve cleared it with her first.

• Get her to release tension. If she tenses up during contraction, it’ll make the pain worse and it may lead to panic. Try to keep her as loose and relaxed as possible.

• Offer encouragement. She’s doing great, no matter what. If she just told you to go f#^k yourself, she’s still doing great.

Between Contractions

• Suggest comfort techniques and position changes. Coaches, you must be education about comfort techniques. It is your job to suggest them—she’s not capable of it during labor.
  

• Recovery time. Unless he’s having back pain, she shouldn’t be in pain in between contractions. This is the time to release any tension she’s holding onto a repair for the next contraction.

• Communicate. Coaches, you need to be asking if she liked how you helped her during that contraction. And moms, you need to be answering, otherwise the coaches keep on doing what they were doing, thinking they’re helping.

• Rewet cool compresses. Moms in labor are very hot and need cool compresses on their foreheads, chests or back of the neck. Cool compresses dry out very quickly and need to be rewetted every 3 or 4 contractions or they don’t do any good.

• Offer water to drink. Moms in labor who are breathing get very dry mouthed and need sips of water between contractions.

• Try something new. If that last contraction was horrible, coaches need to be ready to try something else. Before you go into labor, have moms make a list of the comfort techniques she wants to use so you have something to refer to.

Bottom line: If all this seems too much for you, consider asking another person to be in the room with the two of you to help you both get through this labor and birth.

Uses of a Birthing Ball during Labor

The birthing ball is many women’s best friend in labor and one of my favorite props. The birthing ball is simply a large exercise or Pilate’s ball. A good birthing ball is one that if it gets a hole in it, it won’t pop, but slowly deflate. Many women in labor also enjoy a ball that has a small packet of sand in the bottom of it for stability since their balance is often off during pregnancy. You can purchase a birthing ball online, at sports stores or at large chain discount stores such as Target.

The birthing ball is surprisingly versitle and there are many positions you can use during labor.

Sitting on the Ball

When you sit on the ball, you’re in a supported squat, opening up the pelvis, aligning your torso and engaging gravity. Your back is open so someone can be providing back massage. If it feels good, you can even rock or sway on the ball during contractions to help deal with them.

Hands and Knees

Hands and knees is a comfortable position for many women during labor, as it can help alleviate back labor and help a posterior baby turn. However, it’s hard on the knees and wrists. But the ball can help here too. Get into a hands and knees position and lean on the ball. Some women will actually sleep between contractions in this position. There are some things to keep in mind though if you use this position.

• Deflate your ball to about 85% so it’s soft.
• Put a pillow on the ball and one beneath your knees
• Put cool compresses on the ball to rest your cheek on if you’re hot

Lean on the Ball

Place the ball onto your bed, raise the bed to a comfortable level and lean over the ball. If it feels good, you can sway in place. This is a great way to stand, opening the pelvis and engaging gravity, but also be resting. Like with hands and knees some women can actually sleep between contractions in this position.

Use a Wall

Lean the ball up against a wall and press your lower back into the ball. Lunge in one direction throughout the contraction and then the opposite direction during the next contraction. This is a great way to do a lunge, but it’s not so hard on your legs and knees. In addition, it provides pressure on the lower back, helping to alleviate painful back labor.

Tips with the Ball

• Inflate it enough so that your legs are at a 90 degree angle when you’re sitting on it. There are 55 cm, 65 cm, and 75 cm balls. Most women are fine with the 65 cm ball as long as their legs are at a 90 degree angle. This may mean inflating or deflating the ball a little. If it’s inflated as full as you can get it and you still feel too low to the ground, go up a size in the ball.
• Put cool compresses on the ball if you feel hot.
• Coaches and support people should be helping you breathe, massage your hands, back and feet while you're sitting on the ball. They should be offering you cool compresses, drinks of water and fanning you. If you don’t want their help, they should be sitting next to you simply offering support.
• You can still be monitored and be using a ball. Just keep the ball close to the fetal monitor machine and have your nurse put the monitors in place while you're using the ball.