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.