All posts for the month February, 2014

This one’s for you guys that are about to be a birth partner for the birth of your first child.  Those of you that already have kids, or those of you that aren’t male (and hence, won’t qualify for “fatherhood” anyway) are welcome to read and try to apply this to your situation.  Also, I will use the term “wife” to refer to the woman who you are helping through labor.  If that’s not the right term for your situation, adjust as needed.  It’s much less cumbersome than “wife/girlfriend/partner/companion/friend/ex-wife/ex-girlfriend/etc”.

The impending birth of your first child is pretty exciting.  It can also fill you with questions.  “Will I be a good dad?”  “Will I have any idea what to do?”  “How am I supposed to take care of my kid and teach him/her everything he/she needs to know?”

Those kinds of questions are common, and they’re questions you’ll have to answer for yourself.  You can be as prepared as you want, but you’ll still have questions, doubts, uncertainty.  That’s normal.  You’re stepping into a new role, one that you haven’t gotten to practice.  It’ll be an adventure for everyone involved.

One of the best things you can do to prepare for fatherhood is to use being a birth partner as a training camp.  During your training camp, you should learn some practical skills you’ll need to know (e.g. diapering and bathing a baby), practice some skills you already have (e.g. loving your wife and being patient through uncertainty), and develop or improve some emotional skills (e.g. putting another human being’s comfort and safety ahead of your own).

I don’t know what kind of background you have:  whether you had a good model of fatherhood growing up or what kind of models of fatherhood people around you in your adult life have been.  But somewhere, you probably have an idea of the kind of father you want to be.  If not, let me give you a vision (and this one’s off the cuff–feel free to develop your own, better vision):  you want to be and you can be a father that is physically and emotionally present for your kid(s), a strong protector and tender enough that your kid(s) will run to you to kiss their bumps and scrapes, a man that’s willing to sacrifice his own comfort and preferences for the good of his wife and kid(s), and an intentional parent that sets a direction for your family that’s best for everyone–all of this because you know that being that kind of father will be more rewarding than looking out for yourself.

So take your vision of fatherhood and apply it now, before your kid is born, and before you officially take on your new role.  Practice being a strong protector by making sure you’re equipped to protect and help your wife through labor.  Practice being tender by equipping yourself to gently comfort her during labor (not just with physical comfort techniques, but with encouraging or distracting words).  Practice being physically and emotionally present by turning off the TV, putting away your smartphone (unless you’re timing contractions), and pay attention to your wife so that you can respond to or even anticipate her needs.

If you take your vision for fatherhood and use that to organize your fatherhood training camp, you’ll be much better equipped to be a father.  And just like a coach might say of a promising rookie “Yep, he had a great training camp.  Throws great, moves great.  He’ll be starting our first game.  He’s got a lot of room to improve, but he showed us that he’s got the tools to succeed”, your wife will be excited about your potential.  “Yep, he’s been a great partner.  Surprisingly gentle, but never gave up, and always put me first.  We’ve both got a lot to learn about taking care of our baby, but he’s going to be–he already is–a great dad.”

It’s very rare that a pregnant woman declares “it’s time!” out of the blue.  Sometimes, her water will break unexpectedly, or something just won’t feel right, and it’ll be obvious.

Most of the time, the drive to the hospital happens after timing contractions for a while.  In the very early part of labor, contractions start, getting closer together as labor progresses.  The general rule for when it’s time is 5-1-1:  contractions five minutes apart, lasting one minute each, for an hour (as always, a doctor’s advice should overrule any guidance from this blog).

In short, timing contractions is a way to figure out when it’s time to head to the hospital.

There are two ways to time contractions:  manually with a clock or watch, or with electronic assistance.  I highly recommend electronic assistance.  The manual approach is much more tedious at a time when your mind should be focused on assisting the woman having the contractions.

Manual Timing

To time contractions manually, you’ll need paper, a writing utensil, and a clock or watch that shows seconds.

  1. Create four columns on the paper:  Start Time, End Time, Duration, and Time Between
  2. When a contraction begins, write the time down in the Start Time column
  3. When the contraction ends, write the time down in the End Time column
  4. Calculate the Duration of the contraction:
    Duration = (End Time – Start Time)
    Write the Duration down.
  5. If this is not the first contraction you have recorded, calculate the Time Between contractions:
    Time Between = (Start Time of previous contraction – Start Time of this contraction)
    Write the Time Between down.

Here is an example:

Start Time End Time Duration Time Between
8:44:10 8:44:45 35 seconds  –
8:55:10 8:56:10 1 minute 11 minutes
9:00:30 9:00:50 20 seconds 5 minutes 20 seconds

It’s not complicated, but it takes your focus away from being a good birth partner and puts it on a clock.  Besides that, time arithmetic is tedious enough under normal circumstances.
If you’re at all able to, use electronic assistance.

Timing with Electronic Assistance

Using a smartphone or other electronic device is much simpler.  Usually, there’s a “Start” button to push when a contraction starts.  When the contraction ends, hit “End”.  They do all the timekeeping and arithmetic for you.

If you have a smartphone or similar device, search your app store for “contraction timer”, find one that looks good and has good reviews, and install it.  Try it out to make sure you’ll like it.  (There are websites that provide similar contraction-timing functionality, if you prefer that.)

One caution when it comes to using electronic assistance:  don’t get distracted by your electronic device.  Games or web-surfing will take your focus off the woman you’re trying to help.  Then she’ll be contracting and annoyed.  When you’re timing contractions, just use your device for timing contractions.

As a birth partner, even if you’re doing your best, you probably will make at least one mistake along the way.  (If you’re not trying, you’re already making a mistake.)  Mistakes happen.  Maybe you step out for a restroom break and miss something important.  Maybe your comfort technique suggestions become irritating.  Maybe you say the wrong thing.  There are lots of possibilities–I’m sure you get the idea.

When you recognize that you have made a mistake, the first thing you need to do is remind yourself that mistakes happen.  You can forgive yourself for it and move past the mistake.  If you wallow in the mistake, you’re taking your focus off the woman you’re supposed to be helping, and put your focus on yourself.  So don’t do that.

Depending on what the mistake was, you may want to apologize before you move on.  “I’m sorry my bathroom break took so long.  I’ll spare you the details, but I really did get back as fast as I could.  Now that I’m back, what can I do to help you?”  Asking what you can do for her moves the focus away from you and back to her.

She might be angry with you.  You might deserve it.  Whether you feel like you deserve it or not, remember that your whole reason for being there is to love and support her through labor.  You’re not there for you, you’re not there to make sure she does things your way, you’re not there to make sure she does things “right”, and you’re certainly not there because you can do all of this for her.  You’re there to love and support her.  So if she’s angry, accept that you did something that she perceived as unloving or unsupportive.  Apologize and turn the focus back to her.  Do not get angry back at her (or, if you do get angry, let the anger go right away).

NFL cornerbacks often talk about taking things one play at a time.  They know that sometimes, no matter how well they’re playing, they’ll be responsible for covering a receiver that ends up making a great catch.  They also know that after making a huge coverage mistake, they can go out, intercept a pass, and return it for a touchdown.  They can’t let themselves get too high or too low after any one play.

As a birth partner, take things one “play” at a time.  You might make a mistake.  Shake it off (doing what’s needed to make things right) and move past it.  Don’t get too down on yourself.  You have the chance to go right back and recover.

Think back to junior high health class, when they made you watch a birth video.  You’re smart enough to know that the video probably didn’t cover the whole labor process.  From what I remember, though, the video my class watched just covered the second-to-last stage of labor.

You might be skeptical about that “second-to-last” thing.  You saw the part where the baby popped out.  Then you stop to think.  Wait a second.  There are different stages of labor?

Yep.  Not only that, but one of them has at least two phases (with the second phase having two parts).  As a birth partner, you need to understand what you’ll need to do to be supportive during each stage, phase, and part.  Please understand that this describes a typical labor, and every labor is different.  This also describes a full-term labor–pre-term labor warrants a call to your doctor.

In the case of any contradiction between what’s written here and what a doctor says, believe the doctor.

Stage 1 – Early and Active Labor

This is the longest stage of labor.  It begins with early labor.

Phase One – Early Labor

The first phase of the first stage of labor starts when “real” (not Braxton-Hicks contractions) become regular.

Your first step is to keep calm and relax.  Sometimes, regular contractions stop.  There’s (usually) no need to rush to the hospital until contractions are regular and close together.  “5-1-1” is the usual rule:  contractions 5 minutes apart, lasting 1 minute, over a 1-hour duration.

If contractions start becoming more regular, you can start timing contractions and getting your last-minute packing done.  Besides that, you and mom-to-be can continue with normal activities.  You can go for a walk, do light household chores, hang out and do things you enjoy–anything that’s comfortable for her, that you both enjoy, and that helps pass the time until you’re sure it’s really labor.

During this time, make sure she gets food and rest.  She’ll need energy for the rest of labor.

Once it’s time, calmly head to the hospital with everything you’ll need.

Phase Two – Active Labor

Active labor is the phase in which contractions get stronger and more frequent, and possibly more painful.  It’s not time for pushing yet.

During active labor, which is usually surprisingly uneventful, mother-in-progress needs your attention, understanding, and help.  She might need comfort or a distraction.  She needs to keep hydrated.

If she needs comfort, you can try comfort techniques or simply helping her move around.  Gentle physical contact (holding hands, slow dancing, etc) can be reassuring and comforting.

If she needs a distraction, find something she likes:  music, board or card games, a good book (you might want to read the book to her–your voice might be helpful).

It’s okay to ask her what she wants or needs every so often.  Don’t be annoying and ask too often.  Feel free to suggest something in particular if you think she needs it.

Phase Two, Part Two – Transition

Transition is the last part of active labor.  It usually begins at 7 or 8 cm dilated.

Transition is also rough on everyone.  It’s usually the hardest, most intense part of labor.  Contractions are even longer and more frequent–in fact, they can even overlap or double-peak.

If you are paying attention, you will notice transition starting.  There are a variety of possible physical and psychological signs.  Generally speaking, her body is going crazy, she’s tired, and her brain is trying to keep everything together.

She needs all the help you can give.  Since each transition is different (even from one pregnancy to the next for the same woman), it’s up to you to pay careful attention to her and do your best to get her through it.  You need to be strong for her, but gentle and soft at the same time.  Keep rational, but keep a loving focus on her.  Stay with her through all of transition.

The best encouragement I can give you is this:  transition won’t last long (usually about 30-45 minutes).

Stage 2 – Pushing and Birthing

Stage two is the stage where the mother pushes the baby out into the world.  This is the part that is usually shown in birthing videos.

If you are paying attention, you should notice when transition ends and Stage 2 begins.  She will be calmer, but tired.  Depending on how things have gone so far, she may perk up, or she may just want to be done.  Neither is “right”; be prepared for either.

During pushing, you need to encourage her, be a voice she can rely on, and help her (say, by helping hold a leg) as needed.

Encouragement is different than coaching.  Reassure her she’s doing a good job.  Acknowledge the work she’s already done and how tired she is.  Remind her that the baby is almost here.  You’re not her coach–you’re her birth partner, and you need to encourage her through this stage.

If the messy part of birth makes you queasy or offends you, stay where you won’t see it.  There will be a lot of mess.  Deal with any issues you have with the mess quietly, and make sure you don’t end up passing out or getting sick.  You need to be physically and mentally there to help.

At the end of this stage, the baby emerges and…

Stage 3 – Placenta

…labor is almost but not quite done.  Really, the hard part is done.  The medical team will clean up baby and hand him/her over to you and the new mother.  That’s where you’ll both be focused during this stage.

The placenta, non-technically speaking, is a thing that looks like a slab of liver that was very important to keeping Baby alive for the past nine months.  Now that Baby has been born, the placenta wants to wave good-bye and set off on its own new adventures.

While the new mother is snuggling Baby, she will have a few more (usually mild) contractions.  The medical team will do whatever they do with the placenta.  Your focus can be on Baby and being excited that labor is over.

This isn’t the only resource for being a good birth partner or understanding pregnancy and birth on the Internet.  Here are a few other resources I’d recommend checking out:

The Art of Manliness ran a series called “A Man’s Guide to Pregnancy”.  Start with How to Take Care of a Pregnant Wife, read about the gear you’ll need in Getting Ready for the Baby Bomb, and wrap up with information about helping with labor in Your Progeny Enters the World.

BabyCenter’s UK site has a good article on the role of a birth partner.  In general, BabyCenter is a pretty good resource, with a lot of articles, newsletters keyed to baby’s delivery date, and online tools.  Most are intended for mothers-to-be and mothers, but many will be useful for birth partners.

Mayo Clinic has some excellent articles about pregnancy, labor, birth, and related topics of interest to a birth partner.  Unfortunately, they don’t seem to have a good starting page.  If a Mayo Clinic link shows up when you’re searching for information, it’s a good bet.

WebMD’s Pregnancy Center is another good resource full of articles, videos, and online tools.

Just remember, whenever you find an article that worries you, sanity-check it with someone (a doctor familiar with the pregnancy in question, a friend that’s tried out the baby gear in question, etc).

“Heck no.  I’m not good at that touchy-feely stuff.  I’ll build the crib, but I’m a man, not some ‘birth partner’ person.”

Would it surprise you to know that some men view being a good birth partner as “touchy-feely” and not particularly manly?

Some men have that view because they understand themselves well.  They realize that they are not naturally empathetic.  They are used to powering through difficulty and getting things done.  They understand that their strength and power don’t easily translate to being a good birth partner.  They may not use those words, but those are the feelings they have.

Some men have that view because they are being selfish.  Being a birth partner, whatever that is, kind of sounds like hard work.  Besides that, it’s going to take preparation to be able to do a good job.  They feel like being physically present in the birthing room should be enough, and that support from the doctors and nurses should be enough to get the mother-to-be through labor.

Most men have had some of those thoughts, both from selfishness and from self-understanding.  Being a birth partner is not something that we get trained to do.  It’s something we end up doing, winging it the whole time, and just hoping to get through it.  We don’t like the idea of failing, but–being untrained and unprepared–we feel like we’re set up for failure.

And so we think of reasons we’re not qualified.  Or too tough and manly to become qualified.

Absolutely understandable, guys.

Keep thinking about it, though, and you come to a different conclusion.  Who better than a tough, manly man to do something difficult for someone he loves?  Who better than someone used to powering through difficulty to be supportive and gentle and loving through a long and difficult labor?  Who better than a man, knowing he can do pretty much whatever he puts his mind to, to put his mind to being the best possible birth partner he can?

That’s right, nobody better.  Guys, who can do a better job than you, if you decide you’re going to do something?  That’s right.  Nobody.  You–you–can be a great birth support person.

Think of it this way:  your mission is to get this woman (your wife, girlfriend, etc.) through childbirth in the best possible physical and emotional condition.  With a little bit of preparation and training, this is an achievable goal.  You don’t have to read all of her pregnancy books or anything like that.  Do some research on your own, or find a book focused on teaching birth partners exactly what they need to know, and get trained for your mission.

Once you’re equipped, you’ll be ready to demonstrate that you’re not just a tough guy.  You’ll be ready to demonstrate that you’re tough enough to be an awesome birth partner.