Planning

Plan Ahead – Series Wrap-Up

Posted by matt on January 29, 2014

Posted in: Uncategorized. Tagged: Planning. Leave a Comment

This is the eighth and last in a series of posts about things a birth partner should plan ahead for.

This series has been all about planning ahead. In this series, on this blog in general, and in the Field Guide to Being an Awesome Birth Partner (the book), planning ahead is a major theme. You can’t be an effective, awesome birth partner if you’re reacting and learning as you go. The woman that you’re going to go through labor with deserves a birth partner that’s fully prepared to be awesome.

So, quickly, let’s recap what you need to plan for, according to this series.

From “The Drive“

Know which door at the hospital you’ll need to go to.
Plan your route.
Plan weather, traffic, and possibly construction alternate routes.
Stay calm.

From “Birth Plan“

Plans change.
Making a birth plan is important.
Planning with mother-to-be helps you understand her preferences.
Review the birth plan with her doctor.
Plans change.

From “Setting Up at Home“

Cheerfully help set up the nursery.
Install the car seat (and consider having it checked).
Get (and test) a contraction timer app.
Do your at-home set-up tasks well before baby’s due date.

From “Take Birthing Classes“

Take the “Labor and Birth” class.
Take the “Comfort Techniques” class.
Take the “Baby Basics” class.
Have parents/in-laws take the “Grandparents” class.
The classes have more benefit than just gaining knowledge.

From “Packing“

Pack as much as you can ahead of time.
Make a checklist for the things you’ll need to pack at the last minute.
Do your last-minute packing when you suspect labor has started, not really at the very last minute.

From “Know Her Situation“

The birth partner must understand the mother-to-be’s pregnancy situation and concerns about birthing.
Listen and learn without dismissing or trying to fix.
Be prepared to hear concerns about you, without getting defensive.
Having the conversation(s) is worth it.

From “Be Ready to Comfort“

A “Comfort Techniques” class is worth the time.
Discuss comfort techniques preferences with the mother-to-be.
During labor, her preferences may change. You will need to help find new effective comfort techniques.
Being prepared to physically comfort can help you be more prepared to emotionally comfort.

So that’s the series. I hope you will apply at least one bit of knowledge from each post so that you can be a more effective birth partner when the time comes.

For more information about planning ahead, checklists to help you plan ahead, and everything else you need to be an awesome birth partner (but without a lot of things you don’t need), buy a copy of the ebook Field Guide to Being an Awesome Birth Partner. It’s much more concise than blog posts.

Plan Ahead – Be Ready to Comfort

Posted by matt on January 26, 2014

Posted in: Uncategorized. Tagged: Comfort Techniques, Planning. Leave a Comment

This is the seventh in a series of posts about things a birth partner should plan ahead for.

Labor is difficult. Lots of things are going on with a woman’s body as she works to give birth. One of your roles as a birth partner is as a comforter. You will help her feel as comfortable, safe, and relaxed as possible, both physically and emotionally.

This post will mainly focus on providing physical comfort. That is not to say that emotional comfort is not important! In fact, it is even more important than physical comfort.

In this series, I have already suggested that you take a birthing class that covers comfort techniques. If you choose not to take such a class, at least find a list of comfort techniques somewhere so that you can try them out and discuss them. (I suspect that by the time you find a good resource that demonstrates or explains comfort techniques and have tried them out, you’ll have invested at least as much time as you would have in taking the class.)

Once you have tried out your potential comfort techniques on mother-to-be–so that she has a chance to experience them–the two of you need to have a discussion about them.

There are two basic questions that you can use at the start of a comfort techniques discussion:

Do you want us to use comfort techniques during labor?
Do you think you’ll want me to touch you (e.g. hold your hand, stroke your hair, hug you) during labor?

Most likely, she will want to at least try comfort techniques. And most likely, she will want some sort of physical touch to reassure her. If she does not think she will want to be touched, you should still discuss comfort techniques. Laboring mothers have been known to change their minds, and you need to be prepared.

You should ask her what comfort techniques she liked, and which ones she absolutely didn’t like. You should also ask which comfort techniques she thinks she’d like to try first during labor. Write these answers down so you can be sure of her answers later. You don’t want to be in the middle of labor, wanting to help her feel more comfortable, and asking yourself, “did she say she liked the hip squeeze thing, or was that the one she hated?” You want to be able to make a useful suggestion. “You really liked that hip squeeze thing. How about we see if that helps things feel better?”

Speaking of making suggestions, it would be a good idea to ask her how active she wants you to be with comfort techniques. She may want you to be very involved, actively making suggestions and helping her through each comfort technique. She may only want you to help when she asks. You should take mental notes on her preferences here. Now, you may end up making suggestions during labor, even if that was not her preference–so knowing her preference will help you phrase the suggestion more gently.

Please understand that during labor, as changes occur in her body, some techniques become ineffective and others suddenly become effective. Be willing to try, abandon, and re-try techniques as labor progresses. You may feel like you’re playing an unfair guessing game, but sometimes just trying will be comforting to her. And as an aside, the nurse may have suggestions if you start running out of ideas.

I said earlier that this post wouldn’t cover emotional support–and it really doesn’t much–but here’s a quick bonus: understanding her preferences and desires regarding comfort techniques will help you be more attuned to her and more responsive to her during labor. That will be emotionally comforting to her. She will be much happier if you suggest something she liked during practice, because she will know you listened and valued her.

Next up in the series: Plan Ahead – Series Wrap-Up

Plan Ahead – Know Her Situation

Posted by matt on January 22, 2014

Posted in: Uncategorized. Tagged: Conversation, Planning. Leave a Comment

This is the sixth in a series of posts about things a birth partner should plan ahead for.

Did you know that the woman whose birth partner you’re going to be has a pretty good idea of what her pregnancy situation is? Did you know she has birth-related concerns, and could list at least a few of them without thinking too much about it?

You probably know that. Those are pretty silly questions. Yes, of course she knows what’s going on with her.

How about you? Can you, without wandering off to think about it, give me a pretty good summary of her pregnancy situation? Can you list a couple of her concerns about giving birth?

If not, it’s time to have a conversation. You need to get inside her head and understand what is going on. A great American philosopher once explained that “knowing is half the battle.”

The point of the conversation is not to try to fix things or dismiss her concerns. The conversation should not go like this:

You: Hey, so I read this post that says I should know about your pregnancy situation and concerns, so let’s talk.

Her (feeling loved and valued, but slightly confused): Okay, I guess now works.

You: So, um, what are your concerns about giving birth?

Her: Well, I’m a bit worried about how much labor is supposed to hurt.

You: Psssh. Don’t worry about that. If it hurts too much, we’ll just get you an epidural. Didn’t Sally say that she couldn’t even feel it after her epidural?

Dismissing her concerns or trying to fix them will tell her that you’re not really interested, even if you’re incredibly interested, taking notes, and doing your best to understand every part of her situation and concerns. Yeah, it could be frustrating. Yes, it might not be an easy conversation to have. Yes, it will be worth it.

Ask her about her concerns. Ask her about how her pregnancy is going. Ask if her doctor has mentioned any potential complications (late-term head-up positioning, gestational diabetes, and Group B Strep come to mind as things that might worry her). Whatever concerns or complications she mentions, reassure her that you will be with her through the whole thing.

Now, she might have concerns about you.

You: Anything else you’re worried about?

Her (uncomfortable): Well, I don’t know…

You: It’s okay, you can tell me. What is it?

Her: Well, it’s just that…well…Sally said Mark thought the birth part was totally gross, and passed out so the doctor had to cut the cord instead of him and then the nurses were trying to take care of him so it took longer to get the baby to her and she didn’t know if the baby was okay or if Mark was okay and she was really worried and then they didn’t get any good pictures of them holding newborn Kayden and I don’t want that to happen!

Well. Good luck with that.

The way you handle her concerns about you will vary based on your relationship and experiences. A good response could be anything from “um, wait a second there, I’m a trauma surgeon, so birth will be a piece of cake” to “yeah, you’re right, maybe I’ll have to sit down by your head so I don’t see blood–you know how I get when I see blood”, to “I know, but this book you got me is helping me be completely prepared and ready to do the right thing, so even if I pass out I should do everything else right.” There are many possible responses. Just pick one that’s gentle and loving, not defensive and snotty.

No matter whether she has concerns about you, no matter what the potential complications, no matter what her pregnancy situation, your taking the time to understand her exact situation gives you two great benefits:

It strengthens your relationship with her. That’s valuable enough on its own. It will also help you be a more effective birth partner.
It gives you more knowledge so you can be better prepared.

Those benefits make the conversation (or multiple conversations) worth having.

Next up in the series: Plan Ahead – Be Ready to Comfort

Plan Ahead – Packing

Posted by matt on January 19, 2014

Posted in: Uncategorized. Tagged: Packing, Planning. Leave a Comment

This is the fifth in a series of posts about things a birth partner should plan ahead for.

Packing for the hospital is not complicated. It’s also not something that needs to be left until the last minute. Packing should be done in two sets, only one of which can be done ahead of time. You are packing for three people: mom, birth partner, and baby.

Packing – Round One

The first set of packing is straightforward. Pack everything that you’ll need for the hospital stay (typically two days, but check with your hospital to make sure) that you don’t need to have out. You probably don’t want to pack your eyeglasses, for example.

Before you start throwing things into suitcases, find or make a checklist of items to bring. I recommend the one in the book, though there are plenty of them out there. Basically, you’re packing for a two-day hotel stay in which people will be in and out of your room, and mother-to-be will likely be breastfeeding. Some things to remember:

Toiletries
This can be one of the more difficult things to pack, because you use those daily. It might be worth buying your next set of most things (toothbrush, shampoo, etc) and packing the new stuff.
Eye care (if you, like me, are not blessed with good vision)
Clothes
For the mother-to-be, comfy pants and tops are highly recommended. Nursing bras and tank tops should also be on your list. Besides the comfy clothes, pack an outfit for going home.
Pajamas suitable for wearing in public
Nurses will be in and out of your room, even when you’re asleep. They may lift up the covers to check on the just-became-a-mother. Don’t be like the guy I heard about in a birthing class who was surprised by the nurse pulling back the covers (to check on the mother) only to discover he preferred no pajamas at all. That’s just awkward all around.
Slippers or heavy socks
Camera and extra batteries
Cell phone(s) and charger(s)
Laptop(s)
Checkbook
Depending on your state, a check may be required for the birth certificate. Call your local hospital, or ask during one of the birthing classes.
Cash for vending machines (snacks)
Birth plan, notes from your Comfort Techniques class or other classes, the Field Guide book
Insurance card
List of people to call after the birth

Of course, you’ll want a few things for Baby:

Going-home outfit
Newborn pictures outfit (optional, and let’s be honest, Baby will be cute in any outfit)
Nursing pillow
Blanket
Car seat

Check with your hospital. Most likely, they will provide sleepers and hats for Baby during your stay. You may bring your own, but you will have to be careful that they don’t get put into the hospital laundry by mistake.

As you go through your packing checklist, write down everything that you can’t pack ahead. This will be your Last Minute Packing Checklist. It should be as short as possible. The fewer things you have to do when you decide it’s definitely time to head to the hospital, the better.

Last Minute Packing

You may not have a lot of time for last-minute packing. Or you may. Because you don’t know, keep your Last Minute Packing Checklist as short as possible (this is why it might be good to buy an extra set of toiletries). Keep it somewhere easy to find (taped to your suitcase?).

Before it’s time for last-minute packing, make sure you know where everything is (laptop: dining room table) and where it will get packed (laptop: computer bag kept in the hall closet).

You don’t have to wait until you’re absolutely sure labor has begun to do your last-minute packing. If you guess wrong, you’ll have to unpack. If you guess right, you’ll be ready ahead of time. Either way, when it’s time for last-minute packing go through your Last Minute Packing Checklist. Pack each item quickly and calmly. Now you’re fully packed, and ready to go have a baby!

Next up in the series: Plan Ahead – Know Her Situation

Plan Ahead – Take Birthing Classes

Posted by matt on January 15, 2014

Posted in: Uncategorized. Tagged: Birthing Classes, Planning. Leave a Comment

This is the fourth in a series of posts about things a birth partner should plan ahead for.

The term “birthing classes” probably brings to mind a scene from a TV show or movie. Rows of women with round bellies are wearing sweats, sitting on yoga mats, leaning against their husbands who look like they’d rather be anywhere else. The instructor at the front of the room is explaining something that you can’t quite hear over the synchronized “hchee hchee hchoooo, hchee hchee hchoooo” breathing.

How the heck is that going to help anyone with anything?

Well, here’s the deal. And a spoiler warning first: (spoiler) TV and movies aren’t entirely accurate (end spoiler). Birthing classes have become more useful over the years. TV just hasn’t caught up.

These days, most hospitals offer some sort of birthing classes for expectant mothers and their birth partners. Some hospitals offer a deluxe menu of class options. Just figuring out which classes to take could be difficult. So here are my recommendations for the minimum classes to take, while still fully preparing yourself to be a great birth partner.

Labor and Birth
The basic Labor and Birth class covers the process of labor and birth. You’ll learn how to recognize labor when it starts, all about the different stages of labor and what to expect, and probably hear about dilation and effacement. There may be a birth video. This class may also include a brief tour of the facility and an explanation of hospital policies.
Comfort Techniques for Labor
The couple of hours you spend in this class will be some of the most valuable time you spend preparing to be an awesome birth partner. It will cover different techniques for making labor more comfortable. It may cover positions for labor and pushing, breathing techniques (but almost certainly not the “hchee hchee hchoooo” stuff), things you can do to reassure and encourage her or help make her comfortable, and possibly more. Seriously, take this class.
Baby Basics
If you have never taken care of a baby before, take this class. You’ll learn about diapering, bathing, feeding, soothing, swaddling, and generally caring for a newborn. In fact, even if you have taken care of a baby before, this might still be helpful in filling in gaps in your knowledge and learning the best ways to do things. Taking this class will help ease your mind about what to do after the birth, and let you focus on being a birth partner.
Grandparents Class
This one isn’t for you–it’s for the grandparents-to-be. Remember hearing about when you were little? You were birthed in the woods over a campfire, swaddled in asbestos, and soothed to sleep with a little bourbon mixed into your lead-lined baby bottle. Well, maybe it wasn’t quite like that, but birthing and baby-care practices have changed a lot since the grandparents-to-be were new parents. This class will bring them up to date on what you’re learning in your classes, and provide helpful hints for being the best grandparents they can.

There might be a little bit of overlap in material covered in some of these classes. That’s okay. Take special note of those items–anything covered in more than one class must be important.

Now, there are two major benefits to these classes beyond learning all kinds of really useful things. First, you are demonstrating to the mother-to-be that you are committed to being the best birth partner you can. That will be comforting to her throughout the birthing process. Second, you are able to observe how she reacts to various things in the classes (which comfort techniques she likes, which stage of labor she looks worried about, her comments on various pain management options). File those observations away–and maybe talk to her about them–because understanding her will be helpful to you in supporting her.

Now go sign up for classes!

Next up in the series: Plan Ahead – Packing

Plan Ahead – Setting up at Home

Posted by matt on January 12, 2014

Posted in: Uncategorized. Tagged: Home, Planning. Leave a Comment

This is the third in a series of posts about things a birth partner should plan ahead for.

Most men like having something tangible to do. We feel a lot better if we can see we’re accomplishing something, instead of reading “this week in your pregnancy” emails and waiting.

Fortunately for men and female birth partners that have a handy inclination, there are usually some things that need to be done around home to prepare for a baby.

The Nursery

Obviously, you’ll need to help set up the nursery. Assemble the crib, get the dresser moved in (just a bit to the left, no, too far, back a bit), hang pictures, set up the changing station, set up a bassinet if that’s part of the plan–all that is important. It’s important to have it done so that baby has a safe and comfortable place to come home to. It’s also important because having those things done will help mom-to-be feel cared for. Her sense of being cared for and supported will set the tone for the birthing room.

(With that tone-setting in mind, here is a caution for guys who tend to grumble through the honey-do lists: suck it up and do this stuff cheerfully. You can negotiate a time that works well for both you and her, but don’t be a grump when you’re doing it. When you’re on the field, have your “game face” on. In this case, your “game face” is helpful, decidedly non-grumpy, and definitely non-resentful. Think of this as practice, if you must.)

The Car Seat

Besides the nursery, install the car seat in whatever vehicle you’re planning to take to the hospital. It’s not hard (after years of practice, I can install a baby car seat in a vehicle without latch in less than a minute). Even though it’s not hard, it will take a while the first time you do it. Make sure to read the manual. Your baby (or if you’re a non-father birth partner, the baby of a woman you care about) is going into that seat. In fact, read the manual for the car and the car seat, give yourself plenty of time, and get the car seat installed solidly.

Many communities offer free car seat safety checks. Search for [your city name] car seat check, and you will probably find some information. Your birthing center or your non-emergency police line may also be able to direct you to the right place. The checks aren’t absolutely required, but they will give you peace of mind knowing that baby will be safe as possible in the car seat you just installed.

Once the car seat is installed, take one more step, just in case. Find two clean towels and tuck them in a large, clean garbage bag. Put the bag of towels in the car seat or somewhere else within easy reach. You will probably not need them, but if the drive to the hospital becomes unexpectedly and messily eventful, you’ll be glad they’re there.

Contraction Timing

At some point, when labor starts, you’ll need to time contractions. You can time using a clock (or watch, or timer) and paper, or you can use technology to help you out.

If you want to time by hand, search for “timing contractions”, or read about the basics of timing contractions. Time a few imaginary practice contractions to make sure you understand the method.

Unless you have to, don’t time by hand. Just don’t. Get an app for your handheld electronic device of choice, or find an online contraction timer that works with your device. Figure out how to use it. It should be ridiculously simple. It’s portable. It frees you up from doing time arithmetic and lets you focus on supporting the lovely woman having contractions.

(With that in mind, don’t use the contraction timer app as a gateway to distractions. Don’t switch from the contraction timer to a game or web surfing. That’s not supportive, and even during a contraction, she will pick up on your drifting attention.)

Other Miscellaneous Set-Up Tasks

Put the doctor and/or hospital’s phone number in your phone
Help the mother-to-be arrange outfits, diapers, etc in the nursery
Pack as much as possible (this will be covered by a future post)
Arrange for someone to care for pets or already-born kids
Sign up for hospital birthing classes if they’re offered (this will be covered by a future post)

When?

Due dates are educated guesses based on statistics and calendars. Baby’s due date is not the same as your target completion date.

Aim to have your set-up tasks finished a month before the due date. Doing so will mean reduced stress for everyone as the due date approaches–or having everything ready if baby comes early. Either way, planning to be set up early is a good idea.

Next up in the series: Plan Ahead – Take Birthing Classes

Plan Ahead – Birth Plan

Posted by matt on January 8, 2014

Posted in: Uncategorized. Tagged: Birth Plan, Planning. Leave a Comment

This is the second in a series of posts about things a birth partner should plan ahead for.

A birth plan is exactly that–a plan for birth. It’s a short, written plan that covers some of the big decisions related to giving birth.

As a birth partner, you should have at least one discussion with the mother-to-be as you work together to develop a birth plan. The completed plan will contain some valuable information, and you will have learned even more things that don’t end up in the plan–those things may be useful to you during the birth process.

There are a variety of checklists and birth plan creator tools on the internet. (Searching “birth plan checklist” brings up some great results.) There’s a just-what’s-necessary checklist in the Field Guide book. The exact decisions that get written down aren’t super-important. Instead it’s talking through the entire birth process and understanding preferences, concerns, fears, hopes, and figuring out how the ideal birth would happen.

It’s important to understand that the birth plan is just a plan. Plans change. It is important to be flexible about the birth plan. As Dwight D. Eisenhower said, “Plans are nothing. Planning is everything.” Make the plan, but be willing to change as circumstances require. In the (translated) words of Helmuth von Moltke, “no plan survives contact with the enemy.” Coming up with the plan helps you understand her preferences. If reality dictates a change of plans, understanding her preferences can help you provide the right kind of support and encouragement to keep the birth experience positive.

For example, she might want to have a natural childbirth, with no drugs or anesthesia. If complications arise and an emergency c-section is needed, she will need some sort of anesthesia. A good birth partner, knowing her preference, can provide encouragement, perhaps saying something like “I know you wanted this to be natural. This isn’t what we’d planned, but I know it’s going to be okay. Baby’s so lucky to have a mommy willing to change plans to keep him/her safe.” (Note: do not actually say “him/her”, although that could be pretty funny.)

As another example, she might want to have her birth partner (you!) cut the cord. Sometimes, though, all the excitement of childbirth, the sights and smells of various fluids, and the emotional exertion of being a supportive birth partner through labor can leave you feeling unsteady. In that case, it’s okay to decide not to cut the cord. “I know you wanted me to cut the cord. I want to too. My knees are too wobbly to do that though. We’ll have the doctor do that and we’ll get baby to you right away.”

Remember, the birth plan is important, but the real value is the process of planning, understanding her preferences, and starting to understand what’s going on inside her head.

After you have a birth plan you’re both pretty happy with, you should attend a prenatal appointment together. That will allow the birth partner, the mother-to-be, and the doctor to go over the birth plan together to make sure you have covered the important things, ensure your plan is reasonable, and doesn’t include any outdated practices. This will help you get a bit of exposure to the viewpoint of medical staff, and once again, this will help you understand the preferences of the mother-to-be.

For more reading, check out these articles from a labor and delivery nurse:

Next up in the series: Plan Ahead – Setting up at Home

Plan Ahead – The Drive

Posted by matt on January 5, 2014

Posted in: Uncategorized. Tagged: Drive, Planning. 1 comment

This is the first in a series of posts about things a birth partner should plan ahead for.

Most babies in the United States are born at a hospital. Most people in the United States do not live at a hospital. That means that when it’s time for a baby to be born, somehow the mother needs to get to the hospital.

That sounds easy enough, right? Load her up in the car, pull out of the driveway, and drive to the hospital. Done.

Yes, the drive to the hospital is pretty straightforward, if:

you know which door to go to,
you know which hospital and how to get there,
traffic isn’t terrible,
the weather cooperates,
construction hasn’t closed the road you planned on, and
you keep calm enough to drive safely.

Let’s take a look at these in a little more detail.

Most hospitals have more than one door. You need to know which one you need to go to. Your first thought may be to take the laboring mother to the emergency room. That’s probably not the right place. Visit the hospital (yes, in person) and find out which door to use. When you find the door that leads to the birth center (or maternity ward, or whatever your local hospital calls it), go in and talk to the receptionist. Ask whether there is anything different you will need to do at night, and ask where you should park.

For some people, there’s only one hospital around. In my hometown, we called it “the hospital”. Today when I say “the hospital”, I mean one of the two hospitals in town. In bigger cities, there might be even more. It’s important that you know the right hospital to go to, and how to get there.

Once you know which hospital to go to and have your route planned out, you should also do some contingency planning. What if you need to get to the hospital at rush hour? (Those of you in “rush minute” towns may not need to worry about this.) Is there an alternative route that is faster at rush hour than your normal route?

Another contingency to prepare for is bad weather. Some parts of the country get snow and ice that make travel difficult, slow, or impossible. Flooding can close low-lying roads. Whatever the potential difficult weather conditions in your area, have a plan. In inclement weather, would a different route be safer or faster?

It is a good idea to drive each one of your selected routes as practice. This will ensure that you are familiar with the route, as well as ensuring that the route is actually correct. It would be embarrassing, at least, to say “don’t worry, honey, we’re almost there”, only to discover that you’ll need to go the wrong way down a one-way street. Driving your selected routes also gives you a chance to check for construction or other unexpected problems.

At some point, you will have to make the drive for real. It can be very stressful driving a contracting, laboring, nervous, very pregnant woman to the hospital to give birth. Your primary task during the drive is to get her to the hospital safely. Traffic laws still apply, physics still apply, and good sense still applies. Running red lights, speeding, or other traffic violations are a bad idea. Stay calm and reassuring. Stay calm. Stay calm. It’s worth repeating, because it can be difficult. Stay calm.

If you plan ahead and stay calm, the drive to the hospital should go well. Now, you might not make it in time if it’s a ridiculously fast labor–which is possible–but your preparation should put you close enough to the hospital that help can get to you quickly. Most of the time, though, labor is not that ridiculously fast, so being prepared and doing the drive safely means you’ll get to the hospital with plenty of time, reasonably calm, and ready for labor and birth.

Not everyone will use a car to get to the hospital for a variety of reasons. If you are in a non-car situation–maybe a city dweller that has no need for a car–planning ahead for the right way to get to the hospital is just as necessary. Many of the factors listed above (which door to use, weather, keeping calm) can be equally important to those not using a car to get to the hospital.

Next up in the series: Plan Ahead – Birth Plan

Field Guide to Being an Awesome Birth Partner

Everything you need to know to do a great job as a birth partner, without a lot of stuff you don't.

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