It's a Guy Thing
As you might expect from a man who later wrote several books on fatherhood, Armin Brott did a lot of things right as he supported his then-wife through the births of their two children. Except for one blunder: He used the C-word.
When the going got tough during the second birth, Brott suggested -- apparently too indelicately -- a cesarean section.
"She had been in labor for 20 hours, plus 16 hours the week before," recalls Brott, who also has a syndicated radio show called "Positive Parenting" in San Francisco. "I thought, God, this is enough already -- who the hell wants to go through this?"
Well, she did, he quickly realized. Two words said it all. "She said 'f--- you,' frankly," says Brott, sheepishly.
That big day is sure to stretch limits -- and not just for the one pushing the baby out. The dad-to-be has lots of pressure, too. But even with the dubious distinction as "The Coach," how can he possibly have all the answers?
"Here's a person who's never had a menstrual cramp, and we're asking him to empathize with somebody who's in freakin' labor," says Susanrachel Condon, a certified nurse midwife, doula and massage therapist in New York City. "It puts a big burden on him."
Nor is it easy straddling the game and sidelines at the same time. "They're going through their own emotional process in the labor, too," says Erica Lyon, a childbirth educator and president of the Childbirth Education Association of Metro New York.
The best game plan? Drop the sports metaphor, for starters.
"It's not about coaching," Condon says. "Women don't need a coach. They know how to give birth. They need support. Labor should be like lovemaking. Hold her. Touch her. Acknowledge her. Let it be intimate. Light the candles. Put on the music. Give her something sensual to eat. Be her lover, not her coach."
Top 5 Ways To Be A Supportive Partner During Labor
No. 1: Be prepared. It's easy to feel scared and helpless, especially if you've never been through it before. But the more you understand about the birth process and what's normal, the more comfortable you'll be.
"Having a basic understanding of what's going to happen with her -- and a basic understanding of how they can help -- makes partners feel a little more in control in a very out-of-control situation," Lyon says.
That means getting a childbirth education class under your belt and reading some childbirth books. There's a slew of them written especially for dads, including "The Birth Partner," by Penny Simkin and "The Expectant Father," by Brott.
That goes for the mom-to-be, too.
"I would encourage women to educate themselves enough about the normal labor process and all their choices, and put the support they need in place, so that they're not venting on their partner during labor," Lyon says. "Women tend to go off on their partner when they're frightened, scared or don't trust the people around them."
Make sure you've shared your feelings and expectations about the birth with your wife ahead of time, not only so that you can anticipate her needs but can talk through any potential differences, like attitudes toward pain management.
Bone up on all the potential detours. Brott recalls his unsettled feelings when his first child had to be delivered by an emergency C-section. They sent him out of the room abruptly so they could prep his wife and give him a chance to get into some scrubs.
"It was disturbing because I wanted to be there to help and because I was completely out of the loop and had no idea what was going on," Brott says. "Ask the doctor: What's going to happen? Where will I be? What's my role going to be? Will you throw me out?"
No. 2: Offer a variety of comfort measures. Doing something concrete will help you feel more useful and connected to what's going on. You might offer her drinks (or snacks, depending on the facility), put on some music, give her a massage or suggest a different labor position or hot bath.
Before Condon gave birth, for example, she and her husband, Richard, had discussed certain poetry she might find relaxing. So as she soaked in a warm bath to relieve the pressure from contractions, Richard didn't need any cues and began reading Walt Whitman to her.
"I didn't need to wonder what to do, or even what to read," he says. "It'll make the partner feel a lot more apt if he has some concrete things to do."
No. 3: Don't assume you need to "fix" anything. "There's this whole guy thing," Brott says. "We want to be in control of everything, and when we see the woman we love in pain, we want to do something about it. But we can't, really ... and laboring women are far more hardy and macho than we think."
The best kind of support isn't offering solutions; it's listening. Avoid the urge to play the role of expert and hound her about those breathing techniques you practiced -- and definitely don't stare at the monitor and hail each coming contraction. She knows.
"If she says it hurts, say 'I hear you,'" Condon says. "You don't have to fix it. Nothing's broken. What a woman needs to hear when the chips are down is, 'I'm here with you, I honor what you're doing, I think you're amazing, I love you and I'm not leaving.'"
Many childbirth experts suggest that couples consider hiring a doula, especially if it's the couple's first birth, so that the partner isn't thrust into a role he can't handle. Doulas gauge each couple's situation and offer educational and emotional support as needed.
No. 4: Be her chief advocate. You may not know what labor is like, but you probably know your partner better than anyone else in the room. So you're the heir apparent she needs to bat for her if she can't do it for herself.
"Support her no matter what she wants," Lyon says. "If she's saying, 'I really feel like I need to push, I have to push, I feel this overwhelming sense to push,' and somebody's saying, 'It's not time yet,' that might be a good time to say, 'You know, my wife is really saying she has to push.'"
Don't be afraid to ask questions or make requests that go beyond apparent hospital policies, and don't blindly accept the care being offered.
"We go in thinking that doctors are gods or that hospitals are these big immovable institutions, and that's the way they like to behave, but that doesn't have to be that way," Brott says.
"He was kind of nit-picky and was told over and over again by the nurse that he had no business looking at the medications they were giving her or touching the IV, and every time he did. Sure enough, he saved her from some sort of serious reaction," Brott says.
Lyon suggests that partners try to maintain a private and respectful atmosphere. Keep the door or curtains closed and solicit introductions from new nurses or doctors who enter the room. "Birth is very private and intimate," she says. Likewise, don't talk over your wife as if she were a plant in the room, she says.
Another word of caution: Don't overdo the Hollywood producer role. Put the video camera on a tripod and use a remote control to start and stop the film. Or stick with a few discreet snapshots.
"I would caution against spending too much time behind the camera," Brott says. "It can become the focus of your attention, and then you're six feet away filming when you really ought to be holding her hand."
No. 5: Don't take things personally. No matter how much your partner ignores you or acts like she doesn't want you around, it's not your cue to catch a baseball game in the local sports bar. Chances are, she really does want you with her.
The wife of one of Brott's friends sat with her eyes closed for a whole 12 hours of labor. The husband could tell from her white knuckles that she was in pain, and he tried to engage her in conversation, but she wasn't interested. He eventually gave up, but stayed with her.
"The way she wanted to deal with it was to completely withdraw, but it was important to her that he was in the room reading or something just in case she changed her mind," Brott says.
"Oftentimes, just maintaining a calm, loving presence is all she needs, and that might be just sitting, holding her hand, and every couple of minutes just whispering, 'You're doing so good. I'm proud of you,'" explains Lyon.
The Doula Difference
When Claudia Bermudez had her second child nine months ago, she decided to hire a doula, someone who would help mother her during the birth. Her own mother was dead, and having a nurturing woman at her side gave her extra strength, confidence and calm.
"When the going got tough and I became scared, I could look in her eyes and she held my hand so tight that I didn't feel alone," says Bermudez, of Lincoln, Mass. "My husband was there and could offer his love, but for me there was something about the female support that was crucial. She was a mother. She had actually birthed children."
A growing number of women like Bermudez are finding that a professional doula (which is the Greek word for "woman caregiver") can be a valuable source of support. Not that they take the place of a partner, doctor or midwife -- they just fill in the gaps, providing continuous support from early labor until after the birth.
Besides making a woman feel more relaxed and confident, doulas can actually help make the labor progress easier and faster. Studies have indicated that the use of doulas can result in labors that are 25 percent shorter. Also, requests for epidurals drop by 60 percent, and women are half as likely to undergo a Caesarean section.
"Mothers who labor alone or don't have a doula may have a great deal of anxiety, which produces substances like epinephrine and neurepinephrine," says Dr. John Kennell, a leading researcher on doulas and professor of pediatrics at Case Western Reserve University in Cleveland. "When levels are high, labor contractions become much less efficient or may even stop."
What each couple needs or wants from a doula will vary.
The doula might be running for ice chips and heat packs so that the partner can stay close by. She might be offering encouragement or explanations about the birth process as questions arise. Or she might be giving a massage to help ease labor pains -- and, yes, even a quick rub for your partner when hours of exhaustion set in.
"I always recommend to partners that they consider having extra support people there like a doula, particularly if they're first-time dads, because oftentimes they're not quite sure what's supposed to happen," says Lyon. "A doula can give him little suggestions and help him feel more effective in what he can do to help."
Women might need the extra emotional support, too, Lyon says. "Sometimes the partner will have a hard time seeing her in pain, or just isn't going to come through for her emotionally, and women tend to know if this is the case in their relationship. Then the doula helps her."
Ideally, couples should hire a doula during the second trimester so that they can meet at least once or twice to get to know each other and the type of birth they're envisioning. When the woman goes into labor, the doula goes to the house and helps support the couple until it's time to go to the hospital, then accompanies them there.
The cost, which is sometimes, but not typically, covered by insurance, can range anywhere from $400 to $1,200, says Condon. Some doulas charge by an hourly or flat rate, others on a sliding scale. Condon's group has a flat rate of $900 for up to 12 hours, then $30 an hour afterward. The fee includes prenatal and postpartum visits, and phone calls are free.
To find a certified doula in your area, several groups provide referrals, including Doulas of North America, (206) 324-5440; the International Childbirth Education Association, (612) 854-8660; or the National Association of Postpartum Care Services, (800) 45-DOULA.©1996-2005 WebMD Inc. All rights reserved.