Category: Hospital Birth

What Partners Can do at Birth

Posted by on in Birth, Birth Prep, Birth Support, Comfort, Education, Hospital Birth, Partners, Prenatal Classes

One of the most common things I hear from partners who consult with me after their first birth is, “I felt so useless.” Most partners or parents to be want to be helpful in labour but feel unsure of what to do. Read on for some good tips.

Read more: What Partners Can do at Birth

Be present

  • Never underestimate the importance of just being close and present, even if you don’t know what else to do.
  • Breathe. 
  • Pay attention to your partner’s immediate needs and wishes, which may change as labour progresses. She may want you to be close or give her space, touch her or not, offer encouragement or silent support.

Speak up!

  • Push the pause button and ask questions if interventions come up. 
  • Ask for time to make decisions. 
  • If the laboring woman wants something changed , then say so. e.g. If the nurse is doing cheerleading / coached pushing when your partner wants quiet support instead. 
  • Prompt staff of birth wishes. e.g. Just before the baby’s born, remind them how long to do delayed cord clamping if that’s part of your birth plan.
  • Remind staff of birth preferences if it seems they haven’t read the birth plan.

Reminder of strength, plan, options

It’s normal for people in labor to feel like they can’t do it or they can’t go on. Remind your partner they are strong and well prepared. 

  • Phrases such as “I love you”, “you are beautiful”, and “you are strong” can bring strength. 
  • If things start to stray from the birth plan then it’s okay to talk about that with your partner and or the staff. 
  • Have conversations as a group to learn what your options are.

Physical support

  • Help with lifting and moving into different birthing positions, walking to the washroom.
  • Walk together while your partner is pacing.
  • Stay close while she’s sitting on the birth ball and make sure it doesn’t roll away when she stands up. 
  • Offer water or electrolytes or snacks. 
  • Take care of your own bio needs along the way so you can be a strong support.

Trust

  • Before you’re in labor together, learn what you need to learn to trust the birthing process.
  • Trust your partner when they ask for something; trust their body will know what to do. 
  • Have conversations with your care providers to build trust with them as well. 

Understand

  • Laboring women are not meant to be in their thinking brain.
  • You will be more likely to advocate if you understand why birth preferences are important. 
  • Understand your options and how to make decisions.
  • Before labour starts, learn things like timing contractions, when to go to birthplace or call midwives.

Comfort measures & tools

  • Learn how to do comfort measures well before labor begins. This includes things like touch, massage, hip squeezes, running the bath, hooking up the TENS machine. 
  • You’ll need to know several tricks and tools because needs change at different stages of labor.
  • Consider working with a doula. Research shows couples with a doula in their birth room share significantly more touch and eye contact!

My prenatal classes include many more tips for what partners can do to support themselves and their laboring partner through birth. We also cover things couples can do and discuss prenatally so they’ll be well equipped during labour and birth, through the first 8 weeks postpartum.

Choices in Planned Caesarean Births

Posted by on in Birth, Birth Prep, Birth Support, Caesarean, Hospital Birth

One of the benefits of a planned caesarean is that there’s time to consider options, ask questions and make choices beforehand. 

Many hospitals are willing to take extra steps to make a caesarean birth more gentle and family friendly. The following is a list of practises that are being requested as part of a “Gentle Caesarean”. Yes I’m aware that the very nature of a caesarean and the postpartum recovery do not seem gentle to most people. However I appreciate that there are medical staff working hard to make the experience as positive, healthy and family-friendly as possible.  

  • Watching your baby being born. Clear surgical drapes, surgical drapes with a panel that can be lowered to reveal a clear panel, or having the drapes lowered entirely.
  • Cord cutting. Most hospitals don’t allow anyone other than staff to cut the cord in the surgical field. But they can leave a longer cord and have the partner trim it – like a ceremonial cutting of the cord – at the baby warmer.
  • Skin-to-skin contact with the birthing parent, from the chest up.
  • Maternal heart monitors on their side or back, leaving the chest available for holding baby skin-to-skin.
  • Music of your choice – played on the sound system or your headphones.
  • Support through the entire procedure, from the moment of entering the O.R. until heading to the recovery room. Most hospitals allow one support person in the O.R. and recovery room. Some allow doulas to come in as well. 
  • Healthy baby stays with the parent(s); family stays together in O.R. and recovery room. (In some hospitals, healthy babies born by caesarean are automatically taken to NICU or a medical nursery for observation. This has to stop! In that case, the non-birthing parent, partner or companion can accompany baby.)
  • Photos / videos – always bring your device. There’s often a nurse who is waiting for the baby to be born and will take some photos of the birth, the first time parents hold the baby, etc. There are many beautiful moments to celebrate at any birth, including caesareans.
  • Flora for the baby – vaginal seeding. You might ask for a GBS test a week before the surgery before going ahead with this. Note that this is still new enough that most medical staff will not participate. Plan to DIY.
  • Any cultural / spiritual aspects you might wish to include. I’ve seen an obstetrician lead a prayer before starting the surgery and have joined the surgical team in singing happy birthday to a newborn. Some people bring in a little card or symbol or small talisman.
  • Obstetrician of your choice. Certainly a perk of scheduling your birth. 
  • Volume of monitoring machines – ask for the volume to be turned up or down if it’s reassuring for you, or not, to hear things like fetal heartbeat, maternal heart beat. 
  • Delayed cord clamping – up to 1 min is considered safe with caesareans. (I’ve heard of a hospital that keeps the placenta and baby attached after the placenta is removed – definitely not standard of care in most places. Never hurts to ask.)

In some facilities the things on this list may already be standard care. In others, requesting these things will provide an opportunity for staff to gain a new perspective. Patient safety is the primary concern. Some of these practices may be considered safe or not, possible or not, depending on patient health, the facility and/or the staff working in the O.R.

Speak with your doctor well ahead of time about the things that interest you from this list. 

If you get a sea of “no ways,” then ask why not. There could be valid reasons or it could be one unbending person. If it’s the latter then you might wish to explore working with another doctor or giving birth in a different facility, if that’s an option. 

Need help to make a birth plan that builds bridges instead of walls?

I can help you sort through your options and find the best wording. Check out my Birth Plan Prep Consultations which are available in person or on Zoom.

Angie The Doula – Guide on When To Go To The Hospital

Posted by on in Birth, Birth Prep, Birth Support, Hospital Birth, Labour

If you’re planning a hospital birth then you have to figure out when to go. This guide will help you make that important decision.

Most people don’t know that the majority of naturally-starting labours is usually done at home. Some people want to get to the hospital later in the birth process. They know the longer they’re in the hospital, the more likely they are to have interventions as part of their birth. They may simply enjoy being at home for longer. 

One of the benefits of working with a doula is that we help clients decide when to go. We will remind you that you won’t be officially admitted if you aren’t “far enough along” in labour. Most first time birthers without professional guidance go far too early, often by many hours. This leads to the disappointment of being sent back home. 

Please note that this is a general guide. At your prenatal appointments, ask your medical care provider if there are any specific recommendations for when you should go in. Some pre-existing conditions or medical issues lead to different recommendations from those below.

Photo by Paula O. Licensed under Attribution 2.0 Generic (CC BY 2.0)

When to go to hospital

Unless you’ve been told otherwise by HCP…

  • Pattern of contractions or sensations (explained below): 311 for a first birth or 411 for subsequent births; even sooner if you have a history of fast birthing. Hot tip: If you feel like eating, then it’s likely too early, based on labour pattern alone.
  • Lots of pressure down low. If contractions end with a grunt or feelings of needing to poop, then get going! 
  • Any signs of labour before 37 weeks.
  • Any health concerns (some “warning signs” are below).
  • Decreased fetal movement that isn’t remedied within an hour or two by eating and resting. This is not a 911 call but it does mean to go presently. Do not sleep on this.
  • When waters release? Maybe, maybe not.
  • If there’s a colour (yellow, brown, green) or foul odour when waters release.
  • Want pharmaceutical help coping with pain.
  • Feel safer at the hospital or want reassurance about your own or baby’s health. You will likely be sent home if all is well and you are not in ‘active labour’ but that’s OK. Consider it a trial-run and some good news that everyone is medically stable.

Before heading in:

  • Have some juice or snack (unless you’ve been instructed to not eat e.g. schedule c/s).
  • Pee before heading out the door.
  • Bring:
    • Health Card
    • Envelope with your prenatal records & birth-plan
    • Any prescription medications
    • Bonus: lip-balm and a hair-tie
  • Be ready to answer these 3 questions:

1.    What’s the labour pattern (just show an app if you’re using one)?

2.    Have waters released? If so was there a colour? 

3.    Is the baby moving normally?

Warning Signs

This is a partial list. Warning signs are covered in detail in prenatal classes and health region documents.

Seek medical attention (do not sleep on these signs or wait in hopes that they pass):

  • Decreased fetal movement
  • Visual disturbances
  • Sudden and severe headache
  • Pain in upper abdomen that doesn’t pass
  • Maternal fever

911 call:

  • Red, flowing bleeding or clots
  • Sudden, severe / intense / sharp pain that brings you to your knees and doesn’t pass
  • Cord prolapse when waters release

A note about “being sent home”: It’s OK. Perhaps it’s inconvenient but it can be reassuring to get checked out, be found healthy, and then be sent home. I’ve met a lot of nice staff at various hospitals who will tell you it’s better to come in for nothing than to miss a problem.  

Note about the contraction pattern: 

  • 311 means 3 minutes between the start of one contraction and the start of the next; 1 minute from start to end of the contraction; at least 1 hour of that pattern consistently. (411 is the same except 4 min between contractions.) 
  • Use 411 as your guide if you wish to get there soon into active labour, and likely stay but maybe sent home . 
  • Use 311 as your guide if you want to be more certain of being admitted and have no need or desire to go earlier in the process

I teach a variety of Child Birth Education classes and prenatal workshops online for people all over.  I have been a birth doula since 2002, and have helped over 300 clients with their births and over 1000 through prenatal classes. Learn more about my birth doula services, and contact me with any questions you may have.