29 Jun Should your partner coach your birth? (part 1)
I remember the months before my first baby was born, when one of my biggest questions about labor was, “Where does everybody STAND?”. I couldn’t quite picture the logistics of my husband, my doula, the midwife and their jobs for 24+ hours. Who assumed which roles? What would everyone be DOING?
I see this sentiment echoed in my classes, too. In our culture, we have locked birth away in a secret building. It is RARE that a person enters my Childbirth Education classes having already witnessed a birth. We just don’t know what it looks like. We don’t know where anyone stands.
This is most obvious when the biggest question from my pregnant clients is, “What IS my partner’s role during my labor?”.
Partners, too, when asked what they want to get out of the class, will say, “I want to know how best to support her.”
Since the recent re-introduction of partners into the labor room (1960s/70s), a partner’s presence at childbirth in the West has undergone a constant shift. We’ve been struggling since then to really figure out how a partner can be integrated into the birth process.
Between the portrayals in media, the changes from the last generation and this and the stories they hear from friends, many couples don’t know exactly WHAT the partner’s job really is.
I think it’s most useful to start, though, by telling you what partners are NOT responsible for.
A Partner is NOT a bystander
Gone are the days of pacing in the waiting-room or self-medicating down the street at the bar while the mother labors. No longer are partners relegated to wait outside the locked labor-floor doors while the experts care for his wife.
He/she is now expected to be present and helpful through the birth process. The partner often attends prenatal medical appointments, takes a childbirth class with the mother and helps her get through the ordeal of labor. The partner is now heavily involved.
There are only a couple times in the process of birth that the partner is separated from the mother (maybe briefly during triage, again during an epidural placement and for a short time if the baby is born by Cesarean).
Sometimes, for cultural or religious reasons, a partner prefers to take a less active role through the process. Sometimes the partner has his or her own difficulties in medical settings. In these circumstances, partners and mothers MUST be on the same page ahead of time. A clear understanding of limitations can pre-empt problems on game day. It is also imperative that everyone has their own needs met, so they can plan for extra support people to fill in any gaps of care.
A Partner is NOT the Bouncer
Depending on what stories they have heard about birth, some couples go into labor with their guns blazing. They are ready to fight to minimize intervention or pushy staff.
Often, the role falls to the partners to stand as protector or advocate during the labor.
I see this play out poorly. If a couple is this concerned about having to battle during labor, it is a giant blinking alarm that an aspect of their plan should change. Perhaps they are not working with the appropriate doctor or midwife and should seek out other options. Perhaps they could have a frank conversation with their care provider about these worries.
Assuming the role of “Bouncer of Birth” places a partner in an unfair position. How does a partner know when an intervention is truly helpful vs. fitting in with the horror-stories of overuse? What if they refuse an intervention that could help the process along? What if they bring strife into the labor room?
A Partner is NOT the Doctor
(for that matter, neither is the mother)
Some parents have the idea that, in order to prepare for birth, they must learn everything there is to know about birth. They take several classes. They read all the books. They Google furiously. They have more than one Pinterest board dedicated to birth. They become mini-Obstetricians.
This can be a trap. For one thing, it is impossible to learn everything there is to know about birth. You WILL be surprised by something.
But also, every birth is unique. Even the vast expertise of a doctor or midwife doesn’t guarantee outcomes. The suggestions that work beautifully for one labor may be problematic in the next. Sometimes an epidural speeds labor up. Sometimes it slows it down.
Of course, knowledge is not a bad thing. (Or I wouldn’t be writing!) However, it is crucial to grapple with the motivation behind the obsession for more of it. Does it feel like control to know enough? Is it an avoidance tactic? Does it bandage the stress of facing the unknown?
I will let partners off the hook on this one: Let the doctor be the doctor (or the midwife be the midwife). Hire a provider you trust, and let them be the expert. Meanwhile, carefully walk that fine-line between obsession and curiosity.
A Partner is NOT the Doula
Sometimes I see partners carrying around “The Birth Partner” book by Penny Simkin in a loving attempt to learn all there is to know about birth. But even I, as a doula with a decade of experience, could not tell you all the things in that tome. It’s a great reference. However, it sure is a lot of pressure to place on ones self to have that entire book memorized.
There is definitely some overlap between the role of a partner and the role of a doula. They are both there to support and care for the laboring woman in a non-medical capacity.
Again, though, the doula knows and understands birth in an experiential way. Her understanding of the birth process can help reassure the mother and partner during their experience. She can also provide suggestions for pain-coping and progress. She knows about birth as a general thing.
The partner needs only be present for THIS birth and THIS woman.
Ideally, a doula is there to support both the mother and the partner as they navigate their unique experience while also remaining anchored in their very specific roles.
Finally, a Partner is NOT a Coach
This pervasive image of Partner-as-Birth-Coach is completely understandable. Modern media perpetuates the idea, for sure. There are so many cliché’d storylines in which the inept partner steps up and instructs the flailing woman how to give birth. Puh-leeease, friends. While those moments can happen, they aren’t the norm.
But beyond modern media’s influence, our recent history has also assigned this task to partners.
When fathers were first being brought into the labor room to help the mother through her labor, a pressure mounted to make him feel useful. This was fertile ground for Childbirth Education models that did just that.
The Bradley Method of Husband-Coached Natural Childbirth has been wildly popular since its beginning in the 60s. Preparing the couple to work together and training the father to be coach has helped thousands of couples get through labor.
This time also saw the rise of the Lamaze Technique, also known as psychoprophylaxis. (Basically, pain control through practiced breathing and relaxation). Again, the partner learned ways to keep her focused on the techniques during labor.
In both of these approaches, as well as numerous others, the partner becomes the coach of the technique. He is trained through the childbirth class to reinforce the method during labor. He is armed with scripts and hand-outs. They may practice at home. The impetus is to get it right.
Even today when people first come to my class, this is what they expect. They want to know what to DO at each point of labor. They expect to be taught how to count through contractions or walk her through visualizations or what kind of breathing to employ at each point.
This is highly technical. Birth is rarely linear, so it is challenging to know exactly what to suggest at each point in the process. And again, it’s so much pressure for partners.
Imagine the relief they feel when I tell them that this is NOT their job. Partners do not have to coach her through one of the most intense experiences of their lives.
It can be a set-up for disappointment and frustration to expect otherwise.
The vast (VAST) majority of partners have never attended a birth. They walk in with ideas and some education, but there is no hands-on experience. And we expect him/her to know exactly what to do and how to help the mother through it!?
This is already far beyond reasonability, but it is compounded because of the emotional intensity of the experience for partners. They are also going through this labor from their own perspective. They are becoming parents. They are passengers on the ride of birth, as well.
To expect partners to coach their lady through birth is like expecting a Marathon runner to direct his running-mates instead of focusing on his own pace. This may work if the runner has already had a few races behind them- they may bark out some ideas. However, if both runners are new to the experience, it is a ridiculous model. Yes, they can encourage each other. But it is beyond the scope of reality to demand more.
I see the shoulders and the furrowed brows relax as I explain this in class.
I will speak directly: Partners, you don’t have to coach her through labor. In fact, assuming the role of “coach” can be disruptive to the hormones necessary for the progress of birth (with a crucial exception). It creates a dynamic between the mother and her partner in which she is depending on him/her to know everything and be everything. This is an IMPOSSIBLE task.
However, partners have a much more important job.
To more effectively support her in birth, partners must take on two other, primary roles.
Read the next post in this series to learn more!