UNDERSTANDING YOUR ROLE

Like many partners, you may be nervous or worry about feeling squeamish, or being inadequate at offering sufficient support. You can help combat this by prepar­ing yourself in advance. It s important that you know as much as possible so that you can effectively help the mother meet the physical and emotional demands of labour. At the antenatal classes there will be demonstra­tions to describe the onset of labour and the effect of contractions, and you will be taught techniques for helping her relax.

If it’s going to be a hospital birth, visit the labour and delivery rooms with her and introduce yourself to her hospital attendants so you wont feel like an outside when the time comes. If the birth is to be at home, find out what will be expected of you.

HOW TO HELP DURING LABOUR

You may have a very active role throughout the labour and birth, but sometimes your presence is all the mother needs. Make sure you are familiar with her birth plan and any alternative version. You need to be aware of her wishes in order to speak on her behalf during labour if necessary.

Use your intuition

You need to judge the situation, observing your partner’s moods and fitting in. Alternatively, she may need a great deal of verbal or physical encour­agement, or to be distracted by music or talking.

Provide emotional support

Stay as intimate as possible using loving words, and keep your movements slow, quiet and steady. Always be positive: offer praise, never criticism. If she wants to hear your voice, constantly tell her how well she is doing (how far dilated), suggest how she can relax herself, tell her what other people such as the midwife are doing to help her, and what will soon happen.

Also, help her to see how much she has achieved already – its easy for her to be overwhelmed by how far she thinks she has to go. Massage and stroke her slowly, but if she just wants to hold your hand, you can offer encouragement by using facial expressions and lots of eye contact.

Combat fatigue

Before labour, remind her to rest as much as possible, particularly if she seems to spend a lot of energy cleaning during the “nesting” period. If she has a long, tiring labour, try to help her relax between contractions to conserve her energy for the second stage. If she’s not feeling nauseous, provide her with as much refreshment as she wants (see also p. 32). She will probably find that having her face wiped is very soothing.

Help her cope with pain

It’s hard to see someone you care about in pain, but try not to reveal your anxiety because she may become discouraged. On the other hand, don’t discredit her suffering. Don’t let her feel embarrassed about expressing her discomfort – encourage her to be as uninhibited as possible. Try not to be upset if she becomes critical or aggressive – this often happens when the pain is very intense.

Assist with breathing

You will probably have practiced this during antenatal classes, but allow her to follow her own rhythm. If she seems to lose control, slowly guide her through the pattern until she can carry on alone. Be prepared to adapt – very few people follow exactly what they practiced at antenatal classes.

However anxious and overwhelmed you are, you must stay calm and reassure her – she needs to feel confident and relaxed. Encourage her to take up any positions in which she feels most comfortable and to eat and drink if she feels like it. Speak quietly and keep any onlookers at bay.

Between contractions

Turn up the heating in the room if at all possible. Wash your hands thoroughly in soap and water, and then fetch several clean bath towels and place them conveniently to hand. Fold one and put it on the bed or floor so that you have something soft on which the baby can be laid.

Then fill several bowls with hand-warm water, and collect as many clean hand towels, face flannels or tea-towels as you have; immerse these in the water and use as wipes for mother and baby during and after delivery.

The birth

Your partner will know when the baby is coming because she will feel a stinging or burning sensation as the baby stretches her vagina. After washing your hands thoroughly again, look to see if you can see the top of the baby’s head in the vaginal outlet. Remind your partner to pant or blow, so that her vagina and perineum have time to thin and stretch, which may enable her to avoid tearing.

The baby’s head will probably be born in one contraction and the rest of his body in the contraction afterwards. When the head is born, wipe each of the baby’s eyes from inside to outside with separate pieces of moist linen, and then feel round his neck to see if the cord is present. If it is, crook your little finger underneath it and pull it very gently over the head, or lift it so that the body can be born through the loop.

Do not cut the cord because it may go into a spasm and deprive your baby of oxygen. If the membranes (called the caul) are still present over the baby’s face, you must gently tear this off so that the baby can breathe.

Delivery of the Placenta

If the placenta is delivered before an attendant arrives:

Never pull on the cord or cut the cord.

After the placenta comes out, massage the mother’s abdomen firmly, with a deep circular motion, gently pushing downwards 5-7cm (2-3in) below the navel. This is important to make sure the uterus contracts and stays hard after the birth without hemorrhaging.

Its normal for a couple of cups of blood to be delivered when the placenta comes out.

Getting the mother to nurse her baby immediately will help contract the uterus and minimize blood loss.

AFTER THE BIRTH

Be careful to hold the baby firmly as he is born, because he will be slippery with blood, mucus and a waxy substance called vernix caseosa. Once he is born, he will probably give a couple of gasps, a cry, and then start to cry properly If he doesn’t cry immediately, place him across your partner’s thigh or abdomen, with his head lower than his feet, and then gently rub his back. This helps any mucus drain away and usually causes a change in blood pressure, which will bring about his first breath. Talk to him lovingly.