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.

Certain procedures historically associated with childbirth are being re-evaluated. Some have been found to be unnecessary, others unjustified. However, most of today`s obstetricians believe that they can guarantee that childbirth is a safer and happier experience for a mother and her baby with the help of modern technology.

By drawing your attention to the arguments con­cerning some standard medical practices, this will help you to question them assertively with your medical and nursing attendants. More often than not, your wishes will be complied with, especially if you have written a birth plan in advance, but occasionally you will be told that to continue with a particular option will put you or your baby at serious risk — for instance, if your baby is showing signs of distress and you fight to continue with a totally natural childbirth. Be prepared to adapt your ideas.

Shaving

Nowadays, shaving is unnecessary unless you are having a Caesarean section. Any chance of infection can be eliminated by wiping the vulva with gauze and simply spraying with an antiseptic.

Nil by mouth

Many modern obstetric units have aban­doned the old custom of nil by mouth but some hospitals may still practice it. There is no medical nor scientific rationale for starving a woman during labour. In fact, quite the opposite: the hard work of labour uses up much energy, which causes sweating, and a woman must replace the fluids that she has lost.

Before epidurals became commonplace for Caesarean sections, if a general anaesthetic became necessary it could not be given to a woman who had eaten recently as she might have inhaled vomit. But, even so, there is no reason why every woman should still suffer simply because a small number need surgical intervention.

Moving to a delivery room

In some hospitals a woman still has to undergo the physical and emotional upheaval of leaving the room in which she had so far laboured in order to have her baby in a delivery room. Ideally, labour should proceed smoothly in peaceful surroundings, and as long as a room is equipped with good lighting, oxygen in some form, and a suction apparatus to clear out the babys air passages, if necessary, I can see no reason why a woman in normal labour should be forced to move to a delivery room. Many progressive hospitals now have more congenial all-in-one labour and birthing rooms and, if possible, you should choose a hospital with these.

Induction

Starting off labour artificially is not a new idea, but it only became an easy procedure in the latter half of the twentieth century. Labour is usually induced for medical reasons such as pre-eclampsia, high blood pressure or post-maturity, when induction can save the lives of mothers and babies.

An induced labour may involve the use of a Syntocinon drip, which will restrict your movements. Such a labour can be shorter and sharper and probably will increase your need for heavy-duty painkillers.

Amniotomy

This is when the membranes (the bag of waters) surrounding the baby are artificially ruptured. It may be carried out in a high-tech birth, and if so, is usually done early in labour for three reasons. The first is so that electronic fetal monitoring equipment can be set in place; the second is to check if the amniotic fluid contains meconium (this is the baby’s first bowel movement and its presence may indicate fetal distress); the third is that once they are ruptured, the baby’s head can press down hard on the cervix, helping dilatation of the cervix and speeding up the first stage.