Monday, January 3, 2011

for your partner

Having now been on both sides of the coin during birth, I have a lot of respect and empathy for your support person.  Typically this will be your husband, mother, or close friend.  In all cases it is someone who loves you and wants the best for you, but is often unsure of how to best help. 

If your birth partner is desiring to be very involved in the birth of your child, have them read "The Birth Partner" by Penny Simkin.  I absolutely loved this book.

Here are some of my favorite parts of a guide created by Penny Simkin for training doulas.  It is also meant to be used by the birth partner. 

1.  Pre-Labor
  • The cervix will ripen, efface, and move forward.  May experience non-progressing contractions
  • Mother may feel tired, discouraged, anxious.  May overestimate progress or focus too much on contractions.
  • You might distract her, if possible.  Alternate with restful activities.  Try some natural labor stimulating measures.  Encourage food and drink, there is a long road ahead.  Stay with her.
2.  Latent Phase
  • The cervix continues ripening, effacing, begins dilating.  Progressing contractions, some bloddy show, rupture of membranes. 
  • She may feel excited, confident, optimistic, or anxious and distressed.
  • You might ask what she thinks about during the contractions, suggest more positive thoughts, give her feedback and not false praise.  Try a few relaxation techniques, focus your attention on her, and remind her to drink, pee, and change positions regularly.
3.  Active Phase
  • The cervix dilates from 4 to 8 or 9 cm.  The head of your baby will rotate into the best birthing position.
  • She may feel she has reached "the moment of truth".  She may feel trapped, or realize that labor is not within her control.  She may become quiet and go inward, resenting interruptions.
  • You should speak quietly and positively, and remind her of her progress.  Follow her lead; if she is quiet, be quiet.  Help with different comfort measures and changing positions, bathroom, and fluids.  Help her to follow her original preferences regarding pain medications.
4.  Transition
  • The cervix dilates the last two centimeters, and the baby begins to descend.  Contractions will be close and the intensity will be at its height.
  • She may feel lost in the intensity of it.  She may tremble, need guidance and reassurance, and vocalize or find a soothing rhythmic physical movement.
  • You may need to take charge if she seems to loose it; remind her how strong she is, how far she has come, and how close she is to the end.  Hold her, do not rub her, and acknowledge her pain.
5.  Possibly a Resting Phase
  • The uterus may "catch up" with the baby, whose head is now out of the uterus and in the birth canal.  There may be little or no observable activity.  Care giver may relax, or worry and start calling for pushing or pitocin.
  • She may feel relief at the break, confidence, and optimism.   She may feel renewed, more aware of her surroundings, and possibly a desire to get on with it.
  • You should help her change positions, and remind her of the importance to release pelvic tension.
6.  The Descent
  • The baby rotates and descends.  The head will rock back and forth between bearing down efforts. 
  • She will push with contractions or on demand if she is on pain medication.  She may feel inadequate, need reminders of what to do, or feel alarmed at the feeling of her baby's head.
  • Be positive, report on progress.  Help her achieve effective pushing.  Remind her to release tension in her perineum, and suggest changing positions to speed progress.
7.  Crowning and Birth
  • Baby's head no longer rocks back and forth, it emerges.  Perineum is most vulnerable to tearing.
  • She may feel a "rim of fire", a stretching or burning.  She may avoid pushing by panting.
  • Don't rush her, let her do what she needs to.  If the caregiver is directing her efforts, stay close to her and support her position.
I love this list.  I have simplified it for your partner; Penny's is a bit more detailed and useful.  But this is something, and I hope it helps.  It is important for you both to feel confident and prepared as you welcome your child into the world.  Probably my favorite thing about being a doula is witnessing the process of change between a couple as they work together to bring their baby into the world.  It humbles and amazes me.  There is nothing more incredible than witnessing the birth of a family.


  1. I love the list...I am going to have Joe review it. A great reminder...thanks!

  2. I'm glad! Hows your pregnancy coming along? Are you feeling alright? Of course the one thing about labor you can count on is it's unpredictability ... we're all individuals, and it's a different experience for everyone. I'm excited to hear how yours goes! Perhaps you could send me a copy of it and I could put it on here ... only if you want. :)