Wednesday, 26 September 2012

Being a birth partner

"If a woman doesn't look like a goddess during labor, someone isn't treating her right"
Ina May Gaskin

As a doula, it is my job to support women on a practical and emotional level, through pregnancy, birth and the postnatal period. It is a task that I often share with the partner, family and/or friends of the mum-to-be, so inevitably it is also my job to support them, and to help them to be as much help to her as they can be. In fact I would much rather do this, then step back and allow the closer family unit to provide the more direct support. So lets assume you are one such birth partner.

Your friend, daughter, sister or other asks you to be the person to support them in their labour. How exciting! Also, daunting, and scary and "oh crikey, what am I supposed to be doing?" So here are my top tips for being a top birth partner.

1) Prepare with her.

I realised fairly on in my doulaing, that it is a very zen profession, it's about being, rather than doing. One of the things that brought me to this realisation, was a client telling me how simply confirming that I was to attend her birth, made her feel better about it. When approaching labour myself for the second time, I understood why; knowing who is going to be with you when you are in labour allows you to more clearly visualise how it will happen, putting faces on the people who will be with you really helps, and knowing that they are people you can trust takes away a lot of the worry.

So once you have agreed to be with a woman, you need to reassure her that you can be depended upon and trusted, you need to keep building the relationship which you presumably already have (that's why she asked you) and help her to build that strong, positive picture of a peaceful birth surrounded by people who love her.

2) Know her plan.

Preparation also has a very practical side. Every woman has different preferences about how they want to bring their child into the world. Talk through her birth plan so you know what to expect. Who is going to be there? What pain relief does she plan to use (and is there anything you need to do to aid this, e.g. learn how to place the electrodes for her TENS machine)? What kind of atmosphere does she want in her birth space?How does she feel about medical intervention? Does she want the ergometrine injection to deliver the placenta, or would she rather wait for it to come naturally?

You should be able to arrive for the birth fully prepared to support her in her choices. You won't be able to speak for her, but you can remind her* (or the medical team) of the detail in her birth plan when necessary.

[*It should be noted that when I say to remind her of her birth plan, I don't mean crossing your arms and tutting and saying "you said you didn't want an epidural"; more along the lines of "you said you wanted to try using a TENS machine, do you feel that might help now". because I completely forgot I had a TENS in my second labour.]

3) Be available.

The natural length of pregnancy is 37-43 weeks. The baby will usually arrive when it is ready, and the estimated due date given by the midwife is only a vague guess (only 4% of  babies arrive on their due dates). Therefore you need to be ready to be at her side, within good time, for that whole period, or at least for 2 weeks either side of the due date. This may mean making sure your work can be flexible, putting off any trips  too far afield and keeping a packed bag by the door so you can be out with as little fuss as possible.

Some births start very quickly with little warning, so it is best if you can always be able to get to her within an hour or so. Even if the labour isn't very fast, an hour can be a long time for a labouring woman to be alone, the less time it takes to get to her, the better, she will appreciate knowing you will be right there when she calls. Keep your phone on at all times, and let her know if you have to be out of signal range, or switched off for any period of time, so she doesn't panic if she can't get through.

4) Be present.

When I say "be present" I am not talking about being physically there, we just did that. You need to be focussed on being with her. Switch your phone off (or put it to one side on silent if you need to periodically check it) and engage with her needs. This may mean spending time with her, talking to her, rubbing her back etc, or it may mean taking a step back and concentrating on maintaining a peaceful space for her. Whatever you are actually doing, you need to completely commit to supporting the birthing mother, wholeheartedly.

5) Leave yourself at the door.

The birth space is sacred. However you look at it. You can think of that literally, in spiritual terms, or if you can't stomach that, think of it scientifically. Birth is controlled by a delicate balance of hormones, get it right and she is riding waves of endorphins, get it wrong and her progress can slow, stop completely or even regress. Fear or doubt are inhibitors of birth, love and comfort promote it.

When you enter that space it is important that you do not bring all your "baggage" with you. Work stress, a fight with a partner, fear for the mother-to-be, none of these things belong here. Drop them at the door. Similarly your own pre-conceptions, judgement and even negative experiences of birth. Walk into that room with nothing but love and support, you are there for her, and nothing else.

When I enter a house as a doula (even as a postnatal doula), I imagine a large pot at the door, where I dump "myself", my troubles, preferences, the daily grind, and cross the threshold pure in purpose. Supporting a birthing mother when I myself was pregnant, I was repeatedly confused that the midwives kept making comments like "you'll be next". I had honestly forgotten about my own pregnancy, it was irrelevant here, and I certainly did not need to be bringing my expectations or issues about my own birth into someone else's space.

6) Make her the centre of your universe.

There are very few occasions where the focus of an event is just the needs of one person. Birth is one of them. The mother-to-be will always be the most important person in the room, her needs, indeed her whims should always come first. So give yourself up for a few hours and watch her turn into a goddess.

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