Birth companionship is part science, part art and whole-hearted work for everyone involved. Holding the space, being present and avoiding the urge to apply a “quick fix” is hard, but very important work. As a partner, relative or friend it can be challenging to find the best ways to support a woman through her pregnancy, birth and early postpartum experiences. Here are some strategies and tools that you may find helpful.
Before the Birth
According to a trio of studies released by the UBC Faculty of Medicine and the Child and Family Research Institute, “fewer than 30 per cent of women approaching their first birth attend prenatal classes.”1 Prenatal classes help expecting parents understand the world of birth and the myriad components that may or may not be part of a birth experience. A personal introduction to the idea of birth is essential, giving expectant parents the opportunity to reflect deeply on their own hopes, fears, understandings, misunderstandings and biases before having any of them challenged by the experience of birth itself. The more opportunity we have to really think through an experience before it happens, the less likely we are to be negatively impacted by that experience when it arrives.
Not all prenatal classes are created equally. The birthing mother should choose the class(es) you take. Support her in choosing the class that she feels will most meet her needs. Take some time to make sure the class aligns with her values and vision of birth. It should offer hands-on opportunities to practice managing the intensity of labour. A good prenatal class will prepare you as a team for the remainder of pregnancy, birth and the early postpartum period. In the Calgary region, there are a range of prenatal classes to suit all philosophies.
Also, prepare for the postpartum period. Materials for maternal healing should be ready in advance: the freezer stocked with meals in lunch and dinner-sized portions, relatives ready to bring food should be on call with your likes and dislikes, resources to support breastfeeding should be handy, baskets with water bottles and snacks by the bed and couch, and glider already set in place.
2) Prepare, but scrap the Plan
It is important to understand that what a woman experiences in birth can have a deep and long-lasting impact on the rest of her life. When we are honoured with the opportunity to support a woman through her birthing experience, we need to understand that our first, second and third task is to listen. Listen to what she is saying about birth before her experience of birth happens. Listen to what she wants, listen to what she fears, listen to what people are telling her and give her the space to form her own opinions. Do not minimize, nor make light, of anything she shares with you. Ultimately, what we, as birth companions, want out of birth is for the mother to have an empowered birth experience. That matters more than winning an argument or cracking a joke.
One thing that goes a long way to having an empowered birth experience is the deep acceptance by all involved that, as with life, sometimes things in birth can (and often will) take an unexpected turn — not for the better, not for the worse, simply a different direction than the one we may have imagined beforehand. It’s difficult to reserve judgment, but that is one of the most important things we can do. This is why I advise birthing families to scrap the idea of planning for birth. That said, I am not suggesting we abdicate our responsibility in preparing for birth, far from it.
As birth companions, we can help a birthing woman discover her preferences by supporting her with quality information that is grounded in research. We can attend prenatal classes with her. We can take responsibility for initiating practice of what we learned in class at home. We can ask her about and record her preferences in a variety of birth circumstances.
During the Birth
3) Be In The Moment
This is critical. And, it’s difficult. It takes focus, energy, stamina and courage. Being in the moment with a labouring woman can look like a variety of things. Some birthing mothers like to be talked through each contraction, others prefer mindful silence. Some birthing mothers like to be touched, or to have counter-pressure applied to their backs and hips, others do not. Some birthing mothers need to be vocal in labour, others not-so-much. Some birthing mothers will be able to connect outward with others in the room. Others will not. One thing you can always do is match your breath to hers — be with her, breathe with her. And tell her, sincerely, about your love and admiration for her. She can do it! She is doing it!
Because you will have practiced all sorts of techniques and skills from your prenatal classes together, you will go into this knowing some of what she would like ahead of time. But birth may change that, so don’t get too attached to what you think is right. Follow her lead, go with what she is telling you in the moment (if she is able to) and carefully tune in to her body language. If it seems like she is not able to speak, you can ask her simple yes or no questions between contractions regarding whether your labour support is helpful. Don’t ask her what you should be doing. It’s not her job to support you through labour. Try something for three contractions and then ask her if that was helpful. Adjust accordingly.
For birth companions, being in the moment also means attending to your needs while respecting the birth space. Make sure your hunger and thirst and occasional need to take a breath are attended to so the birthing mother doesn’t start trying to do that for you. If you are going to leave the room, make sure she knows that you’re going, that she is okay with you doing so in that moment, and that you’re going to be back in x-minutes. Also, give yourself time to refresh yourself.
4) Know What to Expect
Birth is an incredibly powerful and moving experience. A birthing mother and her baby are undertaking a unique and labour-intensive journey together. There may be blood, vomit, fluid and fecal matter — for the most part, these things are a normal part of birth. Your birth attendant (midwife or doctor) will let you know if things are looking unusual, but sometimes they forget to reassure you when everything is looking just fine. Things may get tense. You may feel helpless. That’s okay. Breathe through it. Bring your curiosity to the sensation. Do not use your sense of helplessness as a reason to suggest the birthing mother do something counter to what she expressed a preference about when you were preparing for birth; however, encouraging her to remain open-minded as she considers the options of a given circumstance of birth as it arises is also important. Just make sure her decisions are hers, make sure she has the time and space she needs to make a decision.
Every contraction, every decision taken, every minute in birth is an accomplishment worth celebrating. With love, joy and compassion celebrate your shared experience, celebrate her Herculean effort. You can do this with a smile, a hug, a sincere, encouraging word or back rub anything that brings new energy into the space.
After The Birth
6) Allow Her Story To Unfold
Remember the first, second and third job of a birth companion? Listen, listen, listen. Your perceptions of how birth went and “what happened when” will be different than hers. That’s okay. You had two fundamentally different experiences of the same event. It’s natural that your stories take different directions. Don’t correct her version, and unless she asks, don’t offer information about what happened. Let the story unfold.
If she is unhappy with or traumatized by what happened in birth, please honour those feelings. Offer to assist her in finding the help and healing she needs. Please, don’t ever EVER say anything along the lines of, “Well, we have a healthy baby and that’s what matters.” That does matter, but so does her experience of birth. It matters deeply.
7) Know That It’s A Journey
Just as you tucked your expectations away for the birth, keep them away during the postpartum period. She is a newborn mother, and in need of nurturing. You may be a newborn parent yourself. Honour that newness in both of you. Take things one step at a time. Try to find the humour in what you are doing. Be prepared to abandon plans/ideas/visitors at a moment’s notice. Remember, in birth and life, you are a team. Support each other. B
Nan Nassef is a local birthing mentor, doula, a mother of two incredible children, a wife, a friend, a daughter, a dreamer.