What you can do as the labor coach

You may be the father-to-be, a partner, parent, sibling, or friend. Whatever your other roles, your job as labor coach is to support the mother-to-be both physically and emotionally during labor and delivery. Here are some ways that you can help your partner through each phase of childbirth:

During early labor

Time her contractions

Measure the time from the beginning of one contraction to the next. Keep a record. When contractions are coming five minutes apart, it's usually time to call the health care provider.

Keep her calm

Once contractions begin, you both may feel some initial butterflies. After all, it's the big moment you've been anticipating for the past nine months. But during labor and delivery, your goal is to keep the expectant mother relaxed. That means staying as calm as possible yourself. Take some deep breaths together. Between contractions, practice those relaxation techniques you learned in childbirth class. For example, suggest that she let her muscles go limp or that she concentrate on relaxing her jaw and hands. Gently massage her back, feet or shoulders. Reassure her with your words and actions that you're both ready to have this baby.

Help distract her

Suggest activities — such as watching television or taking a walk — that will help keep both your minds off labor. Humor can be a great distraction, too. Enjoy some laughs, when appropriate.

Ask her what she needs

If you're unsure what to do for your partner, ask her what would make her more comfortable. If she isn't sure what she needs, do your best to suggest something that you think might make her feel better. But don't take it personally if she doesn't take you up on your suggestions or focuses inward during contractions.

Give encouragement

Offer her encouragement and praise through each contraction. Remind her that with each contraction, and with each passing hour of labor, she's getting closer to meeting the baby. What you don't want to do is criticize her or pretend that the pain doesn't exist. She needs your empathy and support, even if she's not complaining.

Take care of yourself, too

To keep up your strength, have some refreshments periodically. But respect that your partner may not want you to eat in front of her or to leave her for an extended period to eat. If you feel faint at any time during labor and delivery, sit down, and then tell someone on the health care team.

During active labor

Quiet the room

If it's possible, keep the labor room or birthing room as calm as possible by keeping the doors closed and the lights dimmed. Some women find it relaxing to listen to soft music during labor.

Help her through contractions

Learn to recognize the start of your partner's contractions. If she's on a fetal monitor, ask the health care team how to read it. Or place your hand on your partner's abdomen and feel for the telltale tightening of the uterus. You can then alert your partner when a contraction is beginning. You can also offer encouragement as each contraction peaks and wanes. If it helps her, breathe with her through difficult contractions. Try to make her more comfortable by massaging her abdomen or lower back or by using counterpressure or any other techniques you've learned.

Some women prefer not to be touched during labor, so take your cues from your partner. If she's uncomfortable, suggest a change of position or a walk — if possible — to help labor progress. Offer her water or ice chips, if she's permitted them. Mop her brow with a cool, damp cloth, if she likes that.

Be an advocate

As much as possible, serve as her go-between with the health care team. Don't be afraid to ask questions about how her labor is progressing or to ask for explanations about any procedures or the need for medications. If your partner requests pain medication, discuss pain relief options with her health care providers, openly or in private. Remember: Labor isn't a test of pain endurance. A woman doesn't fail at labor if she chooses pain relief medication.

Continue to give encouragement

By the time a woman is in active labor, she's likely feeling quite tired and uncomfortable, and perhaps edgy. As in early labor, be supportive and encouraging by saying things such as: "You did a good job to get through that contraction," or "You're doing great! I'm really proud of you."

Don't take things personalty

Things may be said in labor that aren't meant. Don't take it personally if your partner seems irritated with your thoughtful attempts to comfort her or if she doesn't respond to your questions. Your presence alone is comforting and sometimes is all that's needed.

During transition

Continue to help her through contractions

Transition, as the baby progresses down the birth canal, is usually the hardest time for the mother. Now is the time to give her even more encouragement and praise. Remind her to take it one contraction at a time. If it helps her, talk her through each contraction again or breathe with her. Some women find that they don't want to have someone coaching them as contractions intensify. Give space, if needed. In fact, holding her hand, making eye contact or simply saying, "I love you," may convey more than many words.

Put her needs first

Throughout labor and delivery, stay conscious of her needs. Offer her water or ice chips, if allowed. Massage her body. Suggest position changes periodically. Keep her informed of how labor is progressing and how well she's doing. It's more important for you to take care of her than to record everything on film or call friends and family.

During pushing and delivery

Help guide her pushing and breathing

Using cues from the health care team or from what you learned in childbirth classes, help guide her breathing while she pushes. Support her back or hold one of her legs while she's pushing. Whatever seems to help her — that's the thing to do!

Stay close by

A lot may happen quickly when it comes time for her to push. Or she may have to keep pushing on and off for several hours. Once she gets ready to push, don't feel that you're in the way as the health care team takes charge. Your presence is important, particularly as labor nears completion.

Point out her progress

As the baby's head crowns, if allowed, hold up a mirror so that she can see for herself how she's progressing. Or tell her how close the baby is to being born!

Cut the cord, if desired

If offered the opportunity to cut the cord, don't panic. You'll get clear directions from the health care team on just what to do. Don't feel pressured to do this, if you're uncomfortable with the idea.

After labor and delivery

Celebrate!

Once the baby has arrived, enjoy bonding with the new baby. But don't forget to give your partner some well-earned words of praise, and congratulate yourself, too, for a job well done!

Immediately after birth

At birth, your baby is still connected to the placenta by the umbilical cord. Often the parents can assist with the clamping and cutting of the cord. If you'd like to assist, make your wishes known, and you'll be shown what to do.

There's usually no particular urgency to cut the umbilical cord. Two clamps are placed on the cord, and then a scissors is used to snip painlessly between the clamps. If the umbilical cord has looped snugly around the baby's neck, the cord may be clamped and cut before the shoulders are delivered.

Immediately after birth, your baby may be placed in your arms or on your abdomen. Or occasionally, the baby may be passed to a nurse or pediatrician for evaluation and attention.

Shortly after birth, your baby is weighed and examined. He or she is dried off and wrapped in blankets to keep warm. The Apgar scores (see page 212) are recorded at one- and five-minute intervals. An identification band is placed on your baby so that there's no mix-up in the nursery. This is just the first of many safeguards to ensure no mistake in identification is made.

In most cases, you'll be able to hold and breast-feed your baby right after birth. But if your baby shows any signs that help is needed, such as trouble breathing, he or she may need to be evaluated more thoroughly in the nursery.

Stage 3: Delivery of the placenta

After your baby is born, a lot is happening. You and your partner are celebrating the excitement of the birth and, perhaps, sharing some private moments. You're likely both decompressing, relieved that labor and childbirth is finally over. Meanwhile, a health care provider in the background is examining your baby as he or she takes the first breaths and you hear those wonderful first cries.

The third — and final — stage of labor and childbirth is delivery of the placenta. The placenta is an organ inside the uterus attached to the baby by the umbilical cord. It's the organ that has nourished your baby throughout your pregnancy.

For most couples, the placenta — also called the afterbirth — is of little significance. For the medical personnel attending the birth, delivering the placenta and ensuring that the mother doesn't bleed excessively are important.

What's happening

After your baby is born, you continue to have contractions. These are mild, and they're necessary for several reasons — one of which is to help you deliver the placenta.

Usually about five to 10 minutes after the birth, the placenta separates from the wall of the uterus. Your final contractions push the placenta out from the uterus and down into the vagina. You may be asked to push one more time to deliver the placenta, which usually comes out with a small gush of blood. Sometimes, it may take up to 30 minutes for the placenta to detach from the wall of the uterus and be expelled.

Your health care provider may massage your lower abdomen after you have delivered your baby. This is to encourage your uterus to contract, to help expel the placenta.

After delivery of your placenta, you may be given a medication such as oxytocin by injection or by intravenous (IV) drip to encourage uterine contractions. Uterine contractions after birth are important. They help close off blood vessels and minimize bleeding. They also help your uterus shrink back to the size it was before it expanded to house your baby.

How you may be feeling

You shouldn't feel much pain while your uterus contracts to push out the placenta. The hardest part may be simply being patient as you wait for the delivery of the placenta. The deep massages of your abdomen by your health care provider may hurt.

What you can do

You can help expel the placenta by pushing when directed. As you push, your health care provider may pull gently on the leftover umbilical cord attached to the placenta.

You can also try to accelerate the process by breast-feeding your baby. Stimulation of the breasts signals your body to release the hormone oxy-tocin, which causes uterine contractions.

In most instances, delivery of the placenta is a routine part of childbirth. But complications can arise if your placenta doesn't spontaneously detach from the uterine wall (retained placenta). In the case of a retained placenta, the health care provider must reach inside the uterus and remove the placenta by hand.

Once the placenta is out, your health care provider examines it to make sure it's normal and intact. If it's not intact, he or she must remove any remaining fragments inside the uterus. Rarely, surgery is needed to remove placental fragments. Remnants that aren't removed could cause bleeding and infection.

After delivery, your health care provider disposes of the placenta. Most women never see the placenta. If you're interested, ask to see it. It's usually round and flat, red, about 6 to 8 inches in diameter and about 20 ounces in weight.

In multiple pregnancies, there may be more than one placenta to deliver. Or there may be one placenta with more than one cord coming from it.

Meeting your new baby

For most parents, all the preparation, pain and effort that went into bringing this newborn into the world are quickly forgotten as they hold their own child. This is one of the most significant moments in your life. You are a new parent. A new human being has taken his or her place among all of us in the human family. It is an absolute miracle. Savor this moment, cherish it and embrace the joy that nothing else in life can quite match.

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