Ask Busca: Dads and Doulas?

July 19, 2010 at 7:21 pm

Fig asked:

My husband only wants the two of us to be present for our first baby’s birth. (No friends or relatives or anything, just him, me, and the people who are delivering the baby.) So … do you think I can convince him a doula would be one of the baby-delivery personnel? I have no idea what the dynamic is like in a delivery room. No idea what to expect. But here’s what I know about my husband: he is extremely private. He doesn’t like big fusses, or loud craziness, and he’s very uncomfortable with profound emotions/pain. He also doesn’t like to be bossed. I guess I just can’t figure out how the husband and doula work together without the husband feeling a little bit weird. Am I worrying about nothing?

Why hire a doula?

July 19, 2010 at 6:41 pm

[Re-post from the old blog.  Originally published in April of 2007.]

When I gave birth for the first time, I didn’t know what a doula was, but I recently realized that the care and support of a “doula” is what actually carried me through that birth.

Her name was Eve. She was the labor and delivery nurse assigned to me when I entered the hospital for my oldest daughter’s birth. She was gentle, unassuming, and kind. When I told her that I was hoping to “go natural,” she mentioned that she could offer positions to try and techniques to cope with the pain of labor. She said she had given birth without drugs before, and knowing she was supportive and experienced gave me courage.

As labor progressed, Eve showed my husband how to provide counter-pressure to ease the discomfort of contractions. She pulled out the rarely-used, water-proof telemetry monitor so my husband could spray my back with hot water in the shower. When I got out of the shower, she brought in a birth ball and helped me to sit and rock on it. Later, she coached me to keep my vocalizing low, deep, and relaxed instead of high-pitched and tense. When I doubted myself and contemplated drugs as I struggled through the hardest contractions, she said, “Why don’t I check you first—you might be almost fully dilated.” Sure enough, I was only a couple of centimeters from the end. She told me that, in her experience, it felt good once you could push (and she was right). She rubbed my feet and sat by my side through those last intense contractions, encouraging me with her reassuring words. Although her shift ended before the pushing started, she chose to stay with me until after the birth. Ultimately, I did it! Giving birth for the first time without complications or drugs was one of the most empowering experiences of my life.

Avoiding tearing and episiotomies

July 19, 2010 at 3:39 pm

Giving birth for the first time was one of the most empowering experiences of my life. My water broke, my contractions started, everything progressed smoothly, and, less than six hours later, my baby girl was born. It was an ideal birth experience, except for one thing. That one thing made my next few weeks of recovery extremely painful. I tore. I really tore.

Despite the painful recovery, this was actually the lesser of two evils for me. Though some caregivers continue to cut episiotomies in as many as 80% of their patients, medical research does not support routine episiotomies. Studies from as far back as the 80s made it clear that routine episiotomies have no benefits and carry real risks. One of the most detrimental risks is that episiotomies can lead to further tearing, sometimes extending into the anus. These fourth degree anal tears almost never occur without an episiotomy. In addition, a spontaneous tear may only reach into the surface layers of skin, while an episiotomy cuts into far more layers. Episiotomies are rarely warranted and should be reserved for those unusual emergency cases. Ultimately, even without all the evidence, I just didn’t want someone cutting me. I knew, going into my first birth experience, that if I had to choose between them, I would choose to tear. And, tear I did.

Labor tips for dads

July 18, 2010 at 10:05 pm

I also like to call this one:  “Parturient Relations:  PR for dads.”  Remember these “Five PR’s”–the most helpful things you can provide for your partner while she labors…

1. Presence

  • Sometimes all she needs is your loving physical presence.
    • Be “Rock Steady”—the familiar, strong, soothing rock she can hold on to.
  • Be “present” in every way—don’t let your fatigue or fear take your attention away from her emotional and physical needs.
  • Do NOT fall asleep (unless she’s asleep).
  • Do NOT leave her alone unless she demands it.
    • Some women prefer to be alone while they labor. (But don’t go too far!)

2. Protection

  • Be a buffer between your wife and the rest of the world.
  • You can’t protect her from the intensity of childbirth or from unexpected complications, but you can protect her personal space and surround her with peace and calm.
    • Close doors.
    • Turn off/down the lights.
    • Take over answering questions so she can keep her energy focused on her hard work.  If someone tries to talk to her mid-contraction, gently ask for them to wait or stand between them and your wife until her contraction is over signaling with your hands for them to wait a moment.
    • No matter what happens or how much stress may arise, ensure that she always feels safe and secure.  “Peace, be still.”

3. Pressure

  • One of the most helpful hands-on ways to help with the most difficult contractions is counter-pressure.
    • Use your hands to provide firm, strong, steady pressure.
      • Lower back/pelvis
      • Double hip squeeze
      • Knees while sitting with something against her back
      • Hip while side-lying
    • Do not let up until the contraction ends!  (You will probably get tired.)

4. Prompts

  • Your wife will likely not be in a position to remember all of the ways to increase her comfort, so your job is to prompt her.
  • Remember PURRR
    • P Position: Is she changing position every half hour?
    • U Urination: Is she using the bathroom every hour?  (And drinking lots of fluids?)
    • R Relaxation: Is she as relaxed as possible?
    • R Respiration: Is she breathing evenly and as calmly as possible?
    • R Rest: Is she resting between contractions?

5. Praise

    • All of your words must instill her with hope, confidence, peace, comfort, pride, and power.
    • Think of it as your job to help her get to the “finish line” without giving up.
      • “You are so amazing right now!”
      • “I am so proud of you!”
      • “You are doing so well!”
      • Kissing counts! (Some women find kissing very helpful.)
      • When she says, “I can’t do it!” reply with, “You are doing it.”
      • When she’s reached the point when she thinks she can’t do it anymore, that usually means she’s almost finished, so shower her with praise, encouragement, and lots of statements like: “You are so close!”  “You’re almost there!”  “The baby is almost here!”

See also:  Emotional Signposts of Labor

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