• Get ready early: Once labor starts, check your lists and make sure everything is packed and ready to go.
• Make the calls & check her in: Call the doctor, handle the paperwork and any hassles at the hospital.
• Manage communications: With the nursing and medical staff, ask questions and get answers.
• Present your birth plan: To the labor nurse on each shift and remind them of its core elements.
• Support her: The nurses will go through shift changes; you are the core member of her support team.
• Manage friends & relatives: You may need to politely ask visitors to wait outside. The nurse will help.
• Be flexible: Deal constructively with new events and changes in course.
• Handle any tough decisions: Keep her informed, though she may not be fully lucid when in labor.
• Listen to her: If she’s shy about making requests, ask her what she wants every now and then.
• Encourage & reassure: Build her confidence. Tell her she’s doing great, how proud of her you are and how much you love her.
• Indulge her: In any way possible, pursue every request regardless of whether you think it’s necessary.
• Take her best shots: It’s the pain and frustration talking. You’re helping her blow off steam (and pain).
• Watch her face: When you present your baby to her to hold for the first time.
Be Her Advocate
Only you will know what she really wants, and you need to express her needs to the staff. Intervene and, if necessary, be assertive, such as askingfor the anesthesiologist or doctor to be paged. Do not lose control and become obnoxious; this will scare her and you will become the problem. Keep her informed and let her wishes guide your actions.
She Needs You
Your presence alone is a major comfort to her as she experiences the surreal, often excruciating experience of birth for the first time. She needs your familiar voice and touch and knowing you care for her more than anything else.
Call her physician, report her status, and follow instructions.
report her status
report her status
report her status
report her status
Err on the side of caution and call early, but try to avoid going early to the hospital because being sent home is very frustrating
Call her physician immediately
• What are the benefits?
• What are the risks?
• What are the alternatives?
• Does your intuition say ‘go for it?’
• Does it need to be done now, or can it wait?
• Trust your doctors; they are highly trained and in emergency situations, time is of the essence.
• Stay calm, ask questions of medical staff, and let them do their jobs.
• Keep mom informed and reassured.
While your own feelings can be overwhelming, your response to the needs of your family at this critical time will be crucial. Hang in there: This is when a new baby really needs his father.
Keep in mind:
•• You may be separated from your mate while she is prepped and she may get scared.
•• A drape is hung across her chest so she (and you) will not be able to see
the actual surgery.
•• In a caesarean, the baby is born in the first 5-10 minutes and another 30-45 minutes is spent repairing mom. With her arms under the surgical drape, she cannot hold her baby.
•• After birth, your baby’s lungs will be suctioned to remove fluid that would be squeezed out during birth.
•• Hold your baby close to her face so she can look him in the eyes, touch
him and say hello.
•• When he is taken from the OR to be checked and cleaned, go with your baby. Tell mom you are going with him and you both will see her soon.
•• When you and your baby get in your room, take your shirt off and
hold him skin-to-skin, look him in the eyes and welcome him.
The hospital stay after a caesarian birth is longer, providing many opportunities to learn how to care for your baby from the nurses and great bonding time alone with your new family. Of course, her recovery will require weeks, and you will need to fill the gap.
"While they were stitching my wife up, I went to the warming table with the nurse and my baby. I was the first voice that she really heard, and when I opened up, she zoned right in on me. That was probably the most heart-melting moment I’ve ever had.” - Veteran Dad
• False labor is frustrating but will pass.
• Labor is real when her contractions steadily intensify and don’t stop if she gets up or changes position.
• She may also develop low back pain; once the real thing kicks in there is no mistaking it.
• Her cervix is gradually effacing (thinning out) and dilating (opening up) to “unplug” her uterus, enabling the baby to pass into the birth canal.
• Her water may break and she may pass the mucus plug.
Labor averages 15 hours for first-time moms, with about half that time spent at home, which is more comfortable than a hospital room.
• Encourage her to relax, sleep, talk, walk, take a bath (get a quick shower yourself), watch a movie, or snuggle (these last hours together before you become parents can be very special).
• Try to get her mind off her labor and save her energy for later, as it gets more intense.
• Encourage her to eat, drink fluids and go to the bathroom.
Check your list and load the car. This is no NASCAR event; drive as smoothly as possible since sudden moves and even small bumps on the road are a shock and painful to a woman in labor. An easy drive also helps mom stay calm and focused.
Her method for dealing with pain is her call. If she wants an epidural, urge that it be provided as early as possible and don’t expect it to eliminate all her pain. Ask the nurses at what point is it too late for her to obtain one, so she doesn’t miss the window. Use basic pain control techniques to help her. If she wants to go without pain meds, support her in every way possible. If she has trouble tolerating the pain early in labor, encourage her to consider medication since it may get much worse. If it’s late in labor, remind her how far along she is and encourage her to stick it out, so she knows she gave it her best shot. Follow her wishes, and if she requests an epidural, ask that it be administered immediately.
Count her through contractions; let her know when the monitor indicates they peak. Ask the nurse what to look for so you can alert her if necessary (not a good time to get fascinated with machines, though). Same with your role as cameraman; take a few pictures but
keep the focus on mom.
• Get hands-on; hold her gently, caress her head, massage her, get whisper-close to her face.
• Talk her through each contraction; pace her breathing, tell her when it peaks and is done.
• Start breathing with her and if she falters, encourage her: “Breathe with me…there you go. Stay with it now…hang in there. It’s starting to peak…it’s on the way down. That’s it, baby.”
• You may need to get face-to-face to get her focus back. Calmly but firmly, tell her: “Look at me, stay with me. I love you and am going to help you get through this…breathe with me.”
• Once a contraction ends, help her relax. Ask if she wants anything else, and depending on how it’s going, suggest a different position, breathing pattern, or whatever you think might work.
If she becomes distraught, desperate, super stressed, or experiences serious pain, it’s time to take your coaching to the next level and help her regroup. This will be intense, so get in close, stay with her, and do whatever you can that may work. Never give up on her; If you do, you can no longer help her. Project confidence and firmness in your manner, touch and tone of voice. Remember, she will be feeling birth pain for the first time and may react in unexpected ways.
She may find an intense, inward focus is her best way to get through strong contractions, and telling her how to breathe may break her concentration. If you sense this is the case, just back off.
If she gives up, tell her you love her, how tough this must be for her, and: “We will get through this!” Ask for help from the nurse who can encourage her, determine her progress, suggest something, or help coach. Tell mom: “Your baby is on the way.” Always remember she WILL get through it.
Common Labor Terms
Dilation: Width in centimeters of opening in the cervix, with 10 cms (4 inches) required for birth.
Effacement: Flatness of the cervix represented by a percent.
Position: Direction the baby is facing.
Presentation: Part of the baby coming first (ideally, head down).
Station: How far down the first part of the baby is in the birth canal, on a scale of -5 (high up) to +5 (ready to birth).
Crowning: When Baby’s head begins to appear before birth.
Apgar Score: A nurse evaluates your baby both 1 and 5 minutes after birth on five characteristics (like breathing and skin color) and gives each a score between 0 and 2. A total score of 7+ indicates your baby is doing well; less than 7 says some added care is needed.
Research has indicated that soft music can reduce mom’s perception of pain in the first hours of active labor, so set her up to listen with an iPod or CD player.
Massage will help her relax between contractions as well as speed labor along. Ask her where to rub or ask the nurse for ideas. Keep at it but pace yourself.
Use the techniques you learned in childbirth class and try anything else you (or she) thinks might work:
- Set up the room with pictures, scented oil, etc.
- Help her establish a focal point.
- Take her mind off labor by reading to her, or engaging her mind in other ways.
- Try slow dancing with her arms around your neck.
- Ask for an exercise ball.
- Let her squeeze your hand during contractions.
- Suggest she change her breathing pattern.
- Encourage her to grunt like a tennis player.
- Suggest she lies in different positions.
- When she’s pushing, work with the nurse to hold her legs in a position that helps her bear down.
Dealing With Back Labor
The hard back of the baby’s head may be pushing on mom’s spine. Ideas to reduce her pain:
- Try a position that moves the baby’s head away from her spine, like mom on her hands and knees.
- Changing positions, pelvic rocking or squatting may help rotate the baby and relieve the pain.
- Strong massage or pushing to create counter pressure where it hurts.
- Try tennis balls in a sock.
- Hot packs, ice, or a warm bath or shower with the water targeting the pain may help.
- Ask the nurse or doctor for ideas.
Once in the hospital, on average, her contractions are 5 minutes apart, her cervix is dilated to 6 centimeters and this stage lasts 6 hours (with lots of variation). Labor is really kicking in and her cervix will dilate to 8 centimeters. Pitocin can speed labor up and an epidural can slow it down.
Contractions will get progressively tougher as they stretch her pelvis. She will soon be unable to talk through them. If pain medications are pre-arranged, now is the time. If they aren’t and she’s having a hard time coping with contractions early in active labor, they should be considered now versus the last part of her labor.
This is when a labor coach really gets to work.
• Encourage her to walk around, but hold her during contractions.
• Suggest a rocking chair, exercise ball, or shower to speed up labor.
• If pain meds are requested, insist they be delivered promptly.
• Use relaxation techniques and lots of gentle encouragement.
• Remind her to breathe through the pain and breathe with her.
• Keep instructions simple and repeat them.
• Review pain control techniques.
Labor shifts into high gear as she dilates from 8 to 10 centimeters and gets ready to give birth. This is the most intense part of labor, averaging 30 minutes, when her contractions are 2 to 3 minutes apart and last 1 to 2 minutes. If she’s not in a birthing room, she will be moved to one.
This part can be scary. You may find her shaking, shivering, making deep grunting sounds, using you as a verbal punching bag, even vomiting, and there’s often a bloody discharge: All normal. Contractions will slow down then build up as the baby descends into her pelvis and her body gathers strength for the final push.
• No matter how scary, remain calm and keep reassuring her everything is OK.
• She may feel a strong urge to push but shouldn’t – help her resist by firmly reminding her to use the panting breathing technique.
• If attempting a natural birth, she’s close to being finished, and you should intensely coach her through each contraction.
• Tell her she’s doing a great job and the end is near.
• If she had an epidural and wants to be more active in the final pushing stage, ask to have her epidural dose lowered at the end of Transition.
She is in the red zone! Your baby is gradually propelled through the birth canal by intense contractions of mom’s uterus and abdomen as she pushes. Averages 1 hour but varies. If she’s had an epidural, it can take a little longer, and her loss of feeling will require more intense coaching.
Things will speed up, and it is time for her to act on an instinctual urge to push. The doctor will direct the action, with the nurse giving your mate instructions on pushing. Follow their lead and reinforce what they tell her to do. This may include a pause in pushing right before the baby is born so the doctor can take steps to prevent tears.
• Get in physically close and help her any way you can.
• Help her maintain the position which provides her the best leverage.
• Anticipate a poopy mess that you should ignore.
• Have her keep her chin down for maximum force, and not arch her back.
• Help her adjust to a new position for more leverage if she needs it.
• If the doctor says stop pushing, have her pant through contractions.
• As the baby’s head appears, suggest she reach down and feel it.
• If she wants to watch, ask for a mirror. Take a look yourself if you want.
One last push and your baby is born! (Cut the cord if you want; ask if it’s not offered.) Mom is almost finished but it will take another 10 to 20 minutes for her to deliver the placenta and get sewn up, if necessary. Remember new babies can look blue, puffy, and scrawny with lopsided or cone heads at first.
Ask that your baby be put on mom’s chest, skin-to-skin, and encourage her to look him in the eyes, hold and touch him. As she takes him into her arms, it’s an amazing, magical moment for your new family. Take your time and enjoy. At some point, pick up your baby, look him in the eyes, and say hello!
• This is when she will truly become a mother, so “congratulations, mom!” is in order. Congratulations to you too, dad!
• Make sure she has a chance to breastfeed soon after the baby is born, if she wants; help by holding your baby’s lips close to her breast.
• Unless your baby needs special care, ask for an hour of family time together.
• Get some pictures; ask the nurse to take a few family shots.
• If mom gets the chills, find her a blanket.
• If afterbirth pains bother her, ask for pain medication.
This is your child. Don’t let the nurses, doctor, your mother-in-law, or anyone else push you away from participating. Don’t lose control of your emotions, and don’t take yourself out of the game.
Watching your baby come out, cutting the cord, etc., is your choice. You can position yourself mom’s head and talk her through the birth, and if you feel light-headed, sit down with your head down on your lap.
The medical staff may want to whisk him away to a warming table to do some quick evaluations: Ask to carry your baby. Some babies require additional care, especially if delivered prematurely.
If it’s turning out to be a long labor, make sure you eat (not in front of mom) and get some rest. If you feel you’re losing control, leave the room, take some deep breaths, and think about what’s most important.
Look at it this way: In her desperate search for relief, you may become her “focal point.” She will remember nothing and neither should you.
If you have to back off for any reason, regroup privately, go back in the room, and resume your role. If you faint, come around, regroup, and get back to work.
Hold him close, look him in the eyes as he stares back, checking out his dad. Talk to him, and take your time to let this wondrous moment soak in.
"I felt like I bonded with my son as soon as I held him. He would kind of look up at me and I felt a lot of love for him right away and was really glad that I had time with him for just ourselves.” - Veteran Dad
Welcome Her To The World
One of the best things we fathers can do with our children as they grow is talk to them. That first conversation will always be special.
• “Hello, Olivia. I’m your daddy! You’re my daughter. I love you.”
• “I’m here. You’re going to be okay. You’re safe. Everything’s going to be all right.”
• “I am always going to take care of you.”
She is definitely wondering what is happening, so tell her.
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