Training Your Team

I received this question from lovely reader Hilary:

I'm pregnant with my third, planning my first natural birth. I'm reading everything I can get my hands on. My husband is super supportive and reads whatever I ask him to. I'm thinking of having my two sisters, who are my best friends, in the room with me as part of my labor support team.

The only problem is, it's not like my husband or either of my single sisters has experienced a natural labor either, so I don't know how to prepare them to help. Are there books/videos/websites you'd recommend to help them prepare for the experience, possibly with some suggestions of things they can do to help? Thanks!

Hilary, congratulations! First, so glad that you're reading voraciously, and that your husband is so willing to absorb the knowledge, too. That's the ticket, girl. My first question is where you're planning to give birth. For the purpose of this post, I'm going to assume you'll be in a hospital setting. Much of the information will still apply if you're in an independent birth center or home, but I just wanted to note it for certain.

Okay, onward: The two best books for your whole team to read, IMO, are "The Birth Partner" by Penny Simkin, and "Your Best Birth" (the link to which is on my sidebar there). The former is just essential, does a fantastic job of explaining the stages of labor, and is very manageable. The latter is written in a way that it's addressed to the mother, but it would be very helpful for them to read through, particularly if you're in a hospital setting. It explains typical interventions, procedures and protocols in a wonderfully accessible way. The related website My Best Birth is also very helpful.

Another classic book that's terrific for labor supporters of all kinds is "Natural Childbirth the Bradley Way" by Susan McCutcheon. Like "The Birth Partner", it also breaks down the stages and processes of birth and addresses supportive techniques (it's assumed it will be the husband, as the original term for the Bradley Method is "Husband-Coached Childbirth", but could really apply to anyone). It also discusses various common interventions, how to fend them off and otherwise cope with a hospital setting. Though it is coming from the perspective of a specific 'technique', the lessons are very useful for anyone in a supportive role. Admittedly, this came out a while ago, and" Your Best Birth" is the most up-to-date of the three (by far), but the core information in them all is still helpful.

Next, are you attending a childbirth class? I would recommend an independent class, as in, not the one that the hospital offers - or at least, not ONLY that one. (Here's 9 reasons why.) It could be Hypnobabies, or the aforementioned Bradley Method, or Birthing From Within, or a more comprehensive class that uses a little bit of everything. Look around and see what appeals to YOU the most, and what's available in your area. What might be key is seeing if you could bring your sisters with you to some or all the classes - check with the instructors to see what's kosher, of course, but having them fully committed, informed, and on the same page as you would be a great bonus if at all possible.

As for videos, I do think y'all should have a "Business of Being Born" movie night if you haven't already! My next recommendation for you all to watch together, preferably with these handy printed PDFs, is the videos for Lamaze's 6 Healthy Birth Practices. I cannot think of a more succinct, clear, straightforward and current set of videos for just such a situation. These 6 Practices can seriously make ALL the difference if they're fully put into practice. Here's a sample, the video for the third Healthy Practice:



But then, of course, you're going to want to watch some actual births. Looking on YouTube for "natural birth" and "home birth" actually yields a lot of great examples, if not full-length instructional films. I of course cannot sing the praises of this collection of older videos from France enough. Other birth professionals out there, especially childbirth educators, do you have favorite films for your clients? Do share!

Now. ALL that said, being me, I still have to plug the option of a doula, even with your wonderful support system, for many of the reasons that I laid out in this post. As loving and devoted as your team may be, you stated that this is the first natural experience for all three of them, and sometimes having an experienced pro who knows the ropes can make the difference when the going gets rough. I say that not to cast doubt on the intentions or the abilities of your team, because with all three there and working harmoniously, you're going to be well-cared for. I just have to include it as another option.

Oh, come on, now, Anne, wouldn't it be overkill with three people already helping? Okay, assuming those people are very well-prepared as per the above, yes, it's possible, but there are still legitimate reasons to consider it. I just gotta throw it out there.

I hope you'll report back here about your experience, both in preparation and in execution (egad, what an awful way to refer to the birth of a child, please forgive me), and I wish you and your team the very, very best!

Quote pop quiz

"You are assisting at someone else's birth. Do good without show of fuss. Facilitate what is happening rather than what you think ought to be happening. If you must take the lead, lead so that the mother is helped, yet still free and in charge. When the baby is born, the mother will rightly say: 'We did it ourselves......!' "

Who do you think said this?

(If you saw this on my Facebook profile, you're lovingly disqualified. And no Googling!)

Fathers and partners and doulas, oh my!

The blogger known as Baby Making Machine is prolifically sharing her pregnancy experience, and much to her credit, she is asking a lot of questions about everything, including birth. One of the topics that has come up for her is to doula or not to doula, and she blogged about one specific, lovable, handsome "doula dilemma": namely, her husband.

He had a few arguments I tried to take into consideration: 1. Doulas are for rich people. 2. I want to help, I want to be your doula (or my "dulla oblongata," as he jokes).

The first argument, while I can see his point isn't necessarily true. To him, if we can make it through labor like many of our family and friends have without one, why spend the money? "Having someone you pay there to help is something rich people do." Well... Many doula's I've found in my area don't have rates on their sites because they work with people to set the right price on an individual basis. Most I've found prices for seem to range from the $200-$1500s but I hear some are in the $2000s, depending on location, experience, services, etc. Most of my friends seem to either have a friend and get one for free, or paid about $300-$600. Everyone has said it's worth every penny.

Now, looking at those numbers my husband says no way. He's rather use that money on things for the baby, or classes, books and material we can take together to be prepared for labor. But I heard you can get doula's who are getting certified and need live births to help you for free! I wrote to my local DONA lady to get the list of women in my area who will be certifying over the next year so I can contact them about helping me out. I told my husband this and he was a little hurt that I was so insistent on this. Which brings me to the next point... Him wanting to help.

I've read great articles and posts here and there about doula's helping husbands know how to help their wives, but he really wants to be the primary support. He really hasn't had a strong opinion about too many things in this pregnancy process unless I pry, so having him out and tell me how he really feels about it made me think again. He told me he wants to take classes with me and learn how to help me through it, but he doesn't want someone with us 24/7 and "taking his place." I can even picture him shying away because there's an extra woman there, and not wanting to help as much... If I had other help.

This is something that comes up for other women, too, so I thought it was worth addressing at some length. I started out just responding to her blog, soon realizing it was definitely a reply-turned-post, and then I couldn't get my comment to appear on her page at all due to some bogus HTML issue, so I just threw it all up here, period. Hope this is helpful to FutureMama (as she goes on Twitter) and to any other mom out there with a reluctant partner.

Again, kudos for taking such a thoughtful approach. I can already sense that this might be a reply-turned-post . . .

I want to briefly echo what Mommy Bee said about epidurals: I completely respect your right to make an informed choice, but do be aware that just because you've decided you want one does not guarantee that you will get one, or that when you do get it it will work, so the need to be prepared and to have support is just as valid even if you feel an epidural will likely be part of your birth experience. There are all kinds of benefits to laboring for quite a good ling time without one, reasons having less to do with the effects of the drugs on the baby and more to do with the effective progress of dilation and with optimal positioning of the baby for birth. As you'll learn when you go through childbirth ed classes and/or read further on your own, the baby's position in your pelvis is key, and the more movement and versatility of position you can bring to your labor the better. Doulas are experts here.

And let's say you labored a good long time without an epidural, and then decide to go ahead and get one. It's not like it's just Game Over at that point: there are still so many decisions to be made, and you have a say in every. single. one of them. Are you going to receive Pitocin as well? If so, how much and how quickly? What about AROM? What about episiotomies? There are so many choices to be informed about. (Do read "Your Best Birth" if you haven't already! It breaks the whole cascade of interventions down masterfully and easily. Immensely readable.) Due to her experience and education, a doula can be vital in keeping abreast of your goals and preferences, and help you ask all the right questions. She helps you advocate for yourself.

As for whether a doula is desirable if you aren't necessarily going for a 100% natural birth, my honest opinion is absolutely. Even if you have a c-section, a doula can be a godsend in dealing with hospital personnel and procedures and protocols. Marfmom's experience is a good example of this. I actually have an upcoming post planned for my own blog on exactly this topic, as inspired by a Twitter conversation the other day: how doulas benefit cesarean birth experiences.

Anyway, I can understand why your husband feels so strongly that he wants to be the primary support - and he ultimately will be, either way! But others here have given good examples of situations where, for all their good intentions, their partners were unprepared for the reality of the hospital setting. No matter how much they read (and if he does do a lot of reading, that is AWESOME and all the better, I don't mean to discount that; some husbands can't even manage that) and how attentive they are in a childbirth ed class, many of them become deer in headlights when faced with the White Coat of Authority suggesting something you both know you don't really want. At those moments, mothers sometimes lose their former allies to fear, and suddenly the man who had been their rock and their solace is now saying "Well, honey, maybe we should just do _____ after all; he IS the doctor . . ."

I'm not saying this WILL be the case with your husband - he really does sound like a peach. But some of the other husbands caught off-guard were wonderful guys, too - it's just a completely foreign experience for them, navigating the thorny maze of hospital protocol.

And this is where doulas are trained and experienced and prepared. It's not just about knowing back massage techniques, offering sips of Recharge, repeating affirmations with you, helping you walk around, bounce on the birth ball or relax in the tub, though those are all useful too. It's about helping both of you make your way through this sterile, high-tech, foreign land.

That brings me to the other point I wanted to mention. You are becoming a mother that day, and that, along with bringing this new being into existence, is the main attraction, of course. But your husband will also undergo a transformation that day. He is becoming a father. As much as he intends to be there for you, he is, by definition, also having his own experience of birth. This is a good thing! And he can still support you, and can still make attending to your needs at the top of his priority list. But the fact remains that a doula is the only person who is 100% there only for you and your support. This takes some of the pressure off your husband. Space has now been created for him to both share this experience with you AND have his own experience of transformation. He will still be your rock and your solace - and he can now breathe a little easier, knowing that someone is there to help you both advocate for your needs.

I hope that came across with compassion - it was meant to. It's truly hard for men to admit that they need help sometimes, especially when it's help in an area that they feel they SHOULD be responsible for. Often they insist on being the sole supporter simply because they think they should be, when in reality they might not feel comfortable once they're actually in the situation. When this is questioned, they can feel their authority threatened, even when they know, rationally, that this isn't really the case. I say let's give the guys a break!

As for the notion that doulas are for rich people, I wholeheartedly disagree that good care and support should only be reserved for the wealthy. This is why doulas have been fighting to be covered by insurance, and are finally starting to succeed, and why many doulas will work on a sliding scale, and why there are organizations providing doula support to low-income mothers in some areas (this is not available everywhere YET, obviously, but you'd better believe we're working on it). And even when none of the above apply, doulas in the certification process will work for free or close to it.

One final question: Labor can last a long time. Ask him how long can he go without using the bathroom. If for NO OTHER REASON than filling in for him so you won't be left abandoned when he needs to pee, you deserve to have this.

:^)

To wrap up: I second (or third, or whatever) the notion of interviewing a few to see who you mesh with, and I agree that it's a good idea to let them know of your husband's ambivalence in advance. If they're experienced doulas, they've addressed this before, I assure you.

And one last idea on cost: if you don't find someone who is in the process of certifying (which I am SURE you can, if you decide to go that route), you could also consider putting it on your registry, so to speak. I can think of no better shower gift, myself (unless it's a postpartum doula). There just might be someone in your life who would be happy to provide such a boon to you. Why not put it out there?