This blog post was originally posted 2/23/2018
It is such an honor to be invited to the birth of a baby. Whether you are the soon to be grandparents, aunt or best friend, to be there for such a special time in the expectant family's life is truly special. With that great honor also comes the responsibility to help keep the birth environment safe, secure and one that will allow the pregnant person to labor the way needed and desired. The people around the laboring person can have a huge influence on the labor, the birth and the entire experience. There are so many things you can do to help the family during this time and there are somethings that, even though well intentioned, might discolor the experience for the new parents.
Let's break down what it means to be a good support person. First, understanding that your title is support person, whether the laboring person has a doula or partner or both you were invited for some sort of support. If you can understand that you are half way there. You aren't there to simply watch, birth is not a spectator sport, you are an active participant. Please talk to the pregnant family before the birth and ask what role do they see you playing and how can you be the best comfort and support. Ask if they are taking a childbirth education class and maybe you can join them. While you are chatting also talk about the birth plan, what are their hopes and dreams for the birth and respect their choices. You may also find that you might need to help them advocate for themselves or remind them of their choices. If you feel you can not respect their choices or at least can't stay silent with your opinion maybe you could wait in the waiting room until after the baby is born.
So you are at the birth place, you are wearing your support person badge of honor and the laboring person is experiencing a significant amount of discomfort, what do you do? You support and encourage, not pity. Sitting there, staring at the laboring person with a sad face and telling them to just get the epidural when you know that not what the family's wishes are is not good support. You are basically telling them to give up their dreams. Yeah, birth can be hard, it can be uncomfortable but the family already knew that. When things get tough that's when your job as support person kicks into effect. You have the power to change things with a few words. There are tons of great things a support person can say but the easiest is, YOU CAN DO THIS! Telling them that you are proud of them, that they are strong, that you love them. These encouraging words are better than gold and can really change things from feeling like throwing in the towel to feeling rejuvenated and confident.
The labor is now progressing but you are starting to get a bit tired, nervous, anxious and that can effect the expectant family. The laboring person can pick up all sorts of energy while in this raw, laboring state. Just as your positivity and support can be contagious and bring the family up, bad vibes can bring a person down. You should prepare yourself that labor can be long. If you are feeling worn out just step out of the room and give yourself a breather, grab a coffee and something to eat and go back feeling renewed. Sometimes taking a walk outside, or a few minutes of meditation and you can support the laboring person better. Make sure you have things you need to be comfortable, a sweater, a toothbrush and snacks. If you feel that you are too anxious to be proper support either during before the labor begins because of your own personal experience be honest with the expectant family. They will appreciate you not wanting to alter their birth environment and you might be a better support to them that way.
As a doula we try to anticipate a laboring person needs, all support people can help by looking for the needs of the family. If the birthing partner looks tired see if they would like to step out and get a bite to eat. Sometimes the partner feels obligated to stay but they need support too. Giving them permission to go and have a breather will allow them to come back a little fresher and able to support their partner better. A support person can model breathing to the laboring person, suggest position change or make sure she has a drink or lip balm if their lips are dry. If they need a hair band or lotion get that for them with out asking. Trying to read them and get them what they need so they don't have to think, keep them in Laborland and focused on what they need to do. If they are having a contraction try not to bother the laboring person with questions or touch. If you are told to stop talking, touching, or anything else just stop and don't take it personal. There are so many things going on in a pregnant person and it is hard to sort that all out in labor. You many be doing some back rubbing that is awesome one minute and then its annoying, its ok, just stop and don't resume unless asked.
This is also a great time to tell you that this experience is the expectant family's experience that you were invited to be part of. The news of the labor and birth and all details that go along with that are the family's to share with the world. This is the most fun news to spread and it should be the person who had to work the hardest that gets to announce it. The worst thing is telling someone about your new baby and they say, "I know, your mom told me!" Supporting a laboring person is a huge honor and responsibility, its a full time job there will probably be very little time to spend on your phone or laptop anyway. If you want to share the special news with anyone make sure your have the permission of the new parents and NEVER announce it on social media before the parents.
After the baby is born the family still needs you. They might even need you more now as they navigate parenthood. There are so many ways you can offer support after birth, from picking up some groceries to dropping off a meal to just hanging out with baby while the exhausted parents nap or shower. A support person is so special to the family, you will always be part of their birth story. You can say you have know their baby since they were 1 second old! What a terrifically special person you are!
This blog was originally posted on April 9, 2019.
Cesarean Awareness Month was started by ICAN (International Cesarean Awareness Network) to shine a spotlight on the number of cesarean births in the United States. ICAN also wanted to bring attention to the lack of access women have to VBAC supportive medical care. In 2016 the cesarean rate in the U.S. was 31.9%, going down from 32% in 2015 but still not where we need to be. The WHO (World Health Organization) recommends a target of 10-15%. Research shows that most pregnant people want to deliver vaginally and half of the Cesareans performed are not medically necessary. So, what's up?
Being overweight, diabetic, or advanced maternal age can make it more likely for someone to have a Cesarean. However, many studies are pointing to the choice of birth place, specifically which hospital you choose that is responsible for your chances of an unnecessary Cesarean. Cesarean rates vary in each state and from one side of a state to another. You can check the cesarean rates at the hospitals near you or ask during your hospital tour. Your choice of medical provider can affect your chances too. Ask your medical provider what their cesarean rates are and if you don't like the answer or they don't want to tell you, switch providers. Low risk pregnancies are also good candidates for birthing at birth centers or at home. For some people it may not be possible to change birth location or medical providers but there are many other things you can do to reduce your chances of an unnecessary cesarean.
Staying home during early labor is one great way to avoid unnecessary interventions at the hospital that could lead to an unnecessary cesarean. Taking a childbirth class, reading books or hiring a doula can help you to know what to expect in early labor so you don't go to the hospital too soon. Depending on your distance to the hospital you can most likely stay home until your contractions are 3-4 minutes apart, one minute in duration, with that pattern lasting for one hour. This is sometimes referred to as 4-1-1 or 3-1-1. Talk to your care provider about what point you should head to the hospital. The longer you are at home, comfortable in your surroundings the more relaxed you may be which is great for labor progress.
If your due date has come and your are not in labor, that's OK too. Don't rush to induce just because you are past your due date. First timers, if left alone to go into labor naturally, are likely to be pregnant for about 40 weeks and 5 days. If it isn't your first rodeo, the average is around 40 weeks and 3 days until baby time. Due dates are an estimation date, not an expiration date. Some people go before their due date and some after, only 10% go past 42 weeks. Your body knows what it’s doing. Once things kick into gear you can expect that labor can be long, especially for first timers. You can educate yourself so you know how labor progresses so you can expect that it may take a while. If you are doing well, and baby is doing well and progress is being made, that's great! A low risk person with a progressing labor, even if its "slow" is no reason for medical interventions.
"You are so big!" is not a complement to those in their final weeks of pregnancy. It is also not a reason for a Cesarean. It is important for all people to eat healthy but for those pregnant proper diet and average weight gain is important to avoid complications. Pregnant people in the U.S. do gain more weight than is recommended by the Institute of Medicine (IOM). You are building a human and your body is working really hard and if you can keep it down, yes eat! The concern is excessive weight gain that can lead to complications and the increased risk of Cesarean. A big belly on you is not the only risk, a suspected big baby is also no reason for an induction and rarely for cesarean delivery. Just because your belly is as big as a beach ball doesn't mean your baby is huge. The methods used, including ultrasound, at the end of pregnancy are not accurate ways to determine baby's size. In my personal experience I have seen these guesses be incorrect. There have been cases where the guess was 2 lbs more than baby's birth weight!
Even if you have taken a childbirth class having a knowledgeable support person there with you during labor can make a real difference. A doula is a trained birth assistant who can provide physical and emotional support throughout labor and delivery. Research shows, people who have continuous support from someone who is not a friend, a family member, or hospital staff have shorter labors and are less likely to need interventions. As a doula and a momma I know the importance of support during that time.
Cesareans are major abdominal surgery and are definitely not the easy way out. The recovery time is 2-4 weeks longer than a vaginal birth and there are so many potential complications to a Cesarean delivery, damage to internal organs, blood clots, internal bleeding and infection to name a few. There is also a lower breastfeeding success rate for families of Cesarean birth. Some reasons for a Cesarean include, placenta previa, baby's position, multiple birth, Diabetes and uncontrolled high blood pressure. When a Cesarean is medically necessary it can save lives but many are not necessary. Educating yourself, knowing your options, making a good choice of provider and hospital are all ways you can avoid an unnecessary Cesarean.
If you do have a Cesarean its OK to feel however you feel about it. This blog and the idea of Cesarean Awareness Month are not to make anyone feel any one way about Cesareans. I have worked with families who needed a Cesarean, were happy with the outcome, support and hospital experience. Some families do choose to have subsequent Cesareans rather than VBAC. Your birth experience is just that, yours. It is the hope of this blog that some information can possibly help decrease some of the unnecessary Cesareans happening in the U.S.